Kemikleşme Miktarı Artış Dağılımı
5. SONUÇ VE ÖNERİLER
Çift taraflı sinüs lifting ve dental implant yapılan hastalarda DELT’e uygulayarak kemiğin dansitometrik değerlendirilmesi incelendiğinde bu çalışmamızda;
• DELT uygulanan tarafla diğer taraf arasında dansitometrik veriler yüksek olmasına rağmen 1. ayda anlamsız, 3. ve 6. aylarda istatistiksel olarak değerler anlamlı çıkmıştır.
• DELT uygulanan bölgede demineralize kemik matriksi greftin putty şeklinin çalışma sonrası iyi bir şekilde optik yoğunluklarında artış tespit edilmiştir.
• DELT’nin greft materyallerine etkisini kemik gelişimi açısından incelemesinde, özeliklede bizim çalışmadaki gibi bir boşluğa yerleşdirildiyse, 3 boyutlu görüntüleme yöntemlerinden faydalanmanın daha hassas sonuç vereceği düşünülmektedir.
• DELT’nin farklı gref materyallerinde kemikleşme sürecini değerlendirecek radyolojik ve histolojik kombinasyonlu çalışmaların yapılmasının gerekli olduğu görüşünü taşımaktayız.
• DELT’nin sinüs ogmentasyonu ve aynı seansda uyguladığımız dental implantaların osseointegrasyonunu artı şeklinde etkileyeceğini düşüncesini taşımaktayız. Ancak osseintegrasyonun değerlendirilebilmesi için daha detaylı bir çalışma planlanması gerekitğini düşünmekteyiz.
ÖZET
Çift taraflı sinüs lifting ve dental implant yapılan hastalarda düşük enerji lazer tedavisi uygulayarak kemiğin dansitometrik değerlendirilmesi.
Çalışmamızda çift taraflı sinüs lifting ve aynı seasnda dental implant yapılan hastalarda DELT’nin kemik iyileşmesi üzerine olan etkisinin değerlendirilmesi planlanmıştır.
Protetik rehabilitasyonu için implant yaptırmak isteyen, posterior maksillada bilateral parsiyel dişsizliği bulunan ve bilateral simüs ogmentasyonu ve aynı seansda dental implantı yapılabilen hastalar çalışmaya alınmıştır. Hastalarda bilateral sinüs ogmentasyonu ve dental implant aynı seansda yapılmış olup bir tarafa 1, 3, 5. ve 7. günlerde λ= 630-660 nm dalga boyunda 75 mw / cm² güc yoğunluğunda, frekansı 0 ayarlanmış 6-8 dak. süreyle DELT uygulanmıştır. Hastalardan operasyon öncesi ve operasyondan sonraki 1., 3. ve 6. aylarda alüminyum step-wedge kullanılarak panoramik filmler alınmıstır. Bu filmler üzerinde optik dansite ölçümleri 1mm çaplı Cardinal Health Dijital Dansitometer (Fluke Biomedical 07-443) ile yapılmıstır. Dijital dansitometreden okunan değerler her bir film için alüminyum eşdeğer kalınlığı belirlenerek kaydedilmiştir. Bu elde edilen veriler her hasta için değerlendirildiğinde zaman içinde DELT’e uygulanan tarafla diğer tarafta kemiğin optik yoğunluklarında değişim saptanmıştır.
Sonuç olarak: dansitometrik elde edilen verilere göre DELT’e uygulanan taraftaki ölçümlerde, diğer tarafa oranla daha fazla artış görülmüştür. Veriler istatistiksel değerlendirildiği zaman 1. ayda anlamsız, 3. ve 6. ayda anlamlı bir fark olduğu saptanmıştır.
Anahtar sözcükler: Alüminiyum step-wedge, DELT, demineralize kemik matriksi, dental implant, dijital dansitrometre, maksiller sinüs, sinüs ogmentasyonu.
SUMMARY
Densitometric Evaluation of Bone After Applying Low Level Laser in Patients Treated With Bilateral Sinus Lifting and Implant Placement.
This study was designed to evaluate the effects of low-level laser therapy on bone healing in patients with simultaneous bilateral sinus lifting and dental implant application.
Patients with bilateral maxillary posterior partially edentulous patients who need sinus bone augmentation were included in our study. Sinus bone augmentation and dental implant surgeries were done simultaneously. Low level laser therapy was (λ= 630-660 nm, 75 mw / cm², 6-8 mins) applied for just one operation side at 1st, 3rd, 5th and 7th days. Panoramic radiographs were taken at the 1st, 3rd and 6th months using aluminum step – wedge technique.
Optic Density analyses were performed using Cardinal Health Digital Densitometer (Fluke Biomedical 07-443) with 1mm diameter. Digital densitometric results and equivalent aluminum thickness for each radiograph. These data were used to evaluate changes in optical bone densitometry to compare the LLLT applied side and control side for each patient.
LLLT showed better results than the control side according to densitometric results.
According to results of the densitometric evaluation, increase of bone density at the 1st month is not statistically significant but it is statistically significant for the 3rd and 6th months for LLLT side.
Key Words: Aluminum step-wedge, demineralized bone matrix, dental implant, digital densitometry, low level laser therapy, maxillary sinus, sins augmentation.
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