{"id":4370,"date":"2019-02-08T16:46:54","date_gmt":"2019-02-08T16:46:54","guid":{"rendered":"https:\/\/eadt.de\/dentale-werkstoffprufung-dynamisch-oder-statisch\/"},"modified":"2024-02-09T09:42:10","modified_gmt":"2024-02-09T09:42:10","slug":"dentale-werkstoffprufung-dynamisch-oder-statisch","status":"publish","type":"post","link":"https:\/\/eadt.de\/dentale-werkstoffprufung-dynamisch-oder-statisch\/","title":{"rendered":"Dentale Werkstoffpr\u00fcfung \u2013 dynamisch oder statisch?"},"content":{"rendered":"\n

Lisa Marie Sch\u00f6nhoff, Annett Kieschnick, Nina L\u00fcmkemann, Bogna Stawarczyk<\/p>\n\n\n\n

Beim Pr\u00fcfen dentaler Werkstoffe im Labor (in-vitro) werden die Belastungen auf Restaurationsmaterialien in verk\u00fcrzter Zeit simuliert. Ziel ist es, Aussagen dazu treffen zu k\u00f6nnen, ob sich Materialien f\u00fcr den Einsatz im Patientenmund eignen. Doch wie hoch sind die Kr\u00e4fte im Mund? Spielen zus\u00e4tzlich zur Kraft weitere Faktoren eine Rolle? Wie werden diese Faktoren in der Werkstoffpr\u00fcfung \u201eimitiert\u201c?<\/em><\/p>\n\n\n\n

Die dentale Werkstoffkunde ist f\u00fcr Zahnarzt und Zahntechniker bzw. den langfristigen Therapieerfolg unentbehrlich. Um Materialien auf ihre klinische Einsatzf\u00e4higkeit zu testen, gibt es verschiedene Pr\u00fcfmethoden. Zu unterscheiden sind in-vivo-Untersuchungen (klinisch) von in-vitro-Untersuchungen (laborseitig). Grunds\u00e4tzlich erlauben moderne Pr\u00fcfverfahren realistische Prognosen \u00fcber das Verhalten dentaler Materialien im Mund. Erschwert werden die Pr\u00fcfungen bzw. der Vergleich der Ergebnisse aufgrund der Vielzahl an Einfl\u00fcssen im Mund sowie der unterschiedlichen Pr\u00fcfmethoden.<\/p>\n\n\n\n

Unterschiede in der Kaukraft<\/strong><\/h4>\n\n\n\n

Die Kaukraft des Menschen ist von vielen Faktoren abh\u00e4ngig. Zus\u00e4tzlich zu Geschlecht und Alter \u2013 junge M\u00e4nner kauen mit h\u00f6heren Kr\u00e4ften als \u00e4ltere Frauen \u2013 spielen der Zahnstatus und die Art der Nahrung eine Rolle. Betrachtet man den Zahnstatus, nimmt die Kaukraft mit abnehmender Anzahl von Z\u00e4hnen ab. Auch die Art der prothetischen Versorgung spielt eine Rolle. Mit festsitzendem Zahnersatz wird kr\u00e4ftiger zugebissen als mit herausnehmbaren Prothesen.<\/p>\n\n\n\n

Einfl\u00fcsse auf Kaukraft und Z\u00e4hne<\/strong><\/h4>\n\n\n\n

Gro\u00dfen Einfluss auf die Kaukraft hat auch die Beschaffenheit respektive die Konsistenz der Nahrung. Bei\u00dfen wir knusprige Chips, werden deutlich geringere Kr\u00e4fte aufgebracht als beim Kauen von Weingummi. Hinzu kommt die Intention, die das Zubei\u00dfen hat. Sollen Speisen abgebissen, gekaut oder soll maximal zugebissen werden? Handelt es sich um Kr\u00e4fte, die beim n\u00e4chtlichen Z\u00e4hneknirschen auftreten? Das Erheben all dieser Fakten wird mit unterschiedlichen Messapparaturen vorgenommen. Unter anderem dienen f\u00fcr das Messen Bissgabeln oder mit Kraftmessern versehene Br\u00fcckenger\u00fcste. In Abh\u00e4ngigkeit von den verschiedenen Messprozesse ergibt sich eine breite Spanne an ermittelten Kaukr\u00e4ften.<\/p>\n\n\n\n

Zus\u00e4tzlich zur Kaukraft variieren zudem Kaufrequenz und Kauzyklenzahl. Beide Faktoren sind von Mensch zu Mensch unterschiedlich und tagesabh\u00e4ngig. Zudem wirken im Mund neben der vertikalen Kraft horizontale Kr\u00e4fte (Mahlbewegungen). Und letztlich resultieren aus der Nahrungsaufnahme physikalische (z. B. thermisch) und chemische Einfl\u00fcsse auf Z\u00e4hne bzw. Restaurationen.<\/p>\n\n\n\n

\n

Aussagekr\u00e4ftige Ergebnisse:  in-vivo und in-vitro-Studien<\/strong><\/h4>\n\n\n\n

Allein diese Gegen\u00fcberstellungen zeigen,<\/p>\n\n\n\n

    \n
  • wie unterschiedlich prothetische Restaurationen in-vivo belastet werden und<\/li>\n\n\n\n
  • wie stark bei in-vitro-Pr\u00fcfungen dentaler Werkstoffe die Tatsache ins Gewicht f\u00e4llt, dass der Mensch ein Individuum ist.<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n

    Restaurationsmaterialien, welche bei dem einem Patienten sehr gute \u00dcberlebensraten zeigen, m\u00fcssen bei einem anderen Patienten nicht zu gleich guten Ergebnissen f\u00fchren. Dies verdeutlicht, dass bei in-vivo-Studien (klinische Studien) hohes Augenmerk auf die Patientenauswahl gelegt werden muss. Au\u00dferdem sind klinische Studien nur aussagekr\u00e4ftig, wenn eine ausreichende Anzahl an Patienten einbezogen worden ist. Um die Power der Studie (Wie viele Patienten sind f\u00fcr eine signifikante Aussage notwendig?)<\/em> sorgf\u00e4ltig bestimmen zu k\u00f6nnen, m\u00fcssen die Wissenschaftler vor Beginn der Studie eng mit Statistikern zusammenarbeiten. Im Vergleich dazu sind in-vitro-Studien (Labor) einfacher und schneller vorzunehmen, da die Bedingungen standardisiert werden k\u00f6nnen. Nichtsdestotrotz sollte auch hier ein ausreichender Pr\u00fcfk\u00f6rperumfang ber\u00fccksichtigt werden, um aussagekr\u00e4ftige Ergebnisse zu gew\u00e4hrleisten.<\/p>\n\n\n\n

    Statische und dynamische Pr\u00fcfungen in der Werkstoffkunde<\/strong><\/h4>\n\n\n\n

    Die Vielzahl an diversen Faktoren ergibt im Mund einen Komplex an Einfl\u00fcssen, die bei Werkstoffpr\u00fcfungen im Labor m\u00f6glichst realistisch nachzuahmen sind. Derzeit beruhen die meisten genormten Untersuchungen f\u00fcr dentale Werkstoffe \u2013 bis auf Ausnahmen \u2013 auf statischen Pr\u00fcfungen. Dynamische Untersuchungen (in Anlehnung an die dynamische Kaubewegung) werden leider immer noch selten vorgenommen. Problematisch bei dynamischen Tests ist, dass sich hierbei unterschiedlicher Parameter bedient wird. Das f\u00fchrt dazu, dass die Vergleichbarkeit zwischen einzelnen Untersuchungen nicht oder nur bedingt gew\u00e4hrleistet ist.<\/p>\n\n\n\n

    \n
    \n
    \"\"
    Pr\u00fcfen einer mit Komposit verblendeten PAEK-Br\u00fccke<\/em><\/figcaption><\/figure>\n<\/div>\n\n\n\n
    \n

    Es gibt bereits eine Vielzahl an Pr\u00fcfger\u00e4ten, mit denen dentale Werkstoffe in-vitro unter realen klinischen Einfl\u00fcssen gepr\u00fcft werden k\u00f6nnen. Die Entwicklungen reichen von Ger\u00e4ten mit reiner vertikaler Belastung mit unterschiedlicher Kraft (Dauerlastmaschinen) \u00fcber solche, mit denen zus\u00e4tzlich horizontale Bewegungen imitiert werden, bis hin zu Ger\u00e4ten, die erg\u00e4nzend die Lagerung in einem Medium \u2013 teilweise mit Temperaturwechsel \u2013 erm\u00f6glichen (Kausimulatoren). Aufgrund verschiedener frei w\u00e4hlbarer Parameter, f\u00fchren die unterschiedlichen Pr\u00fcfger\u00e4te momentan zu unterschiedlichen Aussagen von den Werkstoffen. So werden zum einen keine Einfl\u00fcsse der Zyklenzahlen oder aufgebrachten Kr\u00e4fte auf das Versagen beobachtet, w\u00e4hrend zum anderen h\u00f6here Kr\u00e4fte bei einer zyklischen Belastung zu einem schnelleren Versagen f\u00fchren.<\/p>\n<\/div>\n<\/div><\/div>\n\n\n\n

    Vergleichbarkeit der Ergebnisse<\/strong><\/h4>\n\n\n\n

    Aus der Bandbreite an Pr\u00fcfmethoden ergeben sich in-vitro-Untersuchungen mit unterschiedlichen Parametern. Dies erschwert die Vergleichbarkeit der Ergebnisse. Aktuell wird daher eine Norm zur dynamischen Pr\u00fcfung dentaler Werkstoffe diskutiert. So soll eine Basis f\u00fcr den Vergleich von Untersuchungsergebnissen geschaffen werden. Hinweis: H\u00e4ufig werden von Herstellern auch statische Pr\u00fcfungen mit unterschiedlichen Methoden vorgenommen, woraus teilweise irref\u00fchrende Daten bzw. Vergleiche resultieren.<\/p>\n\n\n\n

    \n
    \n
    \"\"
    Vier-Punkt-Biegeversuch eines eingekerbten Pr\u00fcfk\u00f6rpers zur Bestimmung der Bruchz\u00e4higkeit<\/figcaption><\/figure>\n\n\n\n
    \"\"
    Ger\u00e4t zur statischen und dynamischen Pr\u00fcfung von Keramiken<\/figcaption><\/figure>\n<\/div>\n\n\n\n
    \n
    \"\"
    Dynamische Pr\u00fcfung von Zirkonoxid in einer 4-Punkt-Biegevorrichtung<\/figcaption><\/figure>\n\n\n\n
    \"\"
    Pr\u00fcfen der biaxialen Biegefestigkeit eines keramischen Materials<\/figcaption><\/figure>\n<\/div>\n<\/div><\/div>\n\n\n\n

    Fazit f\u00fcr den Praktiker<\/strong><\/h4>\n\n\n\n

    F\u00fcr den Anwender ist es nach derzeitigen Bedingungen ratsam, Materialvergleiche aus dynamischen Tests nur innerhalb einer wissenschaftlichen Untersuchung zu betrachten. Ein verbindlicher Vergleich resultiert nur aus Werten, die unter denselben Bedingungen im Werkstoffkunde-Labor erhoben worden sind.<\/p>\n","protected":false},"excerpt":{"rendered":"

    Lisa Marie Sch\u00f6nhoff, Annett Kieschnick, Nina L\u00fcmkemann, Bogna Stawarczyk Beim Pr\u00fcfen dentaler Werkstoffe im Labor (in-vitro) werden die Belastungen auf Restaurationsmaterialien in verk\u00fcrzter Zeit simuliert. Ziel ist es, Aussagen dazu treffen zu k\u00f6nnen, ob sich Materialien f\u00fcr den Einsatz im Patientenmund eignen. Doch wie hoch sind die Kr\u00e4fte im Mund? Spielen zus\u00e4tzlich zur Kraft weitere […]<\/p>\n","protected":false},"author":6,"featured_media":11649,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_uag_custom_page_level_css":"","_swt_meta_header_display":false,"_swt_meta_footer_display":false,"_swt_meta_site_title_display":false,"_swt_meta_sticky_header":false,"_swt_meta_transparent_header":false,"footnotes":""},"categories":[17],"tags":[],"yoast_head":"\nDentale Werkstoffpr\u00fcfung \u2013 dynamisch oder statisch? - EADT<\/title>\n<meta name=\"description\" content=\"Eignen sich Restaurationsmaterialien f\u00fcr den Einsatz im Patientenmund? 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