{"id":20779,"date":"2023-04-16T11:54:23","date_gmt":"2023-04-16T04:54:23","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=20779"},"modified":"2023-05-02T14:33:59","modified_gmt":"2023-05-02T07:33:59","slug":"nho-rang-khon-nguyen-nhan-va-thoi-diem","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/16\/nho-rang-khon-nguyen-nhan-va-thoi-diem\/","title":{"rendered":"Nh\u1ed5 r\u0103ng kh\u00f4n &#8211; Nguy\u00ean nh\u00e2n v\u00e0 th\u1eddi \u0111i\u1ec3m."},"content":{"rendered":"<p><strong>B\u00e0i vi\u1ebft n\u00e0y n\u00f3i v\u1ec1 \u0111\u1eb7c \u0111i\u1ec3m nguy\u00ean nh\u00e2n v\u00e0 th\u1eddi \u0111i\u1ec3m ch\u1ec9 \u0111\u1ecbnh n\u00ean nh\u1ed5 r\u0103ng kh\u00f4n cho b\u1ec7nh nh\u00e2n. Nha s\u0129 c\u1ea7n n\u1eafm r\u00f5 c\u00e1c v\u1ea5n \u0111\u1ec1 li\u00ean quan \u0111\u1ebfn qu\u00e1 tr\u00ecnh m\u1ecdc r\u0103ng, m\u00f4 ph\u00f4i h\u1ecdc, ti\u00ean l\u01b0\u1ee3ng s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a r\u0103ng kh\u00f4n\/tr\u1ee5c r\u0103ng kh\u00f4n v\u00e0 \u0111\u1eb7c bi\u1ec7t nh\u1eefng ch\u1ec9 \u0111\u1ecbnh nh\u1ed5 r\u0103ng kh\u00f4n trong ch\u1ec9nh h\u00ecnh. C\u00f9ng t\u00ecm hi\u1ec3u k\u1ef9 h\u01a1n v\u1ea5n \u0111\u1ec1 n\u00e0y<\/strong><\/p>\n<h2>1. Nh\u1ed5 r\u0103ng kh\u00f4n: t\u1ea1i sao v\u00e0 khi n\u00e0o?<\/h2>\n<p>Nh\u1ed5 r\u0103ng kh\u00f4n l\u00e0 m\u1ed9t trong nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb trong nha khoa. \u0110\u00e3 c\u00f3 nhi\u1ec1u nghi\u00ean c\u1ee9u, b\u00e1o c\u00e1o v\u1edbi m\u1ee5c \u0111\u00edch t\u00ecm hi\u1ec3u nh\u1eefng nguy\u00ean nh\u00e2n \u0111\u01b0a \u0111\u1ebfn vi\u1ec7c nh\u1ed5 m\u1ed9t hay nhi\u1ec1u r\u0103ng kh\u00f4n.<\/p>\n<p>T\u1ed5 ch\u1ee9c National Institute of Health (NIH)- Hoa K\u1ef3- trong h\u1ed9i ngh\u1ecb qu\u1ed1c t\u1ebf n\u0103m 1979, khi ch\u01b0a c\u00f3 s\u1ef1 \u0111\u1ed3ng thu\u1eadn v\u1ec1 th\u1eddi \u0111i\u1ec3m nh\u1ed5 r\u0103ng kh\u00f4n, \u0111\u00e3 \u0111\u01b0a ra nh\u1eefng khuy\u1ebfn c\u00e1o v\u1ec1 ch\u1ec9 \u0111\u1ecbnh nh\u1ed5 r\u0103ng nh\u01b0 sau:<\/p>\n<ul>\n<li>Hi\u1ec7n di\u1ec7n t\u00e2n sinh, nang hay u trong th\u00e0nh bao m\u1ea7m<\/li>\n<li>Vi\u00eam quanh R8 l\u1eb7p l\u1ea1i nhi\u1ec1u l\u1ea7n.<\/li>\n<li>Sang th\u01b0\u01a1ng s\u00e2u R kh\u00f4ng h\u1ed3i ph\u1ee5c.<\/li>\n<li>L\u00e0m t\u1ed5n h\u1ea1i m\u00f4 nha chu R7.<\/li>\n<li>L\u00e0m s\u00e2u m\u1eb7t xa R7.<\/li>\n<\/ul>\n<p>Y v\u0103n \u0111\u00e3 b\u00e0n nhi\u1ec1u v\u1ec1 nh\u1eefng kinh nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb c\u00e1c r\u1ed1i lo\u1ea1n ph\u00e1t tri\u1ec3n li\u00ean quan \u0111\u1ebfn R8, tuy nhi\u00ean th\u1eddi \u0111i\u1ec3m nh\u1ed5 r\u0103ng n\u00e0y khi b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng v\u1eabn c\u00f2n \u0111ang b\u00e0n c\u00e3i. Th\u1ef1c t\u1ebf th\u00ec nh\u1ed5 R8 d\u1ef1 ph\u00f2ng c\u00e1c tai bi\u1ebfn ng\u00e0y c\u00e0ng t\u0103ng, chi\u1ebfm 18% \u0111\u1ebfn 40% tr\u01b0\u1eddng h\u1ee3p nh\u1ecf R8 \u1edf c\u00e1c n\u01b0\u1edbc ph\u00e1t tri\u1ec3n (Liedholm et al; Lysel &amp; Rohlin). Tu\u1ed5i b\u1ec7nh nh\u00e2n nh\u1ecf R8 trung b\u00ecnh t\u1eeb 20-29. M\u1ee5c \u0111\u00edch nh\u1ed5 r\u0103ng ch\u00ednh l\u00e0:<\/p>\n<ul>\n<li>Gi\u1ea3m \u0111i nguy c\u01a1 di ch\u1ee9ng, tai bi\u1ebfn ph\u1eabu thu\u1eadt, v\u00e0 bi\u1ebfn ch\u1ee9ng cho c\u00e1c R k\u1ebf b\u00ean \u1edf ng\u01b0\u1eddi l\u1edbn.<\/li>\n<li>T\u0103ng c\u01b0\u1eddng s\u1ee9c kho\u1ebb cho nh\u1eefng ng\u01b0\u1eddi tr\u1ebb tu\u1ed5i (\u0111\u00e3 qua tu\u1ed5i tr\u01b0\u1edfng th\u00e0nh).<\/li>\n<\/ul>\n<p>Ch\u1ea5t l\u01b0\u1ee3ng c\u1ee7a quy tr\u00ecnh \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh b\u1edfi nh\u1eefng y\u1ebfu t\u1ed1 sau:<\/p>\n<ul>\n<li>T\u00ednh ch\u00ednh x\u00e1c c\u1ee7a ch\u1ec9 \u0111\u1ecbnh nh\u1ed5 r\u0103ng d\u1ef1 ph\u00f2ng (1 hay nhi\u1ec1u R kh\u00f4n).<\/li>\n<li>Giai \u0111o\u1ea1n th\u00edch h\u1ee3p v\u00e0 k\u1ef9 thu\u1eadt nh\u1ecf R \u0111\u01b0\u1ee3c ch\u1ecdn l\u1ef1a, n\u0103ng l\u1ef1c ph\u1eabu thu\u1eadt vi\u00ean v\u00e0 k\u00edp m\u1ed5.<\/li>\n<\/ul>\n<p>Tuy nhi\u00ean, kh\u00f4ng th\u1ec3 \u0111\u01b0a ra m\u1ed9t h\u01b0\u1edbng d\u1eabn chu\u1ea9n x\u00e1c ch\u1ec9 \u0111\u1ecbnh nh\u1ed5 r\u0103ng d\u1ef1 ph\u00f2ng, v\u00ec nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb (\u0111\u01b0\u1ee3c \u0111\u01b0a ra b\u1edfi c\u00e1c c\u1ed9ng \u0111\u1ed3ng B\u00e1c s\u0129 l\u00e2m s\u00e0ng, v\u00e0 c\u00e1c nh\u00e0 khoa h\u1ecdc) kh\u00f4ng th\u1ed1ng nh\u1ea5t \u1edf c\u00e1c n\u01b0\u1edbc kh\u00e1c nhau (Worral et al).<\/p>\n<p>H\u01a1n n\u1eefa, ngay c\u1ea3 c\u00e1c t\u1ed5ng quan y v\u0103n hi\u1ec7n th\u1eddi kh\u00f4ng th\u1ec3 so s\u00e1nh gi\u1eefa c\u00e1c nguy c\u01a1 v\u00e0 l\u1ee3i \u00edch trong nh\u1ecf R8. Ngo\u00e0i ra, quy\u1ebft \u0111\u1ecbnh nh\u1ecf R8 th\u01b0\u1eddng b\u1edfi m\u1ed9t th\u1ea7y thu\u1ed1c, chi d\u1ef1a v\u00e0o m\u1ed9t t\u1ea5m phim X-quang tr\u00ean m\u1ed9t b\u1ec7nh nh\u00e2n \u0111\u00e3 qua tu\u1ed5i d\u1eady th\u00ec. N\u00ean nh\u1ed5 r\u0103ng n\u00e0y v\u1eabn c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c xem l\u00e0 nh\u1eefng quy\u1ebft \u0111\u1ecbnh ch\u1ee7 quan c\u1ee7a c\u00e1c nh\u00e0 l\u00e2m s\u00e0ng.<\/p>\n<p>\u0110\u1ec3 c\u00f3 ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c, c\u1ea7n hi\u1ec3u r\u00f5 v\u00e0 l\u01b0\u1ee3ng gi\u00e1 \u0111\u01b0\u1ee3c c\u00e1c giai \u0111o\u1ea1n m\u1ecdc r\u0103ng. Sau \u0111\u00f3 \u0111\u00e1nh gi\u00e1 \u0111\u1ed9 ng\u1ea7m, k\u1eb9t m\u1ed9t ph\u1ea7n, nh\u1eefng sang th\u01b0\u01a1ng nha chu R8 hay R7, v\u00e0 nguy c\u01a1 g\u00e2y r\u1ed1i lo\u1ea1n s\u1ef1 ph\u00e1t tri\u1ec3n c\u00e1c r\u0103ng k\u1ebf c\u1ea1nh.<\/p>\n<p>Theo Lielholm, ba y\u1ebfu t\u1ed1 quan tr\u1ecdng c\u1ea7n xem x\u00e9t khi quy\u1ebft \u0111\u1ecbnh nh\u1ed5 R8 l\u00e0:<\/p>\n<ul>\n<li>Tu\u1ed5i b\u1ec7nh nh\u00e2n.<\/li>\n<li>G\u00f3c t\u1ea1o b\u1edfi tr\u1ee5c r\u0103ng v\u00e0 m\u1eb7t ph\u1eb3ng nhai, c\u0169ng nh\u01b0 h\u01b0\u1edbng m\u1ecdc r\u0103ng<\/li>\n<li>V\u1ecb tr\u00ed m\u1ecdc r\u0103ng.<\/li>\n<\/ul>\n<p>M\u1ed9t s\u1ed1 y\u1ebfu t\u1ed1 kh\u00e1c c\u0169ng c\u1ea7n quan t\u00e2m l\u00e0:<\/p>\n<ul>\n<li>V\u1ec7 sinh r\u0103ng mi\u1ec7ng.<\/li>\n<li>Ch\u1ec9 s\u1ed1 nha chu v\u00e0 s\u00e2u r\u0103ng.<\/li>\n<\/ul>\n<p>Theo Lielholm v\u00e0 Winter, v\u1ec1 ki\u1ec3u l\u1ec7ch c\u1ee7a tr\u1ee5c R, c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i nh\u01b0 sau:<\/p>\n<ul>\n<li>\u0110\u1ee9ng.<\/li>\n<li>Ngang.<\/li>\n<li>Xa.<\/li>\n<\/ul>\n<p>H\u01a1n n\u1eefa, c\u00e1c giai \u0111o\u1ea1n m\u1ecdc r\u0103ng c\u0169ng c\u1ea7n \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1:<\/p>\n<ul>\n<li>M\u1ecdc ho\u00e0n to\u00e0n.<\/li>\n<li>M\u1ecdc kh\u1ecfi x\u01b0\u01a1ng nh\u01b0ng v\u1eabn c\u00f2n m\u00f4 m\u1ec1m che ph\u1ee7 b\u00ean tr\u00ean.<\/li>\n<li>N\u1eb1m ho\u00e0n to\u00e0n trong x\u01b0\u01a1ng.<\/li>\n<\/ul>\n<p>NIH (National Institute of Health) cho r\u1eb1ng:<\/p>\n<ul>\n<li>Ph\u1eabu thu\u1eadt l\u1ea5y R8 ng\u1ea7m \u0111\u1ea1t k\u1ebft qu\u1ea3 t\u1ed1t tr\u00ean nh\u1eefng b\u1ec7nh nh\u00e2n tr\u1ebb.<\/li>\n<li>Tuy nhi\u00ean, \u1edf b\u1ec7nh nh\u00e2n thanh thi\u1ebfu ni\u00ean, ch\u1ec9 \u0111\u1ecbnh l\u1ea5y to\u00e0n b\u1ed9 m\u1ea7m r\u0103ng tr\u01b0\u1edbc khi ch\u00e2n r\u0103ng h\u00ecnh th\u00e0nh- th\u1ea5y \u0111\u01b0\u1ee3c tr\u00ean phim tia X- th\u00ec kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o, v\u00ec nhi\u1ec1u nguy c\u01a1 tai bi\u1ebfn ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 x\u1ea3y ra.<\/li>\n<li>Nh\u1eefng R8 ng\u1ea7m l\u1ec7ch xa c\u00f3 khuynh h\u01b0\u1edbng g\u00e2y nhi\u1ec1u bi\u1ebfn ch\u1ee9ng h\u01a1n so v\u1edbi nh\u1eefng g\u00f3c l\u1ec7ch kh\u00e1c.<\/li>\n<li>Nh\u1eefng R8 v\u1edbi m\u00f4 m\u1ec1m bao ph\u1ee7 m\u1ed9t ph\u1ea7n hay ho\u00e0n to\u00e0n th\u00ec c\u00f3 khuynh h\u01b0\u1edbng g\u00e2y bi\u1ebfn ch\u1ee9ng nhi\u1ec1u h\u01a1n so v\u1edbi ng\u1ea7m ho\u00e0n to\u00e0n trong x\u01b0\u01a1ng.<\/li>\n<\/ul>\n<p>Trong ch\u1ec9nh nha ng\u00e0y nay, t\u1ec9 l\u1ec7 ch\u1ec9 \u0111\u1ecbnh nh\u1ed5 R8 d\u1ef1 ph\u00f2ng ng\u00e0y c\u00e0ng t\u0103ng, \u0111i\u1ec1u n\u00e0y c\u1ea7n ph\u1ea3i xem x\u00e9t l\u1ea1i m\u1ed9t c\u00e1ch khoa h\u1ecdc.<\/p>\n<p>Ch\u1ec9 \u0111\u1ecbnh nh\u1ed5 r\u0103ng trong ch\u1ec9nh h\u00ecnh th\u01b0\u1eddng l\u00e0 R8 h\u00e0m d\u01b0\u1edbi. Nhi\u1ec1u b\u00e1o c\u00e1o \u0111\u00e3 ch\u1ee9ng minh m\u1ed1i li\u00ean h\u1ec7 gi\u1eefa vi\u1ec7c ph\u00e1t tri\u1ec3n g\u00e2y l\u1ec7ch c\u00e1c r\u0103ng tr\u01b0\u1edbc h\u00e0m d\u01b0\u1edbi v\u00e0 qu\u00e1 tr\u00ecnh m\u1ecdc R8 \u1edf thanh thi\u1ebfu ni\u00ean, v\u00ec v\u1eady nh\u1ed5 b\u1ecf r\u0103ng n\u00e0y l\u00e0 c\u1ea7n thi\u1ebft. Khi quy\u1ebft \u0111\u1ecbnh nh\u1ed5 R8 d\u01b0\u1edbi c\u0169ng c\u00f3 ngh\u0129a r\u1eb1ng ph\u1ea3i nh\u1ed5 lu\u00f4n R8 h\u00e0m tr\u00ean \u0111\u1ec3 \u0111\u01b0a v\u1ec1 kh\u1edbp c\u1eafn h\u1ea1ng I.<\/p>\n<h2>2. M\u00f4 ph\u00f4i h\u1ecdc v\u00e0 s\u1ef1 m\u1ecdc R8<\/h2>\n<p>Gi\u1ed1ng v\u1edbi c\u00e1c R\u0103ng kh\u00e1c \u1edf ng\u01b0\u1eddi, R8 l\u00e0 r\u0103ng m\u1ecdc th\u00eam v\u00e0o sau khi c\u00e1c r\u0103ng kh\u00e1c \u0111\u00e3 m\u1ecdc ho\u00e0n ch\u1ec9nh, n\u1eb1m \u1edf ph\u00eda xa nh\u1ea5t. N\u00f3 c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb l\u1edbp lamina nguy\u00ean ph\u00e1t, v\u00e0 c\u00f3 th\u1ec3 th\u1ea5y n\u1ee5 r\u0103ng v\u00e0o kho\u1ea3ng 4-5 tu\u1ed5i. Calci ho\u00e1 x\u1ea3y ra kho\u1ea3ng 9-10 tu\u1ed5i v\u00e0 th\u00e2n r\u0103ng h\u00ecnh th\u00e0nh xong v\u00e0o kho\u1ea3ng 12-15 tu\u1ed5i. Khi chuy\u1ec3n \u0111\u1ed9ng m\u1ecdc b\u1eaft \u0111\u1ea7u, r\u0103ng t\u1ef1 thi\u1ebft l\u1eadp tr\u1ee5c c\u1ee7a n\u00f3. Kho\u1ea3ng tr\u1ed1ng c\u1ea7n thi\u1ebft m\u1ecdc r\u0103ng tuy v\u00e0o s\u1ef1 ph\u00e1t tri\u1ec3n v\u00f9ng sau cung h\u00e0m.R\u0103ng th\u1ea5y trong mi\u1ec7ng v\u00e0o kho\u1ea3ng 17-21 tu\u1ed5i. Trong qu\u00e1 tr\u00ecnh m\u1ecdc, n\u00f3 t\u1ef1a v\u00e0o ph\u00eda xa R7 \u0111\u1ebfn khi \u0111\u1ea1t \u1edf m\u1eb7t ph\u1eb3ng nhai c\u1ee7a cung h\u00e0m. S\u1ef1 th\u00e0nh l\u1eadp ch\u00e2n r\u1eb1ng xong v\u00e0o kho\u1ea3ng 18-25 tu\u1ed5i.<\/p>\n<p>R8 u\u1ed1n cong theo ph\u00eda xa R7 \u0111\u1ec3 m\u1ecdc, v\u00e0 th\u01b0\u1eddng c\u00f3 m\u1ed9t s\u1ed1 r\u1ed1i lo\u1ea1n trong qu\u00e1 tr\u00ecnh n\u00e0y. M\u1eb7t nhai c\u1ee7a n\u00f3 \u0111\u00e2m v\u00e0o d\u01b0\u1edbi c\u1ed5 R7, v\u00ec th\u1ebf g\u00e2y hi\u1ec7n t\u01b0\u1ee3ng R8 ng\u1ea7m m\u1ed9t ph\u1ea7n hay ho\u00e0n to\u00e0n.<\/p>\n<p>Nh\u01b0 l\u00e0 m\u1ed9t quy lu\u1eadt, R8 h\u00e0m d\u01b0\u1edbi th\u01b0\u1eddng l\u1ea5p \u0111\u1ea7y kho\u1ea3ng tr\u1ed1ng t\u1ea1o b\u1edfi v\u00f9ng tam gi\u00e1c h\u1eadu h\u00e0m ph\u00eda xa R7.<\/p>\n<p>\u1ede h\u00e0m tr\u00ean, x\u01b0\u01a1ng c\u00f3 th\u1ec3 b\u1ea3o \u0111\u1ea3m \u0111\u1ee7 hay kh\u00f4ng \u0111\u1ee7 ch\u1ed7 cho R8 m\u1ecdc, v\u00e0 do \u0111\u00f3, n\u00f3 c\u00f3 th\u1ec3 m\u1ecdc \u0111\u00fang v\u1ecb tr\u00ed hay l\u1ec7ch ngo\u00e0i. V\u00e0 th\u01b0\u1edfng nh\u1eefng th\u00e0nh ph\u1ea7n m\u00f4 m\u1ec1m b\u00ean tr\u00ean g\u00e2y c\u1ea3n tr\u1edf r\u0103ng m\u1ecdc \u0111\u00fang v\u1ecb tr\u00ed.<\/p>\n<h2>3. Ti\u00ean l\u01b0\u1ee3ng s\u1ef1 ph\u00e1t tri\u1ec3n v\u00e0 tr\u1ee5c r\u0103ng kh\u00f4n<\/h2>\n<p>H\u1ea7u h\u1ebft c\u00e1c nghi\u00ean c\u1ee9u th\u1ea5y r\u1eb1ng R8 m\u1ecdc k\u1eb9t c\u00f3 nhi\u1ec1u c\u01a1 ch\u1ebf ph\u1ee9c t\u1ea1p. Kh\u00f4ng c\u00f3 b\u00e1o c\u00e1o c\u00f3 \u00fd ngh\u0129a n\u00e0o v\u1ec1 m\u1ed1i li\u00ean quan gi\u1eefa g\u00f3c h\u00e0m d\u01b0\u1edbi v\u00e0 hi\u1ec7n t\u01b0\u1ee3ng k\u1eb9t R8.<br \/>\nTrong giai \u0111o\u1ea1n s\u1edbm c\u1ee7a qu\u00e1 tr\u00ecnh calci ho\u00e1, R8 h\u00e0m d\u01b0\u1edbi th\u01b0\u1eddng c\u00f3 h\u01b0\u1edbng m\u1ecdc g\u1ea7n trong. S\u1ef1 \u0111\u1ed5i h\u01b0\u1edbng sau n\u00e0y l\u00e0m r\u0103ng m\u1ecdc \u0111\u1ee9ng, x\u1ea3y ra trong kho\u1ea3ng 14-16 tu\u1ed5i (Richardson-1978).<br \/>\nC\u0169ng theo Richardson, n\u1ebfu s\u1ef1 ph\u00e1t tri\u1ec3n th\u00e2n h\u01b0\u1edbng v\u1ec1 \u0111\u01b0\u1eddng gi\u1eefa s\u1ebd l\u00e0m r\u0103ng n\u1eb1m ngang; n\u1ebfu ch\u00e2n r\u0103ng ph\u00e1t tri\u1ec3n v\u1ec1 ph\u00eda xa th\u00ec th\u00e2n R s\u1ebd m\u1ecdc \u0111\u1ee9ng.<\/p>\n<figure id=\"attachment_20803\" aria-describedby=\"caption-attachment-20803\" style=\"width: 308px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-20803\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Untitled-21.png\" alt=\"nho-rang-khon-1\" width=\"308\" height=\"301\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Untitled-21.png 308w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Untitled-21-300x293.png 300w\" sizes=\"(max-width: 308px) 100vw, 308px\" \/><figcaption id=\"caption-attachment-20803\" class=\"wp-caption-text\">H\u01b0\u1edbng th\u00e2n r\u0103ng<\/figcaption><\/figure>\n<p>T\u00f3m l\u1ea1i, C\u00f3 th\u1ec3 ti\u00ean l\u01b0\u1ee3ng s\u1ef1 ph\u00e1t tri\u1ec3n R8 v\u00e0o kho\u1ea3ng 16 tu\u1ed5i. Theo Bj\u00f6rk, c\u00f3 m\u1ed1i li\u00ean h\u1ec7 gi\u1eefa thi\u1ebfu kho\u1ea3ng m\u1ecdc R8 v\u1edbi ba y\u1ebfu t\u1ed1 nh\u01b0 sau:<\/p>\n<ul>\n<li>H\u01b0\u1edbng ph\u00e1t tri\u1ec3n theo chi\u1ec1u ngang c\u1ee7a l\u1ed3i c\u1ea7u x\u01b0\u01a1ng h\u00e0m d\u01b0\u1edbi.<\/li>\n<li>Gi\u1ea3m chi\u1ec1u d\u00e0i th\u00e2n x\u01b0\u01a1ng h\u00e0m d\u01b0\u1edbi.<\/li>\n<li>R m\u1ecdc h\u01b0\u1edbng v\u1ec1 ph\u00eda xa.<\/li>\n<\/ul>\n<p>Theo Silling, t\u01b0\u01a1ng quan x\u01b0\u01a1ng h\u00e0m d\u01b0\u1edbi v\u00e0 h\u00e0m tr\u00ean theo h\u1ea1ng II, ng\u1eafn x\u01b0\u01a1ng h\u00e0m d\u01b0\u1edbi k\u1ebft h\u1ee3p v\u1edbi g\u00f3c \u0111\u00f3ng h\u00e0m d\u01b0\u1edbi th\u00ec c\u00f3 li\u00ean quan \u0111\u1ebfn hi\u1ec7n t\u01b0\u1ee3ng m\u1ecdc k\u1eb9t R8. Ng\u01b0\u1ee3c l\u1ea1i, t\u1ec9 l\u1ec7 k\u1eb9t gi\u1ea3m \u0111i khi qu\u00e1 s\u1ea3n x\u01b0\u01a1ng h\u00e0m d\u01b0\u1edbi (t\u01b0\u01a1ng quan x\u01b0\u01a1ng h\u1ea1ng III).<\/p>\n<h2>4. Nh\u1eefng ch\u1ec9 \u0111\u1ecbnh nh\u1ed5 r\u0103ng kh\u00f4n trong ch\u1ec9nh h\u00ecnh<\/h2>\n<p>M\u1ed9t s\u1ed1 k\u1ef9 thu\u1eadt \u0111i\u1ec1u tr\u1ecb r\u0103ng mi\u1ec7ng c\u1ea7n nh\u1ed5 b\u1ecf R8 tr\u01b0\u1edbc v\u00e0 trong \u0111i\u1ec1u tr\u1ecb.<\/p>\n<p><strong>T\u1ea7m quan tr\u1ecdng c\u1ee7a r\u0103ng l\u1ec7ch xa<\/strong><\/p>\n<p>Trong k\u1ef9 thu\u1eadt ch\u1ec9nh h\u00ecnh theo Tweed-Merrifield, cung r\u0103ng \u0111\u01b0\u1ee3c chia ra l\u00e0m ba v\u00f9ng; R7 v\u00e0 R8 n\u1eb1m trong v\u00f9ng sau. \u0110i\u1ec1u ki\u1ec7n quan tr\u1ecdng \u0111\u1ec3 r\u0103ng m\u1ecdc \u0111\u01b0\u1ee3c l\u00e0 kho\u1ea3ng kh\u00f4ng gian c\u1ea7n thi\u1ebft cho R7 v\u00e0 R8 m\u1ecdc tr\u00ean cung h\u00e0m. <strong>Kho\u1ea3ng c\u00e1ch c\u00f3 th\u1ec3 ch\u1ea5p nh\u1eadn<\/strong> (available space) l\u00e0 kho\u1ea3ng gi\u1eefa b\u1edd tr\u01b0\u1edbc c\u1ea3nh l\u00ean x\u01b0\u01a1ng h\u00e0m d\u01b0\u1edbi v\u00e0 m\u1eb7t xa R6 \u0111o t\u1ea1i v\u1ecb tr\u00ed song song v\u1edbi m\u1eb7t ph\u1eb3ng nhai. <strong>Kho\u1ea3ng c\u00e1ch c\u1ea7n thi\u1ebft<\/strong> (required space) l\u00e0 t\u1ed5ng kho\u1ea3ng c\u00e1ch g\u1ea7n xa R7 v\u00e0 R8 tr\u00ean phim \u0111o so (Cephalogram). S\u1ef1 kh\u00e1c nhau c\u1ee7a c\u00e1c ch\u1ec9 s\u1ed1 n\u00e0y x\u00e1c \u0111\u1ecbnh \u0111i\u1ec1u ki\u1ec7n r\u0103ng c\u00f3 th\u1ec3 m\u1ecdc l\u1ec7ch, v\u00e0 s\u1ef1 c\u1eabn thi\u1ebft ph\u1ea3i nh\u1ed5 R8.<\/p>\n<p>\u1ede b\u1ec7nh nh\u00e2n \u0111ang ph\u00e1t tri\u1ec3n, b\u1eaft \u0111\u1ea7u t\u1eeb 8 tu\u1ed5i, trung b\u00ecnh m\u1ed7i n\u0103m t\u0103ng th\u00eam \u0111\u1ed9 d\u00e0i 1.5 mm \u1edf m\u1ed7i cung h\u00e0m th\u00ec c\u00f3 th\u1ec3 \u0111\u00e1p \u1ee9ng \u0111\u01b0\u1ee3c kho\u1ea3ng c\u00e1ch ch\u1ea5p nh\u1eadn (available space) m\u1ecdc r\u0103ng, v\u00e0 c\u00f3 th\u1ec3 k\u1ebft lu\u1eadn r\u0103ng m\u1ecdc \u0111\u01b0\u1ee3c hay kh\u00f4ng v\u00e0o kho\u1ea3ng 17 tu\u1ed5i \u1edf nam, v\u00e0 15 tu\u1ed5i \u1edf n\u1eef (Tweed). Kho\u1ea3ng kh\u00f4ng gian th\u00eam v\u00e0o n\u00e0y l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a hi\u1ec7n t\u01b0\u1ee3ng ti\u00eau b\u1edd tr\u01b0\u1edbc c\u1ea3nh cao x\u01b0\u01a1ng h\u00e0m d\u01b0\u1edbi trong qu\u00e1 tr\u00ecnh ph\u00e1t tri\u1ec3n (h\u00ecnh 1.2a- 1.2b). Tuy nhi\u00ean, c\u0169ng theo Tweed, kho\u1ea3ng x\u01b0\u01a1ng ph\u00eda sau \u0111\u1ee7 \u0111\u1ebf m\u1ecdc r\u0103ng \u1ea3nh h\u01b0\u1edfng b\u1edfi nhi\u1ec1u y\u1ebfu t\u1ed1:<\/p>\n<ul>\n<li>\u0110\u1ed9 nghi\u00eang g\u1ea7n c\u1ee7a m\u1eb7t nhai R6 h\u00e0m d\u01b0\u1edbi.<\/li>\n<li>\u0110\u1ed9 ti\u00eau b\u1edd tr\u01b0\u1edbc c\u1ea3nh cao x\u01b0\u01a1ng h\u00e0m d\u01b0\u1edbi.<\/li>\n<li>\u0110\u1ed9 nghi\u00eang r\u0103ng c\u1ed1i.<\/li>\n<li>Gi\u1edbi<\/li>\n<li>Tu\u1ed5i<\/li>\n<\/ul>\n<p>Ricketts n\u0103m 1970 \u0111\u00e3 \u0111o kho\u1ea3ng g\u1ea7n xa t\u1ea1i v\u1ecb tr\u00ed m\u1ecdc R8 tr\u00ean phim \u0111o s\u1ecd v\u00e0 ph\u00e1t hi\u1ec7n:<\/p>\n<ul>\n<li>V\u1edbi x\u01b0\u01a1ng h\u00e0m tr\u00ean, kho\u1ea3ng c\u00e1ch t\u1eeb m\u1eb7t xa R6 \u0111\u1ebfn m\u1eb7t ph\u1eb3ng \u0111\u1ee9ng qua c\u1ea3nh x\u01b0\u01a1ng b\u01b0\u1edbm, xuy\u00ean b\u1edd sau khe b\u01b0\u1edbm h\u00e0m c\u1ea7n \u0111\u01b0\u1ee3c \u0111o c\u1ea9n th\u1eadn. Kho\u1ea3ng c\u00e1ch n\u00e0y b\u1eb1ng tu\u1ed5i b\u1ec7nh nh\u00e2n c\u1ed9ng th\u00eam 3mm v\u1edbi \u0111\u1ed9 l\u1ec7ch +\/- 2mm.<\/li>\n<li>V\u1edbi x\u01b0\u01a1ng h\u00e0m d\u01b0\u1edbi, kh\u1ea3 n\u0103ng m\u1ecdc R8 \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 d\u1ef1a tr\u00ean kho\u1ea3ng c\u00e1ch gi\u1eefa \u0111i\u1ec3m Xi (\u0111i\u1ec3m trung t\u00e2m c\u1ea3nh cao XHD tr\u00ean phim \u0111o s\u1ee3) \u0111\u1ebfn m\u1eb7t x\u00e3 R7, song song v\u1edbi m\u1eb7t ph\u1eb3ng c\u1eafn. Turley v\u00e0 Chaconas \u0111\u00e3 x\u00e2y d\u1ef1ng m\u1ed9t \u0111\u01b0\u1eddng cong nh\u1eb1m x\u00e1c \u0111\u1ecbnh kh\u1ea3 n\u0103ng k\u1eb9t R8 li\u00ean quan \u0111\u1ebfn kho\u1ea3ng c\u00e1ch ch\u1ea5p nh\u1eadn. C\u1ee5 th\u1ec3 nh\u01b0 sau:\n<ul>\n<li>21 mm th\u00ec r\u0103ng c\u00f3 th\u1ec3 m\u1ecdc k\u1eb9t.<\/li>\n<li>25 mm th\u00ec r\u0103ng c\u00f3 th\u1ec3 m\u1ecdc k\u1eb9t m\u1ed9t ph\u1ea7n (b\u1edd xa).<\/li>\n<li>30 mm th\u00ec r\u0103ng c\u00f3 th\u1ec3 m\u1ecdc ho\u00e0n to\u00e0n v\u00e0 th\u1ef1c hi\u1ec7n \u0111\u01b0\u1ee3c ch\u1ee9c n\u0103ng.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2>5. Y\u00eau c\u1ea7u c\u1eafm gh\u00e9p implant cho ch\u1ec9nh h\u00ecnh<\/h2>\n<p>Trong k\u1ef9 thu\u1eadt ch\u1ec9nh h\u00ecnh Tweed-Merrified, \u0111i\u1ec1u tr\u1ecb kh\u1edbp c\u1eafn h\u1ea1ng II \u1edf b\u1ec7nh nh\u00e2n \u0111ang ph\u00e1t tri\u1ec3n b\u1eb1ng k\u1ef9 thu\u1eadt c\u1eafm implant (ph\u01b0\u01a1ng ph\u00e1p di xa r\u0103ng c\u1ed1i h\u00e0m d\u01b0\u1edbi tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u g\u1eafn m\u1eafc c\u00e0i) nh\u1eb1m gi\u1ea3m t\u00e1c d\u1ee5ng c\u00f3 h\u1ea1i. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 l\u00e0m R8 m\u1ecdc k\u1eb9t. S\u1ef1 hi\u1ec7n di\u1ec7n R8 gi\u1edbi h\u1ea1n hi\u1ec7u qu\u1ea3 di xa R7 trong k\u1ef9 thu\u1eadt n\u00e0y. Theo t\u00e1c gi\u1ea3 n\u00e0y, nh\u1ed5 b\u1ecf r\u0103ng n\u00e0y g\u00f3p ph\u1ea7n t\u0103ng hi\u1ec7u qu\u1ea3 di R7 ra xa. \u0110i\u1ec1u n\u00e0y c\u0169ng \u0111\u00fang \u0111\u1ed1i v\u1edbi h\u00e0m tr\u00ean.<\/p>\n<p><strong>R\u0103ng kh\u00f4n v\u00e0 s\u1ef1 m\u1ea5t h\u00e0i h\u00f2a r\u0103ng<\/strong><\/p>\n<p>S\u1ef1 m\u1ea5t h\u00e0i h\u00f2a r\u0103ng nh\u00ecn chung c\u00f3 hai c\u01a1 ch\u1ebfsinh h\u1ecdc:<\/p>\n<ul>\n<li>Trong qu\u00e1 tr\u00ecnh ph\u00e1t tri\u1ec3n, c\u00f3 hi\u1ec7n t\u01b0\u1ee3ng gi\u1ea3m th\u1ec3 t\u00edch m\u1eb7t, li\u00ean quan \u0111\u1ebfn lo\u00e0i v\u00e0 di truy\u1ec1n.<\/li>\n<li>Kho\u1ea3ng c\u00e1ch gi\u1eefa r\u0103ng v\u00e0 b\u1edd x\u01b0\u01a1ng b\u00ean d\u01b0\u1edbi.<\/li>\n<\/ul>\n<p>Y\u00eau c\u1ea7u nh\u1ed5 r\u0103ng ti\u1ec1n c\u1ed1i t\u00f9y v\u00e0o k\u00edch th\u01b0\u1edbc c\u0169ng nh\u01b0 s\u1ef1 ph\u00e1t tri\u1ec3n c\u00e1c r\u0103ng tr\u01b0\u1edbc, \u0111\u1ed9 nghi\u00eang ph\u00eda m\u00f4i c\u1ee7a r\u0103ng c\u1eeda h\u00e0m d\u01b0\u1edbi, s\u1ef1 b\u1ea5t x\u1ee9ng h\u1ec7 x\u01b0\u01a1ng qu\u00e1 nhi\u1ec1u, g\u00f3c t\u1ea1o b\u1edfi n\u1ec1n s\u1ecd hay m\u1eb7t ph\u1eb3ng Frankfort v\u00e0 b\u1edd d\u01b0\u1edbi x\u01b0\u01a1ng h\u00e0m d\u01b0\u1edbi \u0111o tr\u00ean l\u00e2m s\u00e0ng. Theo Schulhof, kho\u1ea3ng c\u00e1ch ch\u1ea5p nh\u1eadn t\u0103ng 1 mm s\u1ebd t\u0103ng nguy c\u01a1 k\u1eb9t R8 10%.<\/p>\n<p>Ricketts (1979) v\u00e0 Richardson (1975) \u0111\u00e3 ch\u1ee9ng minh r\u1eb1ng, t\u1ec9 l\u1ec7 k\u1eb9t R8 t\u0103ng l\u00ean \u1edf nh\u1eefng tr\u01b0\u1eddng h\u1ee3p ch\u1ec9nh h\u00ecnh kh\u00f4ng nh\u1ed5 r\u0103ng (nh\u01b0 r\u0103ng ti\u1ec1n c\u1ed1i), hay trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p nh\u1ecf R4 so v\u1edbi nh\u1ed5 R5.<\/p>\n<p>Tuy nhi\u00ean, vi\u1ec7c nh\u1ed5 r\u0103ng ti\u1ec1n c\u1ed1i kh\u00f4ng c\u00f3 ngh\u0129a l\u00e0 ch\u1eafc ch\u1eafn R8 m\u1ecdc ho\u00e0n ch\u1ec9nh. V\u00ec v\u1eady, kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng cho r\u1eb1ng nh\u1ed5 r\u0103ng ti\u1ec1n c\u1ed1i s\u1ebd gi\u1ea3i quy\u1ebft v\u1ea5n \u0111\u1ec1 R8 k\u1eb9t. Cu\u1ed1i c\u00f9ng, quy\u1ebft \u0111\u1ecbnh nh\u1ed5 nhi\u1ec1u R8 t\u00f9y v\u00e0o R7 m\u1ecdc b\u1ea5t th\u01b0\u1eddng hay kh\u00f4ng.<\/p>\n<p><strong>V\u1ea5n \u0111\u1ec1 \u0111i\u1ec1u tr\u1ecb kh\u1edbp c\u1eafn v\u00e0 R8<\/strong><\/p>\n<p>Nh\u1ed5 r\u0103ng ti\u1ec1n c\u1ed1i h\u00e0m tr\u00ean trong \u0111i\u1ec1u tr\u1ecb sai kh\u1edbp c\u1eafn h\u1ea1ng II th\u00ec kh\u00f4ng nh\u1ea5t thi\u1ebft ph\u1ea3i nh\u1ed5 t\u1ea5t c\u1ea3 c\u00e1c R8, v\u00ec nh\u1ed5 R8 h\u00e0m d\u01b0\u1edbi c\u0169ng c\u00f3 th\u1ec3 l\u00e0 \u0111\u1ee7.<\/p>\n<h2>6. S\u1ef1 t\u00e1i ph\u00e1t c\u1ee7a nh\u00f3m r\u0103ng c\u1eeda trong ch\u1ec9nh h\u00ecnh v\u00e0 \u1ea3nh h\u01b0\u1edfng c\u1ee7a n\u00f3 \u0111\u1ed1i v\u1edbi nh\u1ed5 r\u0103ng kh\u00f4n<\/h2>\n<p>\u0110i\u1ec1u tr\u1ecb ch\u1ec9nh h\u00ecnh n\u00ean l\u1eadp k\u1ebf ho\u1ea1ch sao cho t\u1ea1o \u0111i\u1ec1u ki\u1ec7n t\u1ed1t nh\u1ea5t gi\u00fap R8 m\u1ecdc.<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb m\u1ea5t h\u00e0i h\u00f2a r\u0103ng m\u1eb7t, n\u1ebfu c\u00f3, v\u00e0 thi\u1ebft l\u1eadp kh\u1edbp c\u1eafn ch\u1ee9c n\u0103ng kh\u00f4ng nh\u1eb1m d\u1ef1 ph\u00f2ng hi\u1ec7n t\u01b0\u1ee3ng l\u1ec7ch hay t\u00e1i ph\u00e1t l\u1ec7ch r\u0103ng, th\u01b0\u1eddng x\u1ea3y ra \u1edf r\u0103ng c\u1eeda. L\u1ec7ch l\u1ea1c n\u00e0y c\u00f2n c\u00f3 li\u00ean quan \u0111\u1ebfn nhi\u1ec1u y\u1ebfu t\u1ed1 kh\u00e1c n\u1eefa.<\/p>\n<p>Theo t\u00e1c gi\u1ea3 Van der Linden, hi\u1ec7n t\u01b0\u1ee3ng ph\u00e1t tri\u1ec3n x\u01b0\u01a1ng h\u00e0m d\u01b0\u1edbi tr\u1ec5 c\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn nh\u00f3m r\u0103ng c\u1eeda, v\u00e0 n\u00f3 x\u1ea3y ra ngay c\u1ea3 trong l\u00fac kh\u00f4ng hi\u1ec7n di\u1ec7n R8.<\/p>\n<p>Bj\u00f6rk cho r\u1eb1ng s\u1ef1 ph\u00e1t tri\u1ec3n x\u01b0\u01a1ng h\u00e0m d\u01b0\u1edbi ch\u1ee7 y\u1ebfu g\u00e2y ra hi\u1ec7n t\u01b0\u1ee3ng l\u1ec7ch l\u1ea1c r\u0103ng c\u1eeda d\u00f9 x\u01b0\u01a1ng h\u00e0m tr\u00ean c\u00f3 ph\u00e1t tri\u1ec3n theo m\u1ed9t c\u00e1ch ho\u00e0n ch\u1ec9nh.<\/p>\n<p>Nhi\u1ec1u t\u00e1c gi\u1ea3 (Darqu\u00e9 v\u00e0 Langlade, Bolender, Deblock, Raberin, Brunner) cho r\u1eb1ng nh\u1eefng y\u1ebfu t\u1ed1 sau c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn chen ch\u00fac r\u0103ng:<\/p>\n<ul>\n<li>H\u01b0\u1edbng r\u0103ng m\u1ecdc c\u00f3 li\u00ean quan tr\u1ef1c ti\u1ebfp \u0111\u1ebfn ki\u1ec3u xoay h\u01b0\u1edbng h\u00e0m d\u01b0\u1edbi trong qu\u00e1 tr\u00ecnh ph\u00e1t tri\u1ec3n; n\u1ebfu xoay tr\u01b0\u1edbc, g\u00f3c t\u1ea1o b\u1edfi th\u00e2n x\u01b0\u01a1ng h\u00e0m d\u01b0\u1edbi v\u00e0 c\u1ea3nh cao x\u01b0\u01a1ng h\u00e0m d\u01b0\u1edbi nh\u1ecf, r\u0103ng c\u1eeda h\u00e0m d\u01b0\u1edbi s\u1ebd chia ra tr\u01b0\u1edbc, k\u00e8m h\u01b0\u1edbng nghi\u00eang g\u1ea7n c\u1ee7a c\u00e1c r\u0103ng kh\u00e1c. \u0110i\u1ec1u n\u00e0y g\u00e2y chen ch\u00fac nh\u00f3m r\u0103ng c\u1eeda.<\/li>\n<li>X\u01b0\u01a1ng h\u00e0m d\u01b0\u1edbi ph\u00e1t tri\u1ec3n tr\u1ec5, theo sau s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a x\u01b0\u01a1ng v\u00f9ng r\u0103ng tr\u01b0\u1edbc, xoay tr\u01b0\u1edbc l\u00e0m t\u0103ng th\u00eam hi\u1ec7n t\u01b0\u1ee3ng chen ch\u00fac r\u0103ng.<\/li>\n<li>X\u00e9t v\u1ec1 m\u1eb7t ph\u00e1t tri\u1ec3n c\u01a1 th\u1ea7n kinh, s\u1ef1 co k\u00e9o c\u1ee7a m\u00f4i \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn v\u1ecb tr\u00ed r\u0103ng c\u1eeda theo chi\u1ec1u d\u1ecdc, l\u00e0m t\u0103ng kho\u1ea3ng c\u00e1ch gi\u1eefa c\u00e1c r\u0103ng v\u1edbi nhau, v\u00ec th\u1ebf c\u1ea7n c\u00f3 kho\u1ea3ng tr\u1ed1ng \u0111\u1ee7 cho r\u0103ng th\u1eb3ng h\u00e0ng.<\/li>\n<li>S\u1ef1 b\u1ea5t x\u1ee9ng r\u0103ng m\u1eb7t (b\u1ea5t c\u00e2n x\u1ee9ng v\u1ec1 t\u1ec9 l\u1ec7 r\u0103ng c\u1eeda h\u00e0m tr\u00ean v\u00e0 d\u01b0\u1edbi) c\u0169ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn hi\u1ec7n t\u01b0\u1ee3ng l\u1ec7ch l\u1ea1c r\u0103ng.<\/li>\n<li>S\u1ef1 thay \u0111\u1ed5i kho\u1ea3ng c\u00e1ch x\u01b0\u01a1ng h\u00e0m d\u01b0\u1edbi t\u1eeb R3 n\u00e0y sang R3 kia (th\u01b0\u1eddng gi\u1ea3m sau \u0111i\u1ec1u tr\u1ecb) l\u00e0m gi\u1ea3m kho\u1ea3ng kh\u00f4ng c\u00e1ch ch\u1ea5p nh\u1eadn.<\/li>\n<li>S\u1ef1 s\u1eafp x\u1ebfp R v\u00e0 kh\u1edbp c\u1eafn kh\u00f4ng ho\u00e0n ch\u1ec9nh sau \u0111i\u1ec1u tr\u1ecb ch\u1ec9nh h\u00ecnh.<\/li>\n<li>T\u1ed1c \u0111\u1ed9 l\u00e0nh m\u00f4 nha chu, gi\u1ea3m \u1edf ng\u01b0\u1eddi l\u1edbn tu\u1ed5i, \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn hi\u1ec7n t\u01b0\u1ee3ng t\u00e1i ph\u00e1t sau \u0111i\u1ec1u tr\u1ecb.<\/li>\n<\/ul>\n<p>B\u1ec7nh c\u0103n h\u1ecdc c\u1ee7a chen ch\u00fac r\u0103ng sau \u0111i\u1ec1u tr\u1ecb kh\u00f4ng ho\u00e0n to\u00e0n do s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a R8. S\u1ef1 ph\u00e1t tri\u1ec3n mu\u1ed9n, quay ra tr\u01b0\u1edbc c\u1ee7a x\u01b0\u01a1ng h\u00e0m d\u01b0\u1edbi, c\u01a1 m\u00f4i c\u1eb1m v\u00e0 m\u1ed9t s\u1ed1 c\u00e1c y\u1ebfu t\u1ed1 kh\u00e1c n\u00ean \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 k\u1ef9 tr\u01b0\u1edbc khi quy\u1ebft \u0111\u1ecbnh nh\u1ed5 R8.<\/p>\n<p>\u0110a s\u1ed1 c\u00e1c tr\u01b0\u1eddng h\u1ee3p, nh\u1ed5 R8 kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng \u1edf b\u1ec7nh nh\u00e2n nh\u1ecf h\u01a1n 16 tu\u1ed5i th\u00ec kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o. N\u00ean \u0111\u00e1nh gi\u00e1 m\u1ed9t c\u00e1ch to\u00e0n di\u1ec7n \u0111\u1ec3 ti\u00ean l\u01b0\u1ee3ng s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a b\u1ec7nh nh\u00e2n sau n\u00e0y.<\/p>\n<p><em>Ngu\u1ed3n:\u00a0Korbendau, J. M., &amp; Korbendau, X. (2019).\u00a0Clinical success in impacted third molar extraction. Quintessence International Editeur.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>B\u00e0i vi\u1ebft n\u00e0y n\u00f3i v\u1ec1 \u0111\u1eb7c \u0111i\u1ec3m nguy\u00ean nh\u00e2n v\u00e0 th\u1eddi \u0111i\u1ec3m ch\u1ec9 \u0111\u1ecbnh n\u00ean nh\u1ed5 r\u0103ng kh\u00f4n cho b\u1ec7nh nh\u00e2n. Nha s\u0129 c\u1ea7n n\u1eafm r\u00f5 c\u00e1c v\u1ea5n \u0111\u1ec1 li\u00ean quan \u0111\u1ebfn qu\u00e1 tr\u00ecnh m\u1ecdc r\u0103ng, m\u00f4 ph\u00f4i h\u1ecdc, ti\u00ean l\u01b0\u1ee3ng s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a r\u0103ng kh\u00f4n\/tr\u1ee5c r\u0103ng kh\u00f4n v\u00e0 \u0111\u1eb7c bi\u1ec7t nh\u1eefng ch\u1ec9 \u0111\u1ecbnh [&hellip;]<\/p>\n","protected":false},"author":21,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[28,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Nh\u1ed5 r\u0103ng kh\u00f4n - Nguy\u00ean nh\u00e2n v\u00e0 th\u1eddi \u0111i\u1ec3m. - Vinmec<\/title>\n<meta name=\"description\" content=\"B\u00e0i vi\u1ebft n\u00e0y n\u00f3i v\u1ec1 \u0111\u1eb7c \u0111i\u1ec3m nguy\u00ean nh\u00e2n v\u00e0 th\u1eddi \u0111i\u1ec3m ch\u1ec9 \u0111\u1ecbnh n\u00ean nh\u1ed5 r\u0103ng kh\u00f4n cho b\u1ec7nh nh\u00e2n. 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