Bruksizmi Olan Bireylerde Seramik Restorasyon Seçimi
Özet
Bruksizmi olan bireylerde seramik restorasyon seçimi, güncel bilimsel veriler ışığında değerlendirilmektedir. Bruksizm, artık bir hastalık değil, multifaktöriyel bir mastikatör kas aktivitesi olarak kabul edilmekte ve restoratif ile protetik tedavilerde önemli bir mekanik risk faktörü oluşturmaktadır. Artmış oklüzal kuvvetler ve tekrarlayıcı yükler, özellikle seramik restorasyonlarda kırık ve başarısızlık riskini artırmaktadır. Bruksizmin tanı yöntemleri ve risk sınıflaması, klinik karar sürecinin temelini oluşturur. Feldspatik seramikler, lityum disilikat, zirkonya, hibrit seramikler ve metal destekli sistemler; biyomekanik özellikleri, yük toleransları ve klinik performansları açısından karşılaştırılmaktadır. Ayrıca seramik materyallerde yorulma davranışı, çatlak ilerleme mekanizmaları ve başarısızlık tipleri ayrıntılı olarak ele alınmaktadır. Klinik karar sürecinde hasta değerlendirme algoritması, materyal seçimi ve oklüzal tasarım ilkeleri kritik öneme sahiptir. Monolitik restorasyonlar, yeterli materyal kalınlığı, lateral yük kontrolü ve oklüzal koruyucu aparey kullanımı komplikasyon riskini azaltan temel faktörlerdir. Sonuç olarak, seramik materyal seçiminin yalnızca estetik gereksinimlere değil, biyomekanik dayanım ve bireysel risk profiline dayandırılması gerekmektedir.
The selection of ceramic restorations in individuals with bruxism is evaluated in light of current scientific evidence. Bruxism is no longer considered a disease but a multifactorial masticatory muscle activity and represents a significant mechanical risk factor in restorative and prosthetic dentistry. Increased occlusal forces and repetitive loading significantly increase the risk of fracture and failure, particularly in ceramic restorations. Diagnostic approaches and risk classification of bruxism form the basis of clinical decision-making. Feldspathic ceramics, lithium disilicate, zirconia, hybrid ceramics, and metal-ceramic systems are compared in terms of their biomechanical properties, load tolerance, and clinical performance. In addition, fatigue behavior, crack propagation mechanisms, and failure modes of ceramic materials are discussed in detail. Patient assessment algorithms, material selection, and occlusal design principles play a critical role in clinical decision-making. Monolithic restorations, adequate material thickness, control of lateral forces, and the use of occlusal splints are key factors in reducing complications. In conclusion, ceramic material selection should be based not only on esthetic demands but also on biomechanical performance and individual risk assessment.
Referanslar
Thomas DC, Manfredini D, Colonna A, Sangalli L. Bruxism: implications in clinical dentistry as related to the specialties in dentistry. Dent Clin North Am. 2026;70(1):63–74.
Mengatto CM, Coelho- de-Souza FH, de Souza Junior OB. Sleep bruxism: challenges and restorative solutions. Clinical, Cosmetic and Investigational Dentistry. 2016:8 71–77.
Ionfrida JA, Stiller HL, Kämmerer PW, Walter C. Dental implant failure risk in patients with bruxism—A systematic review and meta-analysis of the literature. Dent J (Basel). 2025;13(1):11. doi:10.3390/dj13010011
Faus-Matoses V, Ruiz-Bell E, Faus-Matoses I, Özcan M, Salvatore S, Faus-Llácer VJ. An 8-year prospective clinical investigation on the survival rate of feldspathic veneers: influence of occlusal splint in patients with bruxism. J Dent. 2020;99:103352.
Ceddia M, Lamberti L, Trentadue B. FEA comparison of the mechanical behavior of three dental crown materials: enamel, ceramic, and zirconia. Materials (Basel). 2024;17(3):673.
Schmitter M, Bömicke W, Behnisch R, Lorenzo-Bermejo J, Waldecker M, Rammelsberg P, et al. Ceramic crowns and sleep bruxism: first results from a randomized trial. J Clin Med. 2023;12(1):273. doi:10.3390/jcm12010273
Zamzam H, Moussa A, Zohdy M, Morsi T, Olivares A, Fok A. Accelerated bruxism-simulating fatigue test of occlusal veneers. J Mech Behav Biomed Mater. 2026;173:107243.
Pjetursson BE, Valente NA, Strasding M, Zwahlen M, Liu S, Sailer I. A systematic review of the survival and complication rates of zirconia-ceramic and metal-ceramic single crowns. Clin Oral Implants Res. 2018;29(Suppl 16):199-214.
Leitão CIMB, Fernandes GVO, Azevedo LPP, Araújo FM, Donato H, Correia ARMC. Clinical performance of monolithic CAD/CAM tooth-supported zirconia restorations: systematic review and meta-analysis. J Prosthodont Res. 2022;66(3):374-384.
Lodi E, Weber KR, Benetti P, Corazza PH, Della Bona A, Borba M. How oral environment simulation affects ceramic materials. J Prosthet Dent. 2018;119(5):812-818.
Kelly JR, Cesar PF, Scherrer SS, Della Bona A, van Noort R, Tholey M, et al. ADM guidance—ceramics: fatigue principles and testing. Dent Mater. 2017;33(11):1192-1204.
Lan TH, Chen PH, Fok ASL, Chen YF. Contact fracture test of monolithic hybrid ceramics on different substrates for bruxism. Dent Mater. 2022;38(1):44-56.
Chochlidakis K, Einarsdottir E, Tsigarida A, Papaspyridakos P, Romeo D, Barmak AB, et al. Survival rates and prosthetic complications of implant fixed complete dental prostheses: an up to 5-year retrospective study. J Prosthet Dent. 2020;124(5):539-546.
Referanslar
Thomas DC, Manfredini D, Colonna A, Sangalli L. Bruxism: implications in clinical dentistry as related to the specialties in dentistry. Dent Clin North Am. 2026;70(1):63–74.
Mengatto CM, Coelho- de-Souza FH, de Souza Junior OB. Sleep bruxism: challenges and restorative solutions. Clinical, Cosmetic and Investigational Dentistry. 2016:8 71–77.
Ionfrida JA, Stiller HL, Kämmerer PW, Walter C. Dental implant failure risk in patients with bruxism—A systematic review and meta-analysis of the literature. Dent J (Basel). 2025;13(1):11. doi:10.3390/dj13010011
Faus-Matoses V, Ruiz-Bell E, Faus-Matoses I, Özcan M, Salvatore S, Faus-Llácer VJ. An 8-year prospective clinical investigation on the survival rate of feldspathic veneers: influence of occlusal splint in patients with bruxism. J Dent. 2020;99:103352.
Ceddia M, Lamberti L, Trentadue B. FEA comparison of the mechanical behavior of three dental crown materials: enamel, ceramic, and zirconia. Materials (Basel). 2024;17(3):673.
Schmitter M, Bömicke W, Behnisch R, Lorenzo-Bermejo J, Waldecker M, Rammelsberg P, et al. Ceramic crowns and sleep bruxism: first results from a randomized trial. J Clin Med. 2023;12(1):273. doi:10.3390/jcm12010273
Zamzam H, Moussa A, Zohdy M, Morsi T, Olivares A, Fok A. Accelerated bruxism-simulating fatigue test of occlusal veneers. J Mech Behav Biomed Mater. 2026;173:107243.
Pjetursson BE, Valente NA, Strasding M, Zwahlen M, Liu S, Sailer I. A systematic review of the survival and complication rates of zirconia-ceramic and metal-ceramic single crowns. Clin Oral Implants Res. 2018;29(Suppl 16):199-214.
Leitão CIMB, Fernandes GVO, Azevedo LPP, Araújo FM, Donato H, Correia ARMC. Clinical performance of monolithic CAD/CAM tooth-supported zirconia restorations: systematic review and meta-analysis. J Prosthodont Res. 2022;66(3):374-384.
Lodi E, Weber KR, Benetti P, Corazza PH, Della Bona A, Borba M. How oral environment simulation affects ceramic materials. J Prosthet Dent. 2018;119(5):812-818.
Kelly JR, Cesar PF, Scherrer SS, Della Bona A, van Noort R, Tholey M, et al. ADM guidance—ceramics: fatigue principles and testing. Dent Mater. 2017;33(11):1192-1204.
Lan TH, Chen PH, Fok ASL, Chen YF. Contact fracture test of monolithic hybrid ceramics on different substrates for bruxism. Dent Mater. 2022;38(1):44-56.
Chochlidakis K, Einarsdottir E, Tsigarida A, Papaspyridakos P, Romeo D, Barmak AB, et al. Survival rates and prosthetic complications of implant fixed complete dental prostheses: an up to 5-year retrospective study. J Prosthet Dent. 2020;124(5):539-546.
