Turkiye Klinikleri Journal of Dental Sciences

.: REVIEW
Dişsiz Dönemden Daimi Dişlenme Sürecine Kadar Oklüzyonun Kurulumu
Development of Occlusion from the Toothless Period Up to the Permanent Dentition
Sibel ÇAYÖNÜa, Burcu Nihan YÜKSELa, Şaziye SARIa
aAnkara Üniversitesi Diş Hekimliği Fakültesi, Çocuk Diş Hekimliği ABD, Ankara, TÜRKİYE
Turkiye Klinikleri J Dental Sci. 2020;26(1):110-21
doi: 10.5336/dentalsci.2018-60529
Article Language: TR
Full Text
ÖZET
 Daimi dentisyonda uyumlu, fonksiyonel ve estetik olarak kabul edilir bir oklüzyon kurulması için dişsiz dönemden itibaren birçok fizyolojik durum ve mekanizma bulunmaktadır. Daimi dentisyonda görüldüğünde anomali olarak kabul edilmesine karşılık, oklüzyonun kurulumu aşamasında kendi dönemi için fizyolojik olan geçiş dönemleri bulunmaktadır. Dişsiz dönemde (0-6 ay) büyüme ve gelişimle beraber çene kemiklerinin uzayın her üç yönünde büyümesi ile dişlerin sürmesi için gereken yer sağlanmaktadır. Süt dişlenme döneminde (6 ay-6 yaş) ise fizyolojik boşluklar, ikinci süt azı ve süt kanin dişlerinin kapanış ilişkisi, alt ve üst süt dişi arklarının özellikleri gibi durumlar daimi dişlerdeki oklüzyonun belirlenmesinde esas rolü üstlenmektedir. Bu dönemde çapraşıklığın görülmesi durumunda daimi dişlenmede de yüksek oranda çapraşıklık görülmesi beklenmektedir. Süt ve daimi dişlerin bir arada bulunması nedeni ile karışık dişlenme dönemi (6-12 yaş) olarak adlandırılan bir diğer dönem erken (6-9 yaş) ve geç (9-12 yaş) olmak üzere iki aşamada tamamlanmaktadır. Süt keserler arasındaki fizyolojik boşlukların kullanılması, daimi kesici dişlerin artmış eğimle sürmeleri, maymun diastemasının kullanılması ve interkanin genişliğin artışı tüm dişlerin oklüzyon ilişkisini belirlemesi bakımından son derece önemlidir. Daimi dişlenme dönemi ise en son süt dişinin düşmesi ve ikinci büyük azı dişlerinin sürmesiyle başlamakta ve ömür boyu sürmektedir. Çocuk diş hekimlerinin, gelişen oklüzyondaki bu anormal durumları ve problemleri tanımlama, ayırt etme, uygun olarak yönetme ve zamanında müdahale etme, bilgi ve becerisine sahip olması için oklüzyonun kurulumu hakkında bilgi sahibi olmaları gerekmektedir. Bu fizyolojik durum ve mekanizmaların bilinmesi hastalara gereksiz bir tedavi uygulanmasını engelleyebileceği gibi gerçekten anomali olan durumu da erken teşhis edip zamanında müdahale edimesine yardımcı olacaktır.

Anahtar Kelimeler: Diş oklüzyonu; diş çıkarma, karışık; diş çıkarma, kalıcı; diş, geçici; erken tanı
ABSTRACT
 There are many physiological conditions and mechanisms from the period of the toothless period to the end of the permanent dentition period in order for the occlusion to be compatible, functional and aesthetically terminated. Conditions that can be considered anomalies when seen in the permanent dentition are considered physiologically acceptable transition periods for the interval when they are seen in the course of the occlusion setup. In the toothless period (0- 6 months), along with growth and development, the jawbone grows in all three directions of space to provide the necessary space for the teeth to eruption. In the dairy period (6 months-6 years), the conditions such as the physiological spaces, the occlusal relation of the primary second molar and the primary canine, and the characteristics of the lower and upper arch forms play an essential role in determining the occlusion in the permanent teeth. In this period, the appearance of crowding is regarded as a sign that it will be seen at a high rate in the permanent dentition. The mixed dentition period (6-12 years), in which the primary and permanent teeth are present together, is completed in two phases, early (6-9 years) and late (9-12 years). The use of physiological spaces between the primary incisors, eruption of permanent incisor teeth with increased inclination, the use of primate spaces and the increase in the intercanine width are crucial in determining the occlusal relationship of the teeth. Finally, the permanent dentition period starts with the last exfoliation of the primary tooth and the eruption of permanent second molar teeth and lasts for life. It is necessary that the pediatric dentists need to have the knowledge abouthe setting up of the occlusion to identify, distinguish, appropriately manage and timely intervene in abnormal situations and problems. Having knowledge about these physiological conditions and mechanisms in the establishment of occlusion by dentists will help patients to be protected from unnecessary treatment as well as early diagnosis and timely intervention planning in cases of anomalies.

Keywords: Dental occlusion; dentition, mixed; dentition, permanent; tooth, deciduous; early diagnosis
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