{"id":22304,"date":"2023-04-16T15:02:24","date_gmt":"2023-04-16T08:02:24","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=22304"},"modified":"2023-05-02T14:27:05","modified_gmt":"2023-05-02T07:27:05","slug":"cac-phuong-phap-de-xac-dinh-tuong-quan-tam","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/16\/cac-phuong-phap-de-xac-dinh-tuong-quan-tam\/","title":{"rendered":"C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh t\u01b0\u01a1ng quan t\u00e2m."},"content":{"rendered":"

C\u00f3 nhi\u1ec1u ph\u01b0\u01a1ng ph\u00e1p c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng c\u00f3 hi\u1ec7u qu\u1ea3 mi\u1ec5n l\u00e0 c\u00e1c nh\u00e0 l\u00e2m s\u00e0ng hi\u1ec3u \u0111\u01b0\u1ee3c m\u1ee5c \u0111\u00edch c\u1ee7a vi\u1ec7c c\u1ea3 hai l\u1ed3i c\u1ea7u \u0111\u1ec1u n\u1eb1m ho\u00e0n to\u00e0n trong \u1ed5 kh\u1edbp v\u00e0 b\u00f3 d\u01b0\u1edbi c\u01a1 ch\u00e2n b\u01b0\u1edbm ngo\u00e0i ho\u00e0n to\u00e0n gi\u00e3n. B\u00e0i vi\u1ebft sau n\u00eau ra c\u00e1c ph\u01b0\u01a1ng ph\u00e1p v\u00e0 \u1ee9ng d\u1ee5ng ch\u00fang trong vi\u1ec7c x\u00e1c \u0111\u1ecbnh t\u01b0\u01a1ng quan t\u00e2m\/t\u00e2m th\u00edch nghi.<\/strong><\/p>\n

1. K\u1ef9 thu\u1eadt hai tay trong x\u00e1c \u0111\u1ecbnh t\u01b0\u01a1ng quan t\u00e2m<\/h2>\n

K\u0129 thu\u1eadt hai tay kh\u00f4ng ph\u1ea3i l\u00e0 ph\u01b0\u01a1ng ph\u00e1p duy nh\u1ea5t \u0111\u1ec3 \u0111\u01b0a h\u00e0m d\u01b0\u1edbi v\u1ec1 v\u1ecb tr\u00ed t\u01b0\u01a1ng quan t\u00e2m. Nh\u01b0ng trong c\u00e1c nghi\u00ean c\u1ee9u c\u1ee7a ch\u00fang t\u00f4i v\u1edbi h\u01a1n 3000 b\u00e1o c\u00e1o c\u1ee7a c\u00e1c nha s\u0129 \u0111\u1ec1u nh\u1eadn th\u1ea5y r\u1eb1ng \u0111\u00f3 l\u00e0 ph\u01b0\u01a1ng ph\u00e1p ch\u00ednh x\u00e1c nh\u1ea5t v\u00e0 kh\u1ea3 n\u0103ng l\u1eb7p l\u1ea1i cao nh\u1ea5t. M\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u c\u1ee7a c\u00e1c tr\u01b0\u1eddng \u0111\u1ea1i h\u1ecdc c\u0169ng c\u00f4ng nh\u1eadn \u0111i\u1ec1u n\u00e0y. V\u00ec th\u1ebf, l\u00fd do \u0111\u1ea7u ti\u00ean \u0111\u1ec3 s\u1eed d\u1ee5ng k\u1ef9 thu\u1eadt n\u00e0y ch\u00ednh l\u00e0 \u0111\u1ed9 ch\u00ednh x\u00e1c c\u1ee7a k\u1ef9 thu\u1eadt.<\/p>\n

K\u0129 thu\u1eadt hai tay \u0111\u1ea1t \u0111\u01b0\u1ee3c v\u1ecb tr\u00ed sinh l\u00fd nh\u1ea5t v\u00e0 s\u1ef1 th\u1eb3ng h\u00e0ng c\u1ee7a ph\u1ee9c h\u1ee3p l\u1ed3i c\u1ea7u \u0111\u0129a kh\u1edbp. Gilboe 3 nghi\u00ean c\u1ee9u s\u1ef1 s\u1eafp x\u1ebfp c\u1ee7a l\u1ed3i c\u1ea7u v\u00e0 \u0111\u0129a kh\u1edbp b\u1eb1ng vi\u1ec7c s\u1eed d\u1ee5ng ch\u1ee5p c\u1eaft l\u1edbp l\u1ed3i c\u1ea7u (arthrotomography), \u00f4ng \u0111\u00e3 li\u00ean k\u1ebft \u0111\u01b0\u1ee3c v\u1ecb tr\u00ed v\u00e0 s\u1ef1 s\u1eafp x\u1ebfp c\u1ee7a l\u1ed3i c\u1ea7u v\u00e0 \u0111\u0129a kh\u1edbp t\u1edbi m\u1ed9t v\u1ecb tr\u00ed kh\u1edbp t\u1ed1i \u01b0u. Sau \u0111\u00f3, \u00f4ng so s\u00e1nh v\u1ecb tr\u00ed t\u1ed1i \u01b0u v\u00e0 s\u1ef1 s\u1eafp x\u1ebfp \u0111\u00f3 v\u1edbi nh\u1eefng k\u1ebft qu\u1ea3 \u0111\u1ea1t \u0111\u01b0\u1ee3c b\u1eb1ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p kh\u00e1c nhau trong vi\u1ec7c ghi t\u01b0\u01a1ng quan t\u00e2m. \u00d4ng th\u1ea5y r\u1eb1ng k\u0129 thu\u1eadt hai tay c\u00f3 t\u00e1c \u0111\u1ed9ng c\u00f3 l\u1ee3i tr\u00ean tr\u01b0\u1eddng h\u1ee3p \u0111\u0129a kh\u1edbp b\u1ecb di d\u1eddi nh\u1eb9 trong khi h\u01b0\u1edbng d\u1eabn c\u1eb1m th\u1ef1c s\u1ef1 di chuy\u1ec3n \u0111\u0129a v\u1ec1 ph\u00eda tr\u01b0\u1edbc nhi\u1ec1u h\u01a1n. Gilboe cho th\u1ea5y l\u00fd do t\u1ea1i sao thao t\u00e1c h\u00e0m d\u01b0\u1edbi m\u1ed9t c\u00e1ch th\u00edch h\u1ee3p c\u00f3 th\u1ec3 \u0111\u1eb7t \u0111\u0129a kh\u1edbp \u1edf v\u1ecb tr\u00ed mong mu\u1ed1n n\u1ebfu sai l\u1ec7ch kh\u00f4ng ph\u1ea3i l\u00e0 qu\u00e1 l\u1edbn: \u201ck\u1ef9 thu\u1eadt hai tay c\u1ee7a Dawson \u0111\u01b0a h\u00e0m d\u01b0\u1edbi v\u1ec1 ph\u00eda sau trong khi \u0111\u1ed3ng th\u1eddi t\u00e1c \u0111\u1ed9ng l\u1ef1c h\u01b0\u1edbng l\u00ean tr\u00ean v\u00e0o l\u1ed3i c\u1ea7u\u201d.<\/p>\n

\"tuong-quan-tam-1\"
Theo Gilboe, 3 \u201c\u00e1p l\u1ef1c truy\u1ec1n qua b\u1ec1 m\u1eb7t l\u1ed3i c\u1ea7u l\u00ean d\u1ea3i ph\u00eda sau \u0111\u00e3 b\u1ecb di d\u1eddi nh\u1eb9 c\u00f3 xu h\u01b0\u1edbng ch\u00e8n \u0111\u0129a kh\u1edbp v\u00e0o v\u1ecb tr\u00ed \u0111\u00fang\u201d<\/figcaption><\/figure>\n

K\u0129 thu\u1eadt hai tay \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c v\u1ecb tr\u00ed cao nh\u1ea5t c\u1ee7a ph\u1ee9c h\u1ee3p l\u1ed3i c\u1ea7u-\u0111\u0129a kh\u1edbp. Williamson b\u00e1o c\u00e1o k\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u t\u1eeb c\u00e1c nghi\u00ean c\u1ee9u h\u00ecnh \u1ea3nh m\u00e0ng (laminographic) \u1ee7ng h\u1ed9 kh\u00e1i ni\u1ec7m n\u00e0y \u201cS\u1ef1 c\u1ea7n thi\u1ebft \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c v\u1ecb tr\u00ed cao nh\u1ea5t c\u1ee7a l\u1ed3i c\u1ea7u tr\u1edf n\u00ean r\u00f5 r\u00e0ng v\u00e0 c\u00f3 xu h\u01b0\u1edbng \u1ee7ng h\u1ed9 gi\u1ea3 thuy\u1ebft c\u1ee7a Dawson: t\u01b0\u01a1ng quan t\u00e2m l\u00e0 khi l\u1ed3i c\u1ea7u \u1edf v\u1ecb tr\u00ed cao nh\u1ea5t trong h\u00f5m kh\u1edbp.<\/p>\n

K\u0129 thu\u1eadt hai tay cung c\u1ea5p m\u1ed9t ki\u1ec3m tra nhanh v\u1ec1:<\/em><\/p>\n

1. T\u00ednh ch\u00ednh x\u00e1c c\u1ee7a v\u1ecb tr\u00ed n\u00e0y.<\/strong><\/p>\n

2. S\u1ef1 s\u1eafp x\u1ebfp c\u1ee7a ph\u1ee9c h\u1ee3p l\u1ed3i c\u1ea7u \u0111\u0129a kh\u1edbp.<\/strong><\/p>\n

3. T\u00ednh to\u00e0n v\u1eb9n c\u1ee7a c\u00e1c di\u1ec7n kh\u1edbp.<\/strong><\/p>\n

\u0110\u00e2y l\u00e0 s\u1ef1 kh\u00e1c bi\u1ec7t quan tr\u1ecdng nh\u1ea5t gi\u1eefa k\u0129 thu\u1eadt hai tay v\u1edbi c\u00e1c ph\u01b0\u01a1ng ph\u00e1p x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed h\u00e0m kh\u00e1c. Kh\u1ea3 n\u0103ng t\u00e1c \u0111\u1ed9ng \u00e1p l\u1ef1c m\u1ea1nh h\u01b0\u1edbng l\u00ean tr\u00ean qua l\u1ed3i c\u1ea7u trong khi r\u0103ng kh\u00f4ng ch\u1ea1m nhau l\u00e0 ch\u00eca kho\u00e1 \u0111\u1ec3 ki\u1ec3m tra kh\u1edbp \u0111\u00e3 ho\u00e0n to\u00e0n v\u00e0o v\u1ecb tr\u00ed. \u0110\u00e2y c\u0169ng l\u00e0 m\u1ed9t b\u01b0\u1edbc quan tr\u1ecdng trong qu\u00e1 tr\u00ecnh x\u00e1c \u0111\u1ecbnh li\u1ec7u c\u00f3 c\u00e1c b\u1ec7nh l\u00fd c\u1ea5u tr\u00fac b\u00ean trong bao kh\u1edbp.<\/p>\n

K\u0129 thu\u1eadt hai tay c\u00f3 \u01b0u \u0111i\u1ec3m l\u00e0 nhanh ch\u00f3ng v\u00e0 \u0111\u01a1n gi\u1ea3n. Khi k\u1ef9 thu\u1eadt n\u00e0y \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n ch\u00ednh x\u00e1c, v\u1ecb tr\u00ed t\u01b0\u01a1ng quan t\u00e2m c\u00f3 th\u1ec3 th\u01b0\u1eddng xuy\u00ean \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y v\u00e0 x\u00e1c nh\u1eadn trong m\u1ed9t v\u00e0i gi\u00e2y. T\u1ea5t nhi\u00ean, k\u1ef9 thu\u1eadt n\u00e0y ph\u1ea3i \u0111\u01b0\u1ee3c h\u1ecdc v\u00e0 luy\u1ec7n t\u1eadp th\u00e0nh th\u1ea1o \u0111\u1ec3 c\u00f3 \u0111\u01b0\u1ee3c k\u1ebft qu\u1ea3 \u0111\u00e1ng tin c\u1eady, c\u0169ng nh\u01b0 t\u1ea5t c\u1ea3 c\u00e1c k\u1ef9 thu\u1eadt kh\u00e1c. B\u1edfi v\u00ec t\u01b0\u01a1ng quan h\u00e0m-h\u00e0m ch\u00ednh x\u00e1c r\u1ea5t quan tr\u1ecdng v\u1edbi c\u1eafn kh\u1edbp, bao g\u1ed3m s\u1ef1 l\u1eb7p l\u1ea1i c\u1ee7a nh\u1eefng sai l\u1ec7ch t\u01b0\u01a1ng quan t\u00e2m trong su\u1ed1t qu\u00e1 tr\u00ecnh c\u00e2n b\u1eb1ng hay ch\u1ec9 l\u00e0 \u0111i\u1ec1u ch\u1ec9nh kh\u1edbp c\u1eafn \u0111\u01a1n gi\u1ea3n sau c\u00e1c th\u1ee7 thu\u1eadt trong mi\u1ec7ng, vi\u1ec7c x\u00e1c \u0111\u1ecbnh t\u01b0\u01a1ng quan t\u00e2m l\u00e0 m\u1ed9t th\u1ee7 thu\u1eadt quan tr\u1ecdng m\u00e0 c\u00e1c nha s\u0129 c\u1ea7n bi\u1ebft. Khi \u0111\u00e3 l\u00e0m t\u1ed1t k\u0129 thu\u1eadt n\u00e0y, c\u00e1c nh\u00e0 l\u00e2m s\u00e0ng c\u00f3 kh\u1ea3 n\u0103ng ki\u1ec3m so\u00e1t chuy\u1ec3n \u0111\u1ed9ng c\u1ee7a h\u00e0m. Trong h\u1ea7u h\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p, n\u00f3 gi\u00fap lo\u1ea1i b\u1ecf nhu c\u1ea7u th\u1ef1c hi\u1ec7n c\u00e1c th\u1ee7 thu\u1eadt kh\u00f4ng c\u1ea7n thi\u1ebft nh\u01b0 \u0111i\u1ec1u ch\u1ec9nh kh\u1edbp c\u1eafn ho\u1eb7c ch\u1ec9nh l\u1ea1i v\u1ecb tr\u00ed v\u00e0 g\u1ea7n nh\u01b0 ho\u00e0n to\u00e0n lo\u1ea1i b\u1ecf nhu c\u1ea7u s\u1eed d\u1ee5ng thu\u1ed1c \u0111\u1ec3 l\u00e0m gi\u1ea3m c\u00e1c ho\u1ea1t \u0111\u1ed9ng c\u01a1.<\/p>\n

2. Mi\u1ebfng ch\u1eb7n r\u0103ng c\u1eeda<\/h2>\n

2.1. C\u00e1c d\u1ea1ng mi\u1ebfng ch\u1eb7n r\u0103ng c\u1eeda<\/h3>\n

Thi\u1ebft b\u1ecb x\u00f3a chu tr\u00ecnh c\u1eafn ph\u00eda tr\u01b0\u1edbc \u0111\u01b0\u1ee3c ch\u1ebf t\u1ea1o tr\u1ef1c ti\u1ebfp<\/strong><\/p>\n

Thi\u1ebft b\u1ecb xo\u00e1 chu tr\u00ecnh c\u1eafn \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c ch\u1ebf t\u1ea1o m\u1ed9t c\u00e1ch tr\u1ef1c ti\u1ebfp, b\u1eb1ng vi\u1ec7c \u0111\u1ed5 nh\u1ef1a acrylic t\u1ef1 c\u1ee9ng kh\u1edbp v\u1edbi r\u00eca c\u1eafn c\u1ee7a r\u0103ng c\u1eeda tr\u00ean.<\/p>\n

\"tuong-quan-tam-2\"
Thi\u1ebft b\u1ecb x\u00f3a chu tr\u00ecnh c\u1eafn \u0111\u01b0\u1ee3c ch\u1ebf t\u1ea1o tr\u1ef1c ti\u1ebfp<\/figcaption><\/figure>\n

Trong giai \u0111o\u1ea1n nh\u00e3o, h\u00e0m d\u01b0\u1edbi \u0111\u01b0\u1ee3c \u0111\u01b0a v\u1ec1 v\u1ecb tr\u00ed t\u01b0\u01a1ng quan t\u00e2m. H\u00e0m d\u01b0\u1edbi \u0111\u00f3ng l\u1ea1i \u0111\u1ec3 r\u0103ng c\u1eeda d\u01b0\u1edbi c\u1eafn v\u00e0o nh\u1ef1a acrylic nh\u01b0ng kh\u00f4ng \u0111\u00f3ng ho\u00e0n to\u00e0n \u0111\u1ec3 c\u00e1c r\u0103ng sau kh\u00f4ng ch\u1ea1m nhau. Sau khi nh\u1ef1a c\u1ee9ng l\u1ea1i, b\u1ec1 m\u1eb7t r\u0103ng ti\u1ebfp x\u00fac \u0111\u01b0\u1ee3c l\u00e0m ph\u1eb3ng \u0111\u1ec3 t\u1ea1o th\u00e0nh m\u1ed9t b\u1ec1 m\u1eb7t nh\u1eb5n ph\u1eb3ng cho ph\u00e9p h\u00e0m d\u01b0\u1edbi ho\u00e0n to\u00e0n di chuy\u1ec3n \u0111\u01b0\u1ee3c theo chi\u1ec1u ngang. N\u1ebfu TMJs kh\u00f4ng b\u1ecb t\u1ed5n th\u01b0\u01a1ng v\u00e0 c\u01a1 ch\u00e2n b\u01b0\u1edbm ngo\u00e0i ho\u00e0n to\u00e0n kh\u00f4ng co, b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 \u00e9p ch\u1eb7t \u0111\u1ec3 gi\u1eef l\u1ed3i c\u1ea7u \u1edf t\u01b0\u01a1ng quan t\u00e2m trong khi v\u1eadt li\u1ec7u c\u1eafn \u0111\u00f4ng c\u1ee9ng nhanh \u0111\u01b0\u1ee3c b\u01a1m v\u00e0o gi\u1eefa c\u00e1c r\u0103ng sau. C\u00e1c thi\u1ebft b\u1ecb \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng sau n\u00e0y c\u00f3 ki\u1ec3u thi\u1ebft k\u1ebf gi\u1ed1ng nh\u01b0 thi\u1ebft b\u1ecb \u0111\u1ea7u ti\u00ean n\u00e0y. Ch\u00fang \u0111\u1ec1u ho\u1ea1t \u0111\u1ed9ng theo c\u00e1ch gi\u1ed1ng nhau \u0111\u00f3 l\u00e0 ng\u0103n c\u00e1c r\u0103ng sau ch\u1ea1m nhau \u0111\u1ec3 l\u1ed3i c\u1ea7u c\u00f3 th\u1ec3 ho\u00e0n to\u00e0n n\u1eb1m trong v\u1ecb tr\u00ed t\u01b0\u01a1ng quan t\u00e2m. M\u1eb7c d\u00f9 m\u1ed9t lo\u1ea1t c\u00e1c thi\u1ebft b\u1ecb \u0111\u01b0\u1ee3c t\u1ea1o ra cho m\u1ee5c \u0111\u00edch th\u01b0\u01a1ng m\u1ea1i, kh\u00f4ng thi\u1ebft b\u1ecb n\u00e0o c\u00f3 th\u1ec3 kh\u1eb3ng \u0111\u1ecbnh t\u00ednh \u01b0u vi\u1ec7t h\u01a1n c\u00e1c thi\u1ebft b\u1ecb kh\u00e1c.<\/p>\n

Pankey Jig<\/strong><\/p>\n

Pankey jig \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf nhi\u1ec1u n\u0103m tr\u01b0\u1edbc \u0111\u00e2y b\u1edfi Ti\u1ebfn s\u0129 Keith Thornton.<\/p>\n

\"tuong-quan-tam-3\"
Pankey Jig<\/figcaption><\/figure>\n

N\u00f3 kh\u00f4ng \u0111\u1eaft v\u00e0 d\u1ec5 s\u1eed d\u1ee5ng. N\u00f3 g\u1eafn v\u1edbi c\u00e1c r\u0103ng c\u1eeda h\u00e0m tr\u00ean v\u1edbi nh\u1ef1a t\u1ef1 c\u1ee9ng ho\u1eb7c b\u1ea5t k\u00ec v\u1eadt li\u1ec7u t\u1ef1 c\u1ee9ng n\u00e0o kh\u00e1c. C\u00e1c r\u0103ng h\u00e0m d\u01b0\u1edbi tr\u01b0\u1ee3t t\u1ef1 do tr\u00ean m\u1ed9t b\u1ec1 m\u1eb7t ph\u1eb3ng \u0111\u1ec3 gi\u00fap l\u1ed3i c\u1ea7u chuy\u1ec3n \u0111\u1ed9ng v\u1ec1 t\u01b0\u01a1ng quan t\u00e2m m\u00e0 kh\u00f4ng b\u1ecb c\u1ea3n tr\u1edf.<\/p>\n

Kh\u00ed c\u1ee5 Best-bite<\/strong><\/p>\n

Kh\u00ed c\u1ee5 Best-bite ho\u1ea1t \u0111\u1ed9ng t\u01b0\u01a1ng t\u1ef1 nh\u01b0 Pankey jig.<\/p>\n

\"\"
Kh\u00ed c\u1ee5 Best-bite<\/figcaption><\/figure>\n

N\u00f3 g\u1ed3m m\u1ed9t b\u1ed9 kit v\u1edbi v\u1eadt li\u1ec7u c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c b\u01a1m v\u00e0o \u0111\u1ec3 c\u1ed1 \u0111\u1ecbnh kh\u00ed c\u1ee5. M\u1ed9t cu\u1ed1n s\u00e1ch c\u1ee7a Ti\u1ebfn s\u0129 Jerry Simons c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 gi\u1ea3i th\u00edch cho b\u1ec7nh nh\u00e2n hi\u1ec3u v\u1ec1 m\u1ed1i li\u00ean quan gi\u1eefa c\u1ea3n tr\u1edf kh\u1edbp c\u1eafn v\u1edbi \u0111au TMJ v\u00e0 \u0111au \u0111\u1ea7u.<\/p>\n

Lucia Jig<\/strong><\/p>\n

Lucia jig c\u0169ng ho\u1ea1t \u0111\u1ed9ng gi\u1ed1ng nh\u01b0 c\u00e1c \u0111i\u1ec3m ch\u1eb7n r\u0103ng c\u1eeda kh\u00e1c.<\/p>\n

\"tuong-quan-tam-4\"
Lucia-jig<\/figcaption><\/figure>\n

Lucia l\u00e0 m\u1ed9t trong nh\u1eefng ng\u01b0\u1eddi \u0111\u1ea7u ti\u00ean s\u1eed d\u1ee5ng \u0111i\u1ec3m ch\u1eb7n r\u0103ng c\u1eeda. Thi\u1ebft k\u1ebf ban \u0111\u1ea7u c\u1ee7a \u00f4ng \u0111\u00e3 \u0111\u01b0\u1ee3c l\u00e0m nghi\u00eang \u0111\u1ec3 h\u01b0\u1edbng c\u00e1c l\u1ed3i c\u1ea7u v\u1ec1 ph\u00eda xa d\u1ef1a tr\u00ean quan ni\u1ec7m sai l\u1ea7m ban \u0111\u1ea7u l\u00e0 t\u01b0\u01a1ng quan t\u00e2m \u1edf v\u1ecb tr\u00ed \u201csau nh\u1ea5t\u201d. Jig \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eeda \u0111\u1ed5i \u0111\u1ea7u ti\u00ean b\u1edfi Ti\u1ebfn s\u0129 Peter Neff \u0111\u1ec3 cho ph\u00e9p l\u1ed3i c\u1ea7u chuy\u1ec3n \u0111\u1ed9ng cao nh\u1ea5t m\u00e0 kh\u00f4ng b\u1ecb \u1ea3nh h\u01b0\u1edfng v\u1ec1 ph\u00eda xa.<\/p>\n

NTI (\u1ee8c ch\u1ebf c\u1ea3m th\u1ee5 \u0111au c\u1ee7a d\u00e2y V)<\/strong><\/p>\n

Thi\u1ebft b\u1ecb NTI \u0111\u00e3 \u0111\u01b0\u1ee3c qu\u1ea3ng c\u00e1o r\u1ea5t nhi\u1ec1u l\u00e0 m\u1ed9t thi\u1ebft b\u1ecb \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ch\u1ee9ng \u0111au n\u1eeda \u0111\u1ea7u v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 \u0111au m\u1eb7t kh\u00e1c.<\/p>\n

\"\"
C\u00e1c d\u1ea1ng thi\u1ebft b\u1ecb NTI<\/figcaption><\/figure>\n

Trong th\u1ef1c t\u1ebf, n\u00f3 kh\u00f4ng h\u01a1n c\u0169ng kh\u00f4ng k\u00e9m h\u01a1n b\u1ea5t k\u1ef3 mi\u1ebfng ch\u1eb7n r\u0103ng c\u1eeda kh\u00e1c. N\u00f3 ho\u1ea1t \u0111\u1ed9ng ch\u00ednh x\u00e1c nh\u01b0 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p kh\u00e1c \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 \u1edf tr\u00ean. N\u1ebfu nguy\u00ean nh\u00e2n c\u1ee7a \u0111au h\u1ec7 th\u1ed1ng nhai v\u00e0 nh\u1ee9c \u0111\u1ea7u l\u00e0 m\u1ed9t r\u1ed1i lo\u1ea1n c\u01a1-kh\u1edbp c\u1eafn (th\u01b0\u1eddng g\u1eb7p) th\u00ec s\u1ef1 nh\u1ea3 kh\u1edbp c\u00e1c r\u0103ng sau, v\u1ecb tr\u00ed \u0111\u00fang c\u1ee7a TMJs v\u00e0 gi\u00e3n b\u00f3 d\u01b0\u1edbi c\u01a1 ch\u00e2n b\u01b0\u1edbm ngo\u00e0i s\u1ebd \u0111\u01b0a \u0111\u1ebfn v\u1ecb tr\u00ed t\u01b0\u01a1ng quan t\u00e2m v\u00e0 gi\u00fap gi\u1ea3m \u0111au bao g\u1ed3m c\u1ea3 \u0111au \u0111\u1ea7u. N\u1ebfu c\u00e1c b\u1ec7nh l\u00fd trong bao kh\u1edbp l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y ra \u0111au, th\u00ec kh\u00f4ng m\u1ed9t thi\u1ebft b\u1ecb n\u00e0o c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m \u0111au ho\u00e0n to\u00e0n, c\u0169ng nh\u01b0 c\u00f3 th\u1ec3 \u0111\u01b0a v\u1ec1 \u0111\u01b0\u1ee3c v\u1ecb tr\u00ed t\u01b0\u01a1ng quan t\u00e2m \u0111\u00fang. Th\u1eadt ra, n\u1ebfu nh\u01b0 c\u00f3 r\u1ed1i lo\u1ea1n trong bao kh\u1edbp th\u00ec vi\u1ec7c s\u1eed d\u1ee5ng c\u00e1c kh\u00ed c\u1ee5 n\u00e0y c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn s\u1ef1 nguy hi\u1ec3m, khi n\u00f3 c\u00f3 th\u1ec3 t\u1ea1o ra s\u1ef1 qu\u00e1 t\u1ea3i l\u1ef1c l\u00ean c\u00e1c m\u00f4 kh\u00f4ng \u0111\u00fang v\u1ecb tr\u00ed \u0111ang b\u1ecb \u0111au.<\/p>\n

Th\u01b0\u1edbc l\u00e1<\/strong><\/p>\n

Th\u01b0\u1edbc l\u00e1 l\u00e0 m\u1ed9t trong nh\u1eefng kh\u00ed c\u1ee5 ph\u1ed5 bi\u1ebfn trong vi\u1ec7c x\u00e1c \u0111\u1ecbnh t\u01b0\u01a1ng quan t\u00e2m, \u0111\u01b0\u1ee3c gi\u1edbi thi\u1ec7u b\u1edfi Ti\u1ebfn s\u0129 Hart Long nhi\u1ec1u n\u0103m tr\u01b0\u1edbc \u0111\u00e2y.<\/p>\n

\"\"
Th\u01b0\u1edbc l\u00e1<\/figcaption><\/figure>\n

Thi\u1ebft b\u1ecb n\u00e0y l\u00e0 m\u1ed9t l\u00e1 g\u1ed3m nhi\u1ec1u l\u1edbp polyester linh ho\u1ea1t c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh \u0111\u1ec3 c\u00f3 \u0111\u1ed9 d\u00e0y kh\u00e1c nhau. Nguy\u00ean t\u1eafc l\u00e0 t\u00e1ch c\u00e1c r\u0103ng h\u00e0m b\u1eb1ng c\u00e1ch \u0111\u1eb7t th\u01b0\u1edbc l\u00e1 gi\u1eefa c\u00e1c r\u0103ng ph\u00eda tr\u01b0\u1edbc. V\u1eadt li\u1ec7u n\u00e0y m\u1ec1m v\u00e0 tr\u01a1n n\u00ean n\u00f3 cho ph\u00e9p h\u00e0m d\u01b0\u1edbi di chuy\u1ec3n ngang khi l\u1ed3i c\u1ea7u v\u1ec1 \u0111\u00fang v\u1ecb tr\u00ed. N\u00f3 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u01b0 m\u1ed9t thi\u1ebft b\u1ecb xo\u00e1 chu tr\u00ecnh \u0111\u1ec3 lo\u1ea1i b\u1ecf s\u1ef1 co c\u1ee7a c\u01a1 ch\u00e2n b\u01b0\u1edbm ngo\u00e0i. Sau khi t\u01b0\u01a1ng quan t\u00e2m \u0111\u01b0\u1ee3c kh\u1eb3ng \u0111\u1ecbnh (b\u1eb1ng load testing), c\u00e1c l\u1edbp c\u1ee7a th\u01b0\u1edbc l\u00e1 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c g\u1ee1 b\u1ecf cho \u0111\u1ebfn khi r\u0103ng \u0111\u1ea7u ti\u00ean ch\u1ea1m nhau.<\/p>\n

L\u01b0u \u00fd: T\u1ea5t c\u1ea3 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p tr\u00ean \u0111\u1ec1u c\u00f3 gi\u00e1 tr\u1ecb n\u1ebfu \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng v\u1edbi m\u1ee5c \u0111\u00edch \u0111\u01b0a l\u1ed3i c\u1ea7u v\u1ec1 v\u1ecb tr\u00ed cao nh\u1ea5t. T\u1ea5t c\u1ea3 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111\u00f2i h\u1ecfi s\u1eed d\u1ee5ng m\u1ed9t v\u1eadt li\u1ec7u ch\u00ednh x\u00e1c \u0111\u1ec3 ghi l\u1ea1i m\u1ed1i quan h\u1ec7 gi\u1eefa c\u00e1c r\u0103ng sau, khi c\u00e1c r\u0103ng tr\u01b0\u1edbc ng\u0103n c\u1ea3n c\u00e1c r\u0103ng sau ti\u1ebfp x\u00fac nhai. C\u00e1ch l\u00fd t\u01b0\u1edfng \u0111\u1ec3 s\u1eed d\u1ee5ng mi\u1ebfng ch\u1eb7n r\u0103ng c\u1eeda l\u00e0 k\u1ebft h\u1ee3p kh\u1ea3 n\u0103ng xo\u00e1 chu tr\u00ecnh nhai c\u1ee7a n\u00f3 v\u1edbi load testing sau khi \u0111\u1ea1t \u0111\u01b0\u1ee3c t\u01b0\u01a1ng quan t\u00e2m. Sau khi t\u01b0\u01a1ng quan t\u00e2m \u0111\u00e3 \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh, b\u1ec7nh nh\u00e2n c\u1ea7n c\u1eafn ch\u1eb7t r\u0103ng \u0111\u1ec3 gi\u1eef cho l\u1ed3i c\u1ea7u n\u1eb1m ho\u00e0n to\u00e0n trong v\u1ecb tr\u00ed \u0111\u00fang trong khi v\u1eadt li\u1ec7u ghi d\u1ea5u c\u1eafn \u0111\u01b0\u1ee3c b\u01a1m v\u00e0o v\u00e0 \u0111\u00f4ng c\u1ee9ng. Vi\u1ec7c c\u1ea7n \u01b0u ti\u00ean l\u00e0 duy tr\u00ec v\u1ecb tr\u00ed l\u1ed3i c\u1ea7u \u1edf c\u1ea3 hai b\u00ean \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o r\u1eb1ng kh\u00f4ng c\u00f3 chuy\u1ec3n \u0111\u1ed9ng n\u00e0o c\u1ee7a kh\u1edbp x\u1ea3y ra \u1edf v\u1ecb tr\u00ed t\u01b0\u01a1ng quan t\u00e2m cho \u0111\u1ebfn khi v\u1eadt li\u1ec7u ghi d\u1ea5u \u0111\u00f4ng l\u1ea1i.<\/em><\/p>\n

2.2. Nh\u01b0\u1ee3c \u0111i\u1ec3m c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p n\u00e0y trong vi\u1ec7c x\u00e1c \u0111\u1ecbnh t\u01b0\u01a1ng quan t\u00e2m<\/h3>\n

Gi\u00e1 tr\u1ecb c\u1ee7a mi\u1ebfng ch\u1eb7n r\u0103ng c\u1eeda ch\u1ee7 y\u1ebfu l\u00e0 \u1edf kh\u1eed chu tr\u00ecnh ho\u1ea1t \u0111\u1ed9ng c\u1ee7a c\u01a1. C\u00e1c thi\u1ebft b\u1ecb l\u00e0m \u0111i\u1ec1u n\u00e0y b\u1eb1ng c\u00e1ch t\u00e1ch r\u0103ng h\u00e0m ph\u00eda sau \u0111\u1ec3 c\u00e1c \u0111i\u1ec3m ch\u1ea1m ph\u00eda sau kh\u00f4ng k\u00edch th\u00edch c\u01a1 g\u00e2y di chuy\u1ec3n v\u1ecb tr\u00ed c\u1ee7a l\u1ed3i c\u1ea7u. Do \u0111\u00f3 ch\u00fang l\u00e0 nh\u1eefng c\u00f4ng c\u1ee5 tuy\u1ec7t v\u1eddi \u0111\u1ec3 t\u00ecm v\u00e0 x\u00e1c \u0111\u1ecbnh t\u01b0\u01a1ng quan t\u00e2m. Nhi\u1ec1u nha s\u0129 th\u00edch s\u1eed d\u1ee5ng mi\u1ebfng ch\u1eb7n r\u0103ng c\u1eeda nh\u01b0 l\u00e0 m\u1ed9t b\u01b0\u1edbc th\u00f4ng th\u01b0\u1eddng trong vi\u1ec7c \u0111\u1ecbnh v\u1ecb t\u01b0\u01a1ng quan t\u00e2m. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 ch\u1ea5p nh\u1eadn \u0111\u01b0\u1ee3c, nh\u01b0ng s\u1eed d\u1ee5ng mi\u1ebfng ch\u1eb7n r\u0103ng c\u1eeda kh\u00f4ng lo\u1ea1i b\u1ecf \u0111\u01b0\u1ee3c s\u1ef1 c\u1ea7n thi\u1ebft hay nhu c\u1ea7u c\u1ee7a vi\u1ec7c th\u1ef1c hi\u1ec7n k\u0129 thu\u1eadt hai tay ch\u00ednh x\u00e1c.<\/p>\n

\"\"
C\u1ea3nh b\u00e1o: Mi\u1ebfng ch\u1eb7n r\u0103ng c\u1eeda tr\u01b0\u1edbc kh\u00f4ng \u0111\u00fang (A) c\u00f3 th\u1ec3 thay \u0111\u1ed5i v\u1ecb tr\u00ed l\u1ed3i c\u1ea7u v\u1ec1 ph\u00eda xa. T\u01b0\u01a1ng t\u1ef1 nh\u01b0 v\u1eady, th\u01b0\u1edbc l\u00e1 (B) c\u00f3 th\u1ec3 \u0111\u1ea9y c\u00e1c l\u1ed3i c\u1ea7u v\u1ec1 ph\u00eda xa n\u1ebfu \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng v\u1edbi s\u1ef1 co m\u1ea1nh c\u1ee7a c\u00e1c c\u01a1 n\u00e2ng h\u00e0m k\u1ebft h\u1ee3p v\u1edbi m\u1ed9t \u0111\u1ed9 c\u1eafn s\u00e2u l\u1edbn v\u00e0 d\u1ed1c.<\/figcaption><\/figure>\n
    \n
  • Trong th\u1ee7 thu\u1eadt t\u00ecm s\u1ef1 c\u00e2n b\u1eb1ng, b\u1ea1n kh\u00f4ng th\u1ec3 \u0111\u00e1nh d\u1ea5u v\u1ecb tr\u00ed c\u1ea3n tr\u1edf kh\u1edbp c\u1eafn khi mi\u1ebfng ch\u1eb7n r\u0103ng c\u1eeda \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u1eb7t v\u00e0o. K\u0129 thu\u1eadt hai tay \u0111\u1ea3m b\u1ea3o cho v\u1ecb tr\u00ed l\u1ed3i c\u1ea7u ch\u00ednh x\u00e1c trong su\u1ed1t \u0111\u01b0\u1eddng chuy\u1ec3n \u0111\u1ed9ng t\u1edbi ti\u1ebfp x\u00fac r\u0103ng.<\/li>\n
  • K\u1ec3 c\u1ea3 khi s\u1eed d\u1ee5ng mi\u1ebfng ch\u1eb7n r\u0103ng c\u1eeda, load testing \u0111\u1ec3 ki\u1ec3m tra v\u1ecb tr\u00ed c\u1ee7a t\u01b0\u01a1ng quan t\u00e2m v\u1eabn l\u00e0 c\u00e1ch ch\u1eafc ch\u1eafn duy nh\u1ea5t \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o s\u1ef1 ch\u00ednh x\u00e1c.<\/li>\n
  • Load testing \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n v\u1edbi bi\u00ean \u0111\u1ed9 t\u0103ng d\u1ea7n t\u1eeb nh\u1eb9 \u0111\u1ec3 lo\u1ea1i tr\u1eeb c\u00e1c r\u1ed1i lo\u1ea1n trong bao kh\u1edbp tr\u01b0\u1edbc khi t\u1ea3i l\u1ef1c m\u1ea1nh b\u1edfi c\u00e1c c\u01a1 n\u00e2ng h\u00e0m khi mi\u1ebfng ch\u1eb7n r\u0103ng c\u1eeda \u1edf \u0111\u00fang v\u1ecb tr\u00ed.<\/li>\n
  • K\u0129 thu\u1eadt hai tay v\u1edbi load testing \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 ch\u00ednh x\u00e1c m\u00e0 kh\u00f4ng c\u1ea7n th\u00eam thi\u1ebft b\u1ecb ho\u1eb7c c\u00e1c b\u01b0\u1edbc ph\u1ee5 kh\u00e1c. Tuy nhi\u00ean, n\u1ebfu k\u1ebft h\u1ee3p k\u0129 thu\u1eadt hai tay v\u1edbi m\u1ed9t thi\u1ebft b\u1ecb xo\u00e1 chu tr\u00ecnh r\u0103ng tr\u01b0\u1edbc s\u1ebd c\u00f3 l\u1ee3i h\u01a1n v\u1edbi nh\u00e0 l\u00e2m s\u00e0ng v\u00ec v\u1eady n\u00f3 n\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng.<\/li>\n
  • S\u1eed d\u1ee5ng b\u1ea5t c\u1ee9 \u0111i\u1ec1u g\u00ec \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c \u0111\u1ed9 ch\u00ednh x\u00e1c trong vi\u1ec7c ghi l\u1ea1i t\u01b0\u01a1ng quan t\u00e2m – nh\u01b0ng \u0111\u1ec3 ch\u00ednh x\u00e1c v\u1edbi m\u1ee9c \u0111\u1ed9 hi\u1ec7u qu\u1ea3 cao nh\u1ea5t, b\u1ea1n s\u1ebd th\u1ea5y r\u1eb1ng r\u1ea5t \u0111\u00e1ng \u0111\u1ec3 b\u1ecf th\u1eddi gian v\u00e0 c\u00f4ng s\u1ee9c \u0111\u1ec3 th\u00e0nh th\u1ea1o k\u0129 thu\u1eadt hai tay. \u0110\u00f3 l\u00e0 m\u1ed9t k\u1ef9 n\u0103ng m\u00e0 s\u1ebd \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng tr\u00ean t\u1ea5t c\u1ea3 c\u00e1c b\u1ec7nh nh\u00e2n.<\/li>\n<\/ul>\n

    Theo:<\/p>\n

    1. Kantor ME, Silverman SI, Garfinkel L: Centric relation re- cording techniques: A comparative investigation. J Pros- thet Dent 28:593, 1975.
    \n2. Hobo S, Iwata T: Reproducibility of mandibular centricity in three dimensions. J Prosthet Dent 53:649, 1985.
    \n3. Gilboe D: Centric relation as the treatment position. J Prosthet Dent 50:685-689, 1983.
    \n4. McKee JR: Comparing condylar position repeatability for standardized versus nonstandardized methods of achiev- ing centric relation. J Prosthet Dent 77:280-284, 1997.
    \n5. Roblee R: A comparison of recording methods for centric relation. Thesis at Baylor University, 1989.
    \n6. Lucia VO: A technique for recording centric relation. J Prosthet Dent 14:492, 1964.
    \n7. Long JH Jr: Location of the terminal hinge axis by intra- oral means. J Prosthet Dent 23:11, 1970.
    \n8. Williamson EH: Laminographic study of mandibular condyle position when recording centric relation. J Pros- thet Dent 39:561-564, 1978.<\/p>\n","protected":false},"excerpt":{"rendered":"

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