Atrofik Alveoler Kretlerin Cerrahi Augmentasyonu: Güncel Yaklaşımlar ve Klinik Sonuçlar
Özet
Alveoler kret rezorpsiyonu, dental implant tedavisinde en sık karşılaşılan zorluklardan biridir ve başarılı bir protetik rehabilitasyon için kemik augmentasyonu sıklıkla gereklidir. Bu amaçla geliştirilen cerrahi yaklaşımlar arasında kret split tekniği, yönlendirilmiş kemik rejenerasyonu (GBR), otojen blok greftleme, distraksiyon osteogenezi ve çadır tekniği yer almaktadır. Kret split tekniği horizontal defektlerde minimal invaziv bir seçenek sunarken, GBR küçük ve orta ölçekli defektlerde öngörülebilir sonuçlar sağlar. Blok greftleme, özellikle ileri defektlerde üç boyutlu augmentasyon için halen “altın standart” olarak kabul edilmektedir. Distraksiyon osteogenezi, dikey kemik kazanımı açısından etkili olup yumuşak dokuların eşzamanlı adaptasyonuna olanak tanır, ancak uzun tedavi süresi ve cerrahi deneyim gerekliliği sınırlayıcı faktörlerdir. Çadır tekniği ise basit uygulanabilirliği, düşük komplikasyon oranı ve implant başarısını artırıcı etkisiyle son yıllarda öne çıkmaktadır. Sonuç olarak, her yöntemin kendine özgü avantaj ve sınırlılıkları bulunmakta olup, tedavi seçimi defektin boyutu, lokalizasyonu, kemik kalitesi, hastanın sistemik durumu ve cerrahın deneyimi doğrultusunda yapılmalıdır. Uygun endikasyonlarda seçilen doğru teknik, yüksek implant başarısı ve uzun dönem stabilite açısından kritik rol oynamaktadır.
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