Dergiler / Uluslararası Diş Hekimliği Bilimleri Dergisi / 2025 / Cilt: 11 Sayı: 3

İMPLANT DESTEKLİ HİBRİT PROTEZLERDE KULLANILAN GÜNCEL MATERYALLER: DERLEME

CURRENT MATERIALS USED IN IMPLANT-SUPPORTED HYBRID PROSTHESES: A REVIEW

Fatma Güneş(Gazi Üniversitesi Diş Hekimliği Fakültesi)0000-0002-0230-2294
Sayfa
142–150
Yayın Tarihi
2025-12-30
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Bu literatür incelemesi, hibrit protez üretiminde kullanılan malzemelere ilişkin güncel bir genel bakış sunmayı ve bu malzemelerin ve tekniklerin klinik faydalarını ve sınırlamalarını değerlendirmeyi amaçlamaktadır.

📌 3 Maddede Bu Makale

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Amaç & Hipotez:İmplant destekli sabit protezler arasında yer alan hibrit protezler, farklı materyallerden üretilen vida tutuculu restorasyonlar olarak tanımlanmaktadır.
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Temel Bulgular & Veri:Bu protezler, kaybedilen diş eti ve çevre dokularla birlikte diş sert dokularını yeniden yapılandırır.
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Sonuç & Katkı:Bu literatür incelemesi, hibrit protez üretiminde kullanılan malzemelere ilişkin güncel bir genel bakış sunmayı ve bu malzemelerin ve tekniklerin klinik faydalarını ve sınırlamalarını değerlendirmeyi amaçlamaktadır.
🔬Tür:Literatür & Derleme Çalışması
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Hibrit protez · Titanyum bar · Monolitik zirkonyum

Özet

İmplant destekli sabit protezler arasında yer alan hibrit protezler, farklı materyallerden üretilen vida tutuculu restorasyonlar olarak tanımlanmaktadır. Bu protezler, kaybedilen diş eti ve çevre dokularla birlikte diş sert dokularını yeniden yapılandırır. Hibrit protezler krom-kobalt (Co-Cr) alaşımından üretilen metal altyapılar, freze edilebilen zirkonya ve polietereterketon (PEEK) gibi alt yapılardan hazırlanabilir. Co-Cr metal alt yapılar geleneksel döküm, selektif lazer sintering ve bilgisayar destekli üretim/ bilgisayar destekle tasarım (CAD/CAM) yöntemleri ile elde edilebilirler. Zirkonya ve PEEK gibi alt yapılar ise genellikle CAD/CAM ile üretilmektedir. CAD/CAM yöntemi ile üretilen alt yapılar, desteklere yüksek hassasiyette uyum göstermesi, kantilever uzunluğunun bir miktar fazla olabilmesi, teknisyene bağlı oluşabilecek hataların ortadan kaldırılması, döküm sırasında metalde oluşabilecek büzülme riskinin ortadan kaldırılması gibi avantajları vardır. Hibrit protezlerde üst yapı üretimi için metal seramikler, tam seramik malzemeler, akrilik rezinler, termoplastik polimer yapıdaki PEEK gibi çeşitli materyaller kullanılır. Üst yapı olarak kullanılacak dental seramikler geleneksel feldspatik olabileceği gibi CAD/CAM yöntemi üretilen monolitik zirkonya gibi tam seramik sistemlerden de elde edilebilir. Materyal yapısında meydana gelen gelişimler ile birlikte CAD/CAM yöntemiyle üretilen titanium barlara simante edilen monolitik zirkonyum hibrit protezler üretilmeye başlanmıştır. Dijitalleştirilmiş bu üretim sürecinin bilgisayarlı iş akışı, tekrarlanabilir sonuçlar ve barların mükemmel adaptasyonu ve pasif yerleştirilmesini sağlar. Bu literatür incelemesi, hibrit protez üretiminde kullanılan malzemelere ilişkin güncel bir genel bakış sunmayı ve bu malzemelerin ve tekniklerin klinik faydalarını ve sınırlamalarını değerlendirmeyi amaçlamaktadır.

Abstract

Hybrid prostheses, which are among the implant-supported fixed prostheses, are defined as screw-retained restorations produced from different materials. These prostheses reconstruct the dental hard tissues together with the lost gums and surrounding tissues. Hybrid prostheses can be prepared from metal substructures produced from chromium-cobalt (Co-Cr) alloy, millable zirconia and polyetheretherketone (PEEK). Co-Cr metal substructures can be obtained by traditional casting, selective laser sintering and computer-aided manufacturing/computer-aided design (CAD/CAM) methods. Substructures such as zirconia and PEEK are generally produced with CAD/CAM. Substructures produced with the CAD/CAM method have advantages such as high precision adaptation to supports, slightly longer cantilever length, elimination of errors that may occur due to the technician, and elimination of the risk of shrinkage in the metal during casting. In hybrid prostheses, various materials such as metal ceramics, all-ceramic materials, acrylic resins, and thermoplastic polymer PEEK are used for the superstructure production. Dental ceramics to be used as the superstructure can be traditional feldspathic or can be obtained from all-ceramic systems such as monolithic zirconia produced by CAD/CAM method. With the developments in material structure, monolithic zirconium hybrid prostheses cemented to titanium bars produced by CAD/CAM method have begun to be produced. The computerized workflow of this digitalized production process provides reproducible results and excellent adaptation and passive placement of the bars. This literature review aims to provide an up-to-date overview of the materials used in hybrid prosthesis production and to evaluate the clinical benefits and limitations of these materials and techniques.

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Bu Makaleye Atıf Yap

Güneş, F. (2025). İMPLANT DESTEKLİ HİBRİT PROTEZLERDE KULLANILAN GÜNCEL MATERYALLER: DERLEME. Uluslararası Diş Hekimliği Bilimleri Dergisi, Cilt: 11 Sayı: 3, 142–150. https://doi.org/10.21306/dishekimligi.1580884

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Kaynakça (52)

  1. Misch CE. Contemporary Implant Dentistry. 4th Ed., Elsevier; 2020.
  2. Denry I, Kelly JR. State of the art of zirconia for dental applications. Dental Materials. 2008; 24: 299-307.
  3. Taş N, Eğilmez F. İmplant Destekli Hibrit Protezlerin Yapımında Kullanılan Materyaller ve Üretim Yöntemleri (Materials and Manufacturing Methods Used in the Construction of Implant-Supported Hybrid Prostheses) Atatürk Univ Fac Dent J. 2021: 31: 305-315.
  4. Su H, Gonzalez-Martin O, Weisgold A, Lee E. Considerations of implant abutment and crown contour: Critical contour and subcritical contour. Int J Periodontics Restorative Dent. 2010; 30: 335-43.
  5. Patras M, Martin W. Simplified custom impression post for implant-supported restorations. J Prosthet Dent. 2016; 115: 556-559.
  6. Scarano A, Stoppaccioli M, Casolino T. Zirconia crowns cemented on titanium bars using CAD/CAM: A five-year follow-up prospective clinical study of 9 patients. BMC Oral Health. 2019; 19: 286.
  7. Mijiritsky E, Elad A, Krausz R, Ivanova V, Zlatev S. Clinical performance of full-arch implant-supported fixed restorations made of monolithic zirconia luted to a titanium bar: A retrospective study with a mean follow-up of 16 months. J Dent. 2023; 137: 104675.
  8. Rubenstein JE. Stereo laser-welded titanium implant frameworks: Clinical and laboratory procedures with a summary of 1-year clinical trials. J Prosthet Dent. 1995; 74: 284-293.
  9. Eliasson A, Wennerberg A, Johansson A, Örtorp A, Jemt T. The precision of fit of milled titanium implant frameworks (I-Bridge®) in the edentulous jaw. Clin Implant Dent Relat Res. 2010; 12: 81-90.
  10. Wong CKK, Narvekar U, Petridis H. Prosthodontic Complications of Metal-Ceramic and All-Ceramic, Complete-Arch Fixed Implant Prostheses with Minimum 5 Years Mean Follow-Up Period. A Systematic Review and Meta-Analysis. J Prosthodont. 2019; 28: e722-e735.
  11. Sadid-Zadeh R, Liu PR, Aponte-Wesson R, O’Neal SJ. Maxillary cement retained implant supported monolithic zirconia prosthesis in a full mouth rehabilitation: a clinical report. J Adv Prosthodont. 2013; 5: 209.
  12. Priest G, Smith J, Wilson MG. Implant survival and prosthetic complications of mandibular metal acrylic resin implant complete fixed dental prostheses. J Prosthet Dent. 2014; 111: 466-475.
  13. Barootchi S, Askar H, Ravidà A, Gargallo-Albiol J, Travan S, Wang HL. Long-term Clinical Outcomes and Cost-Effectiveness of Full-Arch Implant Supported Zirconia-Based and Metal-Acrylic Fixed Dental Prostheses: A Retrospective Analysis. Int J Oral Maxillofac Implants. 2020; 35: 395-405.
  14. Güneş F, Kocacikli M, Korkmaz T. Dental İmplantolojide Polietereterketon (PEEK): Geleneksel Derleme (Polyetheretherketone (PEEK) in Dental Implantology: Traditional Review). Selcuk Dent J. 2023; 10: 611-617.
  15. Pereira GKR, Venturini AB, Silvestri T, Dapieve KS, Montagner AF, Soares FZM, Valandro LF. Low temperature degradation of Y-TZP ceramics: A systematic review and meta-analysis. J Mech Behav Biomed Mater. 2015, 55: 151-163.
  16. Sadowsky SJ. Has zirconia made a material difference in implant prosthodontics? A review. Dental Materials. 2020; 36: 1-8.
  17. Gonzalez J. The evolution of dental materials for hybrid prosthesis. Open Dent J. 2014; 8: 85-94.
  18. Zarb GA, Symington JM. Osseointegrated dental implants: Preliminary report on a replication study. J Prosthet Dent. 1983; 50: 271-276.
  19. Lundqvist S, Carlsson GE. Maxillary fixed prostheses on osseointegrated dental implants. J Prosthet Dent. 1983; 50: 262-270.
  20. Goll GE. Production of accurately fitting full-arch implant frameworks: Part I- Clinical procedures. J Prosthet Dent. 1991; 66: 377-384.
  21. Jemt T, Johansson J. Implant Treatment in the Edentulous Maxillae: A 15‐Year Follow‐Up Study on 76 Consecutive Patients Provided with Fixed Prostheses. Clin Implant Dent Relat Res. 2006; 8: 61-69.
  22. Davis DM, Packer ME, Watson RM. Maintenance requirements of implant-supported fixed prostheses opposed by implant-supported fixed prostheses, natural teeth, or complete dentures: A 5-year retrospective study. Int J Prosthodont. 2003; 16: 521-523.
  23. Freilich MA, Duncan JP, Alarcon EK, Eckrote KA, Goldberg AJ. The design and fabrication of fiber reinforced implant prostheses. J Prosthet Dent 2002; 88: 449–54.
  24. Lahoud L, Boulos P, Kahale D, Gheno E, Benedicenti S, Calasans-Maia ônica D, et al. Fracture load comparison of a new fiber-reinforced composite and zirconia in all on-four prosthesis: An in vitro study. Int J Prosthodont. 2025;38:315-323.
  25. Cheng YC, Perpetuini P, Murcko L, Hirayama M, Morgan K, Marincola M, et al. Fiber-reinforced composite full-arch prosthetic reconstructions supported by three standard, short or extra-short implants: a two center retrospective study. Clin Oral Investig. 2023;27:4191–203.
  26. Ruyter IE, Ekstrand K, Björk N. Development of carbon/graphite fiber reinforced polymethyl methacrylate suitable for implant-fixed dental bridges. Dental Materials 1986; 2: 6–9.
  27. Ekstrand K, Ruyter IE, Wellendorf H. Carbon/graphite fiber reinforced polymethyl methacrylate: Properties under dry and wet conditions. J Biomed Mater Res 1987; 21: 1065–80.
  28. Björk N, Ekstrand K, Ruyter IE. Implant-fixed, dental bridges from carbon/graphite fibre reinforced polymethyl methacrylate. Biomaterials. 1986; 7: 73–5.
  29. Özdoğan A, İncesu A. İmplant Destekli Hibrit Protezler (Implant-Supported Hybrid Dentures). Atatürk Univ Fac Dent J. 2016; 26.
  30. Örtorp A, Jemt T. CNC-milled titanium frameworks supported by implants in the edentulous jaw: A 10-year comparative clinical study. Clin Implant Dent Relat Res 2012; 14: 88-99.
  31. Scarano A, Stoppaccioli M, Casolino T. Zirconia crowns cemented on titanium bars using CAD/CAM: A five-year follow-up prospective clinical study of 9 patients. BMC Oral Health 2019; 19.
  32. Hagiwara Y, Nakajima K, Tsuge T, McGlumphy EA. The use of customized implant frameworks with gingiva-colored composite resin to restore deficient gingival architecture. J Prosthet Dent 2007; 97: 112 117.
  33. Baig MR, Rajan G, Rajan M. Edentulous arch treatment with a CAD/CAM screw-retained framework and cemented crowns: a clinical case report. J Oral Implantol 2009; 35: 295-9.
  34. Maló P, de Araújo Nobre M, Moura Guedes C, Almeida R, Silva A, Sereno N, Legatheaux J. Short term report of an ongoing prospective cohort study evaluating the outcome of full-arch implant-supported fixed hybrid polyetheretherketone-acrylic resin prostheses and the All-on-Four concept. Clin Implant Dent Relat Res 2018; 20: 692-702.
  35. Mostafa Ali S, Bahgat El Talawy D, Bahgat El Talawy DE. Clinical And Radiographic Outcomes of Poly-Etheretherketone (Peek) Hybrid Prosthesis Used For “All on Four” Rehabilitation of Edentulous Maxilla. A Short-Term Case Series Study. Egyptian Dental Journal 2019; 65: 3699-3712.
  36. Tipton P. Professor Paul Tipton examines the application of the high-performance polymer PEEK for CAD/CAM produced ful- arch implant retained prostheses. Clinical Excellence. 2019.
  37. de Araújo Nobre M, Moura Guedes C, Almeida R, Silva A, Sereno N. Hybrid Polyetheretherketone (PEEK)-Acrylic Resin Prostheses and the All-on-4 Concept: A Full-Arch Implant-Supported Fixed Solution with 3 Years of Follow-Up. J Clin Med 2020; 9: 2187.
  38. Tribst JPM, Campanelli de Morais D, Melo de Matos JD, Lopes GDRS, Dal Piva AMO, Souto Borges AL, Bottino MA, Lanzotti A, Martorelli M, Ausiello P. Influence of Framework Material and Posterior Implant Angulation in Full-Arch All-on-4 Implant-Supported Prosthesis Stress Concentration. Dent J (Basel) 2022; 10: 12.
  39. Deniz D, Aktaş G. Zirkonya Güncel Jenerasyonları: Klinik İpuçları. Acta Odontologica Turcica. 2023; 40: 95 102.
  40. Alwade FH, Ismail IJ, Ibrahim FJ. Zirconia in Dental and Other Biomedical Applications: An Overview. International Journal of Medical Research & Health Sciences 2019; 8: 30–7.
  41. Noè G, Toffoli A, Bonfiglioli R, Macaluso GM, Manfredi E. Full-Arch, Implant-Fixed Complete Dentures in Monolithic Zirconia and Titanium: A Digital Workflow to Maximize Cost Effectiveness. Prosthesis 2022; 4: 73 79.
  42. Manicone PF, Rossi Iommetti P, Raffaelli L. An overview of zirconia ceramics: Basic properties and clinical applications. J Dent 2007; 35: 819–26.
  43. Stawarczyk B, Keul C, Eichberger M, Figge D, Edelhoff D, Lümkemann N. Three generations of zirconia: From veneered to monolithic. Part I. Quintessence Int 2017; 48: 369-380.
  44. Örtorp A, Jemt T. Clinical experience of CNC-milled titanium frameworks supported by implants in the edentulous jaw: A 3-year interim report. Clin Implant Dent Relat Res 2002; 4: 104–9.
  45. Froimovici FO, Butnărașu CC, Montanari M, Săndulescu M. Fixed Full-Arch Implant-Supported Restorations: Techniques Review and Proposal for Improvement. Dent J (Basel) 2024; 12: 408.
  46. Tribst JPM, Dal Piva AM de O, Borges ALS, Rodrigues VA, Bottino MA, Kleverlaan CJ. Does the prosthesis weight matter? 3D finite element analysis of a fixed implant-supported prosthesis at different weights and implant numbers. J Adv Prosthodont 2020; 12: 67.
  47. Guess PC, Att W, Strub JR. Zirconia in Fixed Implant Prosthodontics. Clin Implant Dent Relat Res 2012; 14: 633-645.
  48. Le M, Papia E, Larsson C. The clinical success of tooth‐ and implant‐supported zirconia‐based fixed dental prostheses. A systematic review. J Oral Rehabil 2015; 42: 467-480.
  49. Cinquini C, Alfonsi F, Marchio V, Gallo F, Zingari F, Bolzoni AR, et al. The Use of Zirconia for Implant-Supported Fixed Complete Dental Prostheses: A Narrative Review. Dent J (Basel) 2023; 11: 144.
  50. Delucchi F, De Giovanni E, Pesce P, Bagnasco F, Pera F, Baldi D, et al. Framework Materials for Full Arch Implant-Supported Rehabilitations: A Systematic Review of Clinical Studies. Materials. 2021; 14: 3251.
  51. Tribst JPM, Dal Piva AM de O, Lo Giudice R, Borges ALS, Bottino MA, Epifania E, et al. The Influence of Custom-Milled Framework Design for an Implant-Supported Full-Arch Fixed Dental Prosthesis: 3D-FEA Study. Int J Environ Res Public Health. 2020; 17: 4040.
  52. Villefort RF, Tribst JPM, Dal Piva AM de O, Borges AL, Binda NC, Ferreira CE de A, et al. Stress distribution on different bar materials in implant retained palatal obturator. PLoS One. 2020; 15: e0241589.