Protetik Diş Tedavisinde Mikro-Bilgisayarlı Tomografi (Mikro-BT): Temel Prensipler ve Uygulamalar
Özet
Görüntüleme teknolojilerindeki gelişmeler, diş hekimliği araştırmalarında tanısal doğruluğun ve analiz yöntemlerinin önemli ölçüde ilerlemesine katkı sağlamıştır. Geleneksel iki boyutlu radyografik yöntemlerin sınırlılıkları, dental dokuların ve restoratif materyallerin daha ayrıntılı incelenmesine olanak sağlayan üç boyutlu görüntüleme tekniklerine olan ilgiyi artırmıştır. Mikro-bilgisayarlı tomografi (mikro-BT), mikrometre düzeyinde yüksek çözünürlüklü ve non-destrüktif görüntüleme sağlayan ileri bir X-ışını temelli analiz yöntemidir. Bu teknoloji, farklı açılardan elde edilen projeksiyon görüntülerinin rekonstrüksiyon algoritmaları aracılığıyla kesitsel görüntülere ve üç boyutlu hacimsel veri setlerine dönüştürülmesi prensibine dayanır. Diş hekimliğinde mikro-BT; endodonti, restoratif diş tedavisi, implantoloji ve kemik biyolojisi gibi farklı alanlarda mineralize dokuların morfolojik değerlendirilmesi ve biyomateryallerin yapısal analizinde yaygın olarak kullanılmaktadır. Protetik diş tedavisinde ise özellikle CAD/CAM sistemleri ve eklemeli üretim teknolojileri ile üretilen restorasyonların değerlendirilmesinde önemli bir araştırma aracı haline gelmiştir. Mikro-BT sayesinde restorasyonların kenar uyumu, internal uyumu, siman boşluğu dağılımı, materyal homojenliği ve üretim doğruluğu gibi kritik parametreler üç boyutlu olarak analiz edilebilmektedir. Bu özellikleriyle mikro-BT, protetik restorasyonların yapısal ve biyomekanik performansının araştırma temelli değerlendirilmesinde güvenilir ve kapsamlı bir analiz yöntemi olarak kabul edilmektedir.
Advances in imaging technologies have significantly contributed to improvements in diagnostic accuracy and analytical methodologies in dental research. The limitations of conventional two-dimensional radiographic techniques have increased interest in three-dimensional imaging modalities that enable a more detailed evaluation of dental tissues and restorative materials. Micro-computed tomography (micro-CT) is an advanced X-ray–based imaging technique that provides high-resolution, micrometer-scale, and non-destructive visualization. This technology is based on the acquisition of projection images from multiple angles and their reconstruction into cross-sectional images and three-dimensional volumetric datasets using reconstruction algorithms. In dentistry, micro-CT has been widely applied in various disciplines, including endodontics, restorative dentistry, implantology, and bone biology, for the morphological evaluation of mineralized tissues and the structural analysis of biomaterials. In prosthetic dentistry, it has become an important research tool particularly for evaluating restorations fabricated using CAD/CAM systems and additive manufacturing technologies. Micro-CT enables three-dimensional analysis of critical parameters such as marginal fit, internal fit, cement space distribution, material homogeneity, and manufacturing accuracy. Owing to its high resolution and non-destructive analytical capability, micro-CT is considered a reliable and comprehensive method for the research-based evaluation of the structural and biomechanical performance of prosthetic restorations.
Referanslar
Oliveira ML. Digital dental radiology and diagnostics – from 2D to 3D. Australian Dental Journal. 2025;70(Suppl 1): S50-S66. doi:10.1111/adj.70024.
Kaasalainen T, Ekholm M, Siiskonen T, Kortesniemi M. Dental cone beam computed tomography: an updated review. Physica Medica. 2021;88:193-217. doi: 10.1016/j.ejmp.2021.07.007.
Seo D, Yi Y, Roh B. The effect of preparation designs on the marginal and internal gaps in CEREC3 partial ceramic crowns. Journal of Dentistry. 2009; 37:374-382.
Ghavami-Lahiji M, Davalloo RT, Tajziehchi G, Shams P. Micro-computed tomography in preventive and restorative dental research: a review. Imaging Science in Dentistry. 2021;51(4):341-350. doi:10.5624/isd.20210087.
Hassouneh L, Jum'ah A, Ferrari M, Wood DJ. A micro-computed tomography analysis of marginal and internal fit of endocrowns fabricated from three CAD/CAM materials. Operative Dentistry. 2023;48(1):79-89. doi:10.2341/21-105-L.
Ritman EL. Current status of developments and applications of micro-computed tomography. Annual Review of Biomedical Engineering. 2011; 13:531-552.
Şahin FÜ, Topuz Ö. Diş hekimliği araştırmalarında mikrobilgisayarlı tomografi uygulamaları. Acta Odontologica Turcica. 2014; 31:114-120.
De Santis R, Mollica F, Prisco D, Rengo S, Ambrosio L, Nicolais L. A three-dimensional analysis of mechanically stressed dentin adhesive-composite interfaces using X-ray micro-computed tomography. Biomaterials. 2005; 25:257-270.
Yıldırım G. Tam seramik sistemlerin kenar ve iç uyumlarının mikro bilgisayarlı tomografi ile incelenmesi [Uzmanlık tezi]. Malatya: İnönü Üniversitesi Diş Hekimliği Fakültesi; 2015.
Bruker. SkyScan 1172 X-ray micro-computed tomography user guide. Kontich, Belgium: Bruker microCT; 2005.
Prokop M, Galanski M, Van Der Molen AJ, Schaefer-Prokop C. Spiral and multislice computed tomography of the body. Volume 1. Stuttgart: Thieme; 2003.
Topkara C. CAD/CAM ile hazırlanan endokron restorasyonların alt ve üst molar dişlerde mikro-bilgisayarlı tomografi yardımıyla incelenmesi [Uzmanlık tezi]. Samsun: Ondokuz Mayıs Üniversitesi Diş Hekimliği Fakültesi; 2019.
Kalender WA. X-ray computed tomography. Physics in Medicine and Biology. 2006;51(13): R29-R43.
Boas FE, Fleischmann D. Computed tomography artifacts: causes and reduction techniques. Radiographics. 2012;32(6):1679-1691.
Barrett JF, Keat N. Artifacts in computed tomography: recognition and avoidance. Radiographics. 2004;24(6):1679-1691.
du Plessis A, et al. Laboratory X-ray micro-computed tomography: non-destructive morphology analysis methods. MethodsX. 2017; 4:278-286.
Sinescu C, Negrutiu M, Topala F, Ionita C, Negru R, Fabriky M, Marcauteanu C, Bradu A, Dobre G, Marsavina L, Rominu M, Podoleanu A. Ceramic and polymeric dental onlays evaluated by photoelasticity, optical coherence tomography and micro-computed tomography. Proceedings of SPIE. 2011;8172.
Çivitci F, Malkoç MA. Diş hekimliğinde mikro-bilgisayarlı tomografinin kullanım alanları. Dicle Diş Hekimliği Dergisi. 2013; 14:279-284.
Simsek N, Ahmetoglu F, Keles A, Bulut ET, Er K. Three-dimensional analysis of D-RaCe and self-adjusting file in removing filling materials from curved root canals instrumented and filled with different techniques. Scientific World Journal. 2014; 2014:1-7.
Neves AdA, Coutinho E, De Munck J, Van Meerbeek B. Caries-removal effectiveness and minimal-invasiveness potential of caries-excavation techniques: a micro-computed tomography investigation. Journal of Dentistry. 2011;39(2):154-162.
Schicho K, Kastner J, Klingesberger R, Seemann R, Enislidis G, Undt G, Wanschitz F, Figl M, Wagner A, Ewers R. Surface area analysis of dental implants using micro-computed tomography. Clinical Oral Implants Research. 2007;18:459-464.
Pelekanos S, Koumanou M, Koutayas SO, Zinelis S, Eliades G. Micro-computed tomography evaluation of the marginal fit of different In-Ceram alumina copings. The European Journal of Esthetic Dentistry. 2009;4:278-292.
Boitelle P, Mawussi B, Tapie L, Fromentin O. A systematic review of CAD/CAM fit accuracy of ceramic restorations. Journal of Oral Rehabilitation. 2014;41(12):928-935.
Revilla-León M, Özcan M. Additive manufacturing technologies used for processing polymers: current status and potential application in prosthetic dentistry. Journal of Prosthodontics. 2019;28(2):146-158.
Swain MV, Xue J. State of the art of micro-computed tomography applications in dental research. International Journal of Oral Science. 2009;1(4):177-188.
Contrepois M, Soenen A, Bartala M, Laviole O. Marginal adaptation of ceramic crowns: a systematic review. Journal of Prosthetic Dentistry. 2013;110(6):447-454.
Yeşil Z. Siman çıkış deliliğinin tam döküm kuronların kenar uyumuna etkisinin incelenmesi. Ankara Üniversitesi Diş Hekimliği Fakültesi Dergisi. 1997;1.
Kaufman EG, Coelho DH, Colin L. Factors influencing the retention of cemented gold castings. Journal of Prosthetic Dentistry. 1961;11(3):487-502.
Kim JH, Lee SJ, Park JM. Evaluation of marginal and internal fit of fixed dental prostheses using micro-computed tomography: a systematic review. Journal of Prosthetic Dentistry. 2018;120(4):551-558.
Bindl A, Mormann WH. Marginal and internal fit of all-ceramic CAD/CAM crown-copings on chamfer preparations. Journal of Oral Rehabilitation. 2005; 32:441-447.
Sorensen JA. A standardized method for determination of crown margin fidelity. Journal of Prosthetic Dentistry. 1990; 64:18-24.
Nawafleh NA, Mack F, Evans J, Mackay J, Hatamleh MM. Accuracy and reliability of methods to measure marginal adaptation of crowns and fixed dental prostheses: a literature review. Journal of Prosthodontics. 2013;22(5):419-428.
Holmes JR, Bayne SC, Holland GA, Sulik WD. Considerations in measurement of marginal fit. Journal of Prosthetic Dentistry. 1989;62(4):405-408.
Referanslar
Oliveira ML. Digital dental radiology and diagnostics – from 2D to 3D. Australian Dental Journal. 2025;70(Suppl 1): S50-S66. doi:10.1111/adj.70024.
Kaasalainen T, Ekholm M, Siiskonen T, Kortesniemi M. Dental cone beam computed tomography: an updated review. Physica Medica. 2021;88:193-217. doi: 10.1016/j.ejmp.2021.07.007.
Seo D, Yi Y, Roh B. The effect of preparation designs on the marginal and internal gaps in CEREC3 partial ceramic crowns. Journal of Dentistry. 2009; 37:374-382.
Ghavami-Lahiji M, Davalloo RT, Tajziehchi G, Shams P. Micro-computed tomography in preventive and restorative dental research: a review. Imaging Science in Dentistry. 2021;51(4):341-350. doi:10.5624/isd.20210087.
Hassouneh L, Jum'ah A, Ferrari M, Wood DJ. A micro-computed tomography analysis of marginal and internal fit of endocrowns fabricated from three CAD/CAM materials. Operative Dentistry. 2023;48(1):79-89. doi:10.2341/21-105-L.
Ritman EL. Current status of developments and applications of micro-computed tomography. Annual Review of Biomedical Engineering. 2011; 13:531-552.
Şahin FÜ, Topuz Ö. Diş hekimliği araştırmalarında mikrobilgisayarlı tomografi uygulamaları. Acta Odontologica Turcica. 2014; 31:114-120.
De Santis R, Mollica F, Prisco D, Rengo S, Ambrosio L, Nicolais L. A three-dimensional analysis of mechanically stressed dentin adhesive-composite interfaces using X-ray micro-computed tomography. Biomaterials. 2005; 25:257-270.
Yıldırım G. Tam seramik sistemlerin kenar ve iç uyumlarının mikro bilgisayarlı tomografi ile incelenmesi [Uzmanlık tezi]. Malatya: İnönü Üniversitesi Diş Hekimliği Fakültesi; 2015.
Bruker. SkyScan 1172 X-ray micro-computed tomography user guide. Kontich, Belgium: Bruker microCT; 2005.
Prokop M, Galanski M, Van Der Molen AJ, Schaefer-Prokop C. Spiral and multislice computed tomography of the body. Volume 1. Stuttgart: Thieme; 2003.
Topkara C. CAD/CAM ile hazırlanan endokron restorasyonların alt ve üst molar dişlerde mikro-bilgisayarlı tomografi yardımıyla incelenmesi [Uzmanlık tezi]. Samsun: Ondokuz Mayıs Üniversitesi Diş Hekimliği Fakültesi; 2019.
Kalender WA. X-ray computed tomography. Physics in Medicine and Biology. 2006;51(13): R29-R43.
Boas FE, Fleischmann D. Computed tomography artifacts: causes and reduction techniques. Radiographics. 2012;32(6):1679-1691.
Barrett JF, Keat N. Artifacts in computed tomography: recognition and avoidance. Radiographics. 2004;24(6):1679-1691.
du Plessis A, et al. Laboratory X-ray micro-computed tomography: non-destructive morphology analysis methods. MethodsX. 2017; 4:278-286.
Sinescu C, Negrutiu M, Topala F, Ionita C, Negru R, Fabriky M, Marcauteanu C, Bradu A, Dobre G, Marsavina L, Rominu M, Podoleanu A. Ceramic and polymeric dental onlays evaluated by photoelasticity, optical coherence tomography and micro-computed tomography. Proceedings of SPIE. 2011;8172.
Çivitci F, Malkoç MA. Diş hekimliğinde mikro-bilgisayarlı tomografinin kullanım alanları. Dicle Diş Hekimliği Dergisi. 2013; 14:279-284.
Simsek N, Ahmetoglu F, Keles A, Bulut ET, Er K. Three-dimensional analysis of D-RaCe and self-adjusting file in removing filling materials from curved root canals instrumented and filled with different techniques. Scientific World Journal. 2014; 2014:1-7.
Neves AdA, Coutinho E, De Munck J, Van Meerbeek B. Caries-removal effectiveness and minimal-invasiveness potential of caries-excavation techniques: a micro-computed tomography investigation. Journal of Dentistry. 2011;39(2):154-162.
Schicho K, Kastner J, Klingesberger R, Seemann R, Enislidis G, Undt G, Wanschitz F, Figl M, Wagner A, Ewers R. Surface area analysis of dental implants using micro-computed tomography. Clinical Oral Implants Research. 2007;18:459-464.
Pelekanos S, Koumanou M, Koutayas SO, Zinelis S, Eliades G. Micro-computed tomography evaluation of the marginal fit of different In-Ceram alumina copings. The European Journal of Esthetic Dentistry. 2009;4:278-292.
Boitelle P, Mawussi B, Tapie L, Fromentin O. A systematic review of CAD/CAM fit accuracy of ceramic restorations. Journal of Oral Rehabilitation. 2014;41(12):928-935.
Revilla-León M, Özcan M. Additive manufacturing technologies used for processing polymers: current status and potential application in prosthetic dentistry. Journal of Prosthodontics. 2019;28(2):146-158.
Swain MV, Xue J. State of the art of micro-computed tomography applications in dental research. International Journal of Oral Science. 2009;1(4):177-188.
Contrepois M, Soenen A, Bartala M, Laviole O. Marginal adaptation of ceramic crowns: a systematic review. Journal of Prosthetic Dentistry. 2013;110(6):447-454.
Yeşil Z. Siman çıkış deliliğinin tam döküm kuronların kenar uyumuna etkisinin incelenmesi. Ankara Üniversitesi Diş Hekimliği Fakültesi Dergisi. 1997;1.
Kaufman EG, Coelho DH, Colin L. Factors influencing the retention of cemented gold castings. Journal of Prosthetic Dentistry. 1961;11(3):487-502.
Kim JH, Lee SJ, Park JM. Evaluation of marginal and internal fit of fixed dental prostheses using micro-computed tomography: a systematic review. Journal of Prosthetic Dentistry. 2018;120(4):551-558.
Bindl A, Mormann WH. Marginal and internal fit of all-ceramic CAD/CAM crown-copings on chamfer preparations. Journal of Oral Rehabilitation. 2005; 32:441-447.
Sorensen JA. A standardized method for determination of crown margin fidelity. Journal of Prosthetic Dentistry. 1990; 64:18-24.
Nawafleh NA, Mack F, Evans J, Mackay J, Hatamleh MM. Accuracy and reliability of methods to measure marginal adaptation of crowns and fixed dental prostheses: a literature review. Journal of Prosthodontics. 2013;22(5):419-428.
Holmes JR, Bayne SC, Holland GA, Sulik WD. Considerations in measurement of marginal fit. Journal of Prosthetic Dentistry. 1989;62(4):405-408.
