{"id":26298,"date":"2023-04-21T23:54:05","date_gmt":"2023-04-21T16:54:05","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=26298"},"modified":"2023-05-02T10:13:00","modified_gmt":"2023-05-02T03:13:00","slug":"ki-thuat-mo-trong-dieu-tri-noi-nha-tai-sinh-va-qua-trinh-phat-trien","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/21\/ki-thuat-mo-trong-dieu-tri-noi-nha-tai-sinh-va-qua-trinh-phat-trien\/","title":{"rendered":"N\u1ed9i nha t\u00e1i sinh: Qu\u00e1 tr\u00ecnh ph\u00e1t tri\u1ec3n k\u0129 thu\u1eadt m\u00f4."},"content":{"rendered":"

M\u1ee5c ti\u00eau c\u1ee7a k\u0129 thu\u1eadt n\u1ed9i nha t\u00e1i sinh l\u00e0 tr\u1ea3 l\u1ea1i ch\u1ee9c n\u0103ng b\u00ecnh th\u01b0\u1eddng c\u1ee7a t\u1ee7y r\u0103ng \u1edf nh\u1eefng r\u0103ng ho\u1ea1i t\u1eed, ngh\u0129a l\u00e0 ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng b\u1ea3o v\u1ec7, bao g\u1ed3m kh\u1ea3 n\u0103ng mi\u1ec5n d\u1ecbch b\u1ea9m sinh, s\u1eeda ch\u1eefa th\u00f4ng qua s\u1ef1 kho\u00e1ng h\u00f3a, c\u1ea3m gi\u00e1c \u0111\u01b0\u1ee3c l\u1ef1c nhai v\u00e0 \u0111au. V\u00e0 \u0111i\u1ec1u quan tr\u1ecdng nh\u1ea5t l\u00e0 ph\u00e1t tri\u1ec3n m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ph\u1ee5c h\u1ed3i m\u1edbi kh\u00f4ng ch\u1ec9 gi\u00fap kh\u00f4i ph\u1ee5c s\u1ef1 s\u1ed1ng c\u1ee7a t\u1ee7y m\u00e0 c\u00f2n t\u00e1i t\u1ea1o to\u00e0n b\u1ed9 m\u00f4 h\u1ecdc t\u1ee7y r\u0103ng v\u1edbi t\u1ea5t c\u1ea3 c\u00e1c ch\u1ee9c n\u0103ng sinh l\u00fd ban \u0111\u1ea7u. C\u00f9ng t\u00ecm hi\u1ec3u v\u1ea5n \u0111\u1ec1.<\/strong><\/p>\n

1. M\u1ee5c ti\u00eau c\u1ee7a k\u1ef9 thu\u1eadt m\u00f4 trong n\u1ed9i nha t\u00e1i sinh<\/h2>\n

N\u1ed9i nha t\u00e1i sinh \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 \u201cth\u1ee7 thu\u1eadt \u0111\u01b0\u1ee3c thi\u1ebft l\u1eadp d\u1ef1a tr\u00ean c\u01a1 s\u1edf sinh h\u1ecdc \u0111\u1ec3 thay th\u1ebf c\u1ea5u tr\u00fac m\u00f4 b\u1ecb t\u1ed5n th\u01b0\u01a1ng, bao g\u1ed3m ng\u00e0 r\u0103ng v\u00e0 ch\u00e2n r\u0103ng, c\u0169ng nh\u01b0 c\u00e1c t\u1ebf b\u00e0o c\u1ee7a ph\u1ee9c h\u1ee3p ng\u00e0 \u2013 t\u1ee7y\u201d. M\u1ee5c ti\u00eau quan tr\u1ecdng nh\u1ea5t c\u1ee7a \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha l\u00e0 lo\u1ea1i b\u1ecf c\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng, tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh l\u00fd t\u1ee7y v\u00e0 m\u00f4 quanh ch\u00f3p. M\u1ee5c ti\u00eau c\u1ee7a k\u0129 thu\u1eadt n\u1ed9i nha t\u00e1i sinh l\u00e0 tr\u1ea3 l\u1ea1i ch\u1ee9c n\u0103ng b\u00ecnh th\u01b0\u1eddng c\u1ee7a t\u1ee7y r\u0103ng \u1edf nh\u1eefng r\u0103ng ho\u1ea1i t\u1eed, ngh\u0129a l\u00e0 ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng b\u1ea3o v\u1ec7, bao g\u1ed3m kh\u1ea3 n\u0103ng mi\u1ec5n d\u1ecbch b\u1ea9m sinh, s\u1eeda ch\u1eefa th\u00f4ng qua s\u1ef1 kho\u00e1ng h\u00f3a, c\u1ea3m gi\u00e1c \u0111\u01b0\u1ee3c l\u1ef1c nhai v\u00e0 \u0111au.\u00a0<\/span><\/p>\n

Ph\u1ee5c h\u1ed3i nh\u1eefng ch\u1ee9c n\u0103ng n\u00e0y c\u1ee7a t\u1ee7y r\u0103ng l\u00e0m t\u0103ng kh\u1ea3 n\u0103ng t\u1ed3n t\u1ea1i l\u00e2u d\u00e0i c\u1ee7a r\u0103ng v\u00e0 gi\u00fap b\u1ec7nh nh\u00e2n gi\u1eef l\u1ea1i \u0111\u01b0\u1ee3c b\u1ed9 r\u0103ng t\u1ef1 nhi\u00ean nh\u1ea5t. Do \u0111\u00f3 \u0111i\u1ec1u quan tr\u1ecdng nh\u1ea5t l\u00e0 ph\u00e1t tri\u1ec3n m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ph\u1ee5c h\u1ed3i m\u1edbi kh\u00f4ng ch\u1ec9 gi\u00fap kh\u00f4i ph\u1ee5c s\u1ef1 s\u1ed1ng c\u1ee7a t\u1ee7y m\u00e0 c\u00f2n t\u00e1i t\u1ea1o to\u00e0n b\u1ed9 m\u00f4 h\u1ecdc t\u1ee7y r\u0103ng v\u1edbi t\u1ea5t c\u1ea3 c\u00e1c ch\u1ee9c n\u0103ng sinh l\u00fd ban \u0111\u1ea7u.<\/span><\/p>\n

2. Qu\u00e1 tr\u00ecnh ph\u00e1t tri\u1ec3n c\u1ee7a k\u1ef9 thu\u1eadt.<\/h2>\n

R\u00f5 r\u00e0ng l\u00e0 k\u0129 thu\u1eadt t\u00e1i t\u1ea1o tu\u1ea7n ho\u00e0n b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p kh\u1eed tr\u00f9ng \u1ed1ng t\u1ee7y s\u1eed d\u1ee5ng Ca(OH)2 ho\u1eb7c kem kh\u00e1ng sinh (triple antibiotic paste) \u0111em l\u1ea1i t\u1ec9 l\u1ec7 th\u00e0nh c\u00f4ng r\u1ea5t cao, \u00edt nh\u1ea5t l\u00e0 trong th\u1eddi gian ng\u1eafn h\u1ea1n, khi th\u00e0nh c\u00f4ng \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 s\u1ef1 l\u00e0nh th\u01b0\u01a1ng t\u1eeb vi\u00eam quanh ch\u00f3p, h\u1ebft c\u00e1c d\u1ea5u hi\u1ec7u ch\u1ea9n \u0111o\u00e1n ban \u0111\u1ea7u c\u1ee7a tri\u1ec7u ch\u1ee9ng b\u1ec7nh l\u00fd n\u1ed9i nha.\u00a0<\/span><\/p>\n

\"noi-nha-tai-sinh-1\"
T\u00e1i t\u1ea1o tu\u1ea7n ho\u00e0n, th\u00fac \u0111\u1ea9y s\u1ef1 \u0111\u00f3ng ch\u00f3p ch\u00e2n r\u0103ng. (a) H\u00ecnh \u1ea3nh Xquang m\u1ed9t b\u1ec7nh nh\u00e2n 8 tu\u1ed5i cho th\u1ea5y ch\u00e2n r\u0103ng ph\u00e1t tri\u1ec3n ch\u01b0a ho\u00e0n t\u1ea5t tr\u00ean m\u1ed9t RCN 2 h\u00e0m d\u01b0\u1edbi b\u00ean (T) b\u1ecb ho\u1ea1i t\u1eed t\u1ee7y. (b) H\u00ecnh \u1ea3nh Xquang sau \u0111i\u1ec1u tr\u1ecb lo\u1ea1i b\u1ecf m\u1ea3nh v\u1ee5n m\u00f4, kh\u1eed tr\u00f9ng \u1ed1ng t\u1ee7y b\u1eb1ng NaOCl, b\u0103ng thu\u1ed1c n\u1ed9i t\u1ee7y b\u1eb1ng Ca(OH)2 v\u00e0 \u0111\u1eb7t MTA r\u1ed3i tr\u00e1m k\u1ebft th\u00fac b\u1eb1ng composite. (c) H\u00ecnh \u1ea3nh Xquang 2 n\u0103m sau \u0111i\u1ec1u tr\u1ecb cho th\u1ea5y ch\u00e2n r\u0103ng \u0111\u00e3 ph\u00e1t tri\u1ec3n ho\u00e0n thi\u1ec7n, th\u00e0nh ng\u00e0 ch\u00e2n r\u0103ng d\u00e0y v\u00e0 ch\u00f3p r\u0103ng \u0111\u00e3 \u0111\u00f3ng.<\/figcaption><\/figure>\n

C\u0169ng c\u00f3 th\u1ec3 th\u1ea5y r\u1eb1ng s\u1ef1 t\u00e1i t\u1ea1o m\u1ea1ch m\u00e1u m\u00e0 kh\u00f4ng c\u1ea7n \u0111\u01b0a t\u1ebf b\u00e0o g\u1ed1c trung m\u00f4 ngo\u1ea1i sinh v\u00e0o s\u1ebd d\u1eabn \u0111\u1ebfn s\u1ef1 h\u00ecnh th\u00e0nh m\u00f4 l\u1ea1c ch\u1ed7 trong \u1ed1ng t\u1ee7y v\u00e0 kh\u00f4ng c\u00f3 ph\u1ee9c h\u1ee3p ng\u00e0 t\u1ee7y \u0111\u01b0\u1ee3c t\u00e1i t\u1ea1o. M\u1ed9t v\u00e0i nghi\u00ean c\u1ee9u g\u1ea7n \u0111\u00e2y cho th\u1ea5y s\u1ef1 t\u00e1i t\u1ea1o c\u1ee7a ng\u00e0 t\u1ee7y c\u1ea7n \u0111\u1ebfn c\u00e1c ph\u01b0\u01a1ng ph\u00e1p d\u1ef1a tr\u00ean t\u1ebf b\u00e0o. Do \u0111\u00f3, qu\u00e1 tr\u00ecnh c\u1ea7n thi\u1ebft cho s\u1ef1 t\u00e1i t\u1ea1o ng\u00e0 t\u1ee7y c\u00f3 th\u1ec3 c\u00f2n ph\u1ee9c t\u1ea1p h\u01a1n nhi\u1ec1u so v\u1edbi nh\u1eefng qu\u00e1 tr\u00ecnh t\u00e1i t\u1ea1o hi\u1ec7n nay, bao g\u1ed3m kh\u1eed tr\u00f9ng \u1ed1ng t\u1ee7y, c\u1ea7m m\u00e1u, \u0111\u1eb7t\u00a0 cement calcium silicate-based t\u01b0\u01a1ng h\u1ee3p sinh h\u1ecdc v\u00e0 tr\u00e1m k\u1ebft th\u00fac. C\u00f3 th\u1ec3 c\u1ea7n c\u00f4 l\u1eadp ph\u1ea7n m\u00f4 t\u1ee7y l\u00e0nh m\u1ea1nh, m\u1edf r\u1ed9ng c\u00e1c t\u1ebf b\u00e0o g\u1ed1c c\u01a1 th\u1ec3, s\u1eed d\u1ee5ng c\u00e1c c\u01a1 s\u1edf nu\u00f4i c\u1ea5y t\u1ebf b\u00e0o chuy\u00ean bi\u1ec7t v\u00e0 t\u00e1i gh\u00e9p nh\u1eefng t\u1ebf b\u00e0o \u0111\u00e3 m\u1edf r\u1ed9ng n\u00e0y v\u00e0o nh\u1eefng \u1ed1ng t\u1ee7y b\u1ecb nhi\u1ec5m tr\u00f9ng. Gi\u1ea3 s\u1eed nh\u1eefng h\u00ecnh th\u1ee9c l\u00e2m s\u00e0ng ph\u1ee9c t\u1ea1p \u0111\u00f3 \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n v\u00e0 hi\u1ec7n th\u1ee9c h\u00f3a th\u00ec ng\u01b0\u1eddi ta c\u00f3 th\u1ec3 s\u1ebd \u0111\u1eb7t ra c\u00e2u h\u1ecfi \u201c T\u1ea1i sao l\u1ea1i ph\u1ea3i t\u00e1i t\u1ea1o m\u00f4 t\u1ee7y?\u201d<\/span><\/p>\n

\u0110\u00e2y l\u00e0 m\u1ed9t c\u00e2u h\u1ecfi r\u1ea5t c\u00f3 c\u01a1 s\u1edf, v\u00ec th\u1ef1c t\u1ebf th\u00ec ph\u01b0\u01a1ng ph\u00e1p\u00a0 \u0111i\u1ec1u tr\u1ecb t\u1ee7y ch\u00e2n th\u00f4ng th\u01b0\u1eddng \u0111\u00e3 c\u00f3 t\u1ec9 l\u1ec7 th\u00e0nh c\u00f4ng r\u1ea5t cao, nhi\u1ec1u nghi\u00ean c\u1ee9u b\u00e1o c\u00e1o t\u1ec9 l\u1ec7 th\u00e0nh c\u00f4ng c\u1ee7a\u00a0 \u0111i\u1ec1u tr\u1ecb t\u1ee7y ch\u00e2n l\u00ean \u0111\u1ebfn 94 \u2013 99%. Tuy nhi\u00ean, t\u1ec9 l\u1ec7 th\u00e0nh c\u00f4ng cao n\u00e0y kh\u00f4ng \u0111\u01b0\u1ee3c kh\u1eb3ng \u0111\u1ecbnh trong nh\u1eefng b\u00e0i t\u1ed5ng quan h\u1ec7 th\u1ed1ng \u0111i\u1ec1u tr\u1ecb t\u1ee7y ch\u00e2n. H\u01a1n n\u1eefa, nh\u1eadn th\u1ee9c chung trong nha khoa l\u00e0 nh\u1eefng r\u0103ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha \u0111\u1ec1u d\u1eabn \u0111\u1ebfn th\u1ea5t b\u1ea1i v\u00ec s\u1ef1 g\u00e3y ch\u00e2n r\u0103ng. Quan \u0111i\u1ec3m n\u00e0y c\u00f3 l\u1ebd l\u00e0 \u0111\u00e3 qu\u00e1 ph\u00f3ng \u0111\u1ea1i, nh\u01b0ng n\u00f3 kh\u00f4ng ho\u00e0n to\u00e0n sai. Vire v\u00e0 c\u1ed9ng s\u1ef1 \u0111\u00e3 b\u00e1o c\u00e1o t\u1ec9 l\u1ec7 59.4% c\u00e1c r\u0103ng \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha ph\u1ea3i nh\u1ed5 b\u1ecf v\u00ec nh\u1eefng thi\u1ebfu h\u1ee5t c\u1ea5u tr\u00fac r\u0103ng, ch\u1eb3ng h\u1ea1n nh\u01b0 g\u00e3y th\u00e2n\/ch\u00e2n r\u0103ng, g\u00e3y ph\u1ee5c h\u00ecnh v\u00e0 s\u00e2u th\u1ee9 ph\u00e1t. Toure v\u00e0 c\u1ed9ng s\u1ef1 b\u00e1o c\u00e1o nh\u1eefng bi\u1ebfn ch\u1ee9ng nha chu l\u00e0 m\u1ed9t trong nh\u1eefng nguy\u00ean nh\u00e2n d\u1eabn \u0111\u1ebfn nh\u1ed5 r\u0103ng \u1edf nh\u1eefng r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha. B\u00e1o c\u00e1o n\u00e0y c\u00f2n ch\u1ec9 ra nh\u1eefng khi\u1ebfm khuy\u1ebft c\u1ea5u tr\u00fac nghi\u00eam tr\u1ecdng, nh\u01b0 g\u00e3y d\u1ecdc ch\u00e2n r\u0103ng, g\u00e3y th\u00e2n, ch\u00e2n r\u0103ng, c\u0169ng l\u00e0 nh\u1eefng nguy\u00ean nh\u00e2n d\u1eabn \u0111\u1ebfn nh\u1ed5 r\u0103ng. Do v\u1eady, r\u00f5 r\u00e0ng l\u00e0 nh\u1eefng r\u0103ng \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha \u0111\u1ec1u c\u00f3 c\u1ea5u tr\u00fac r\u0103ng y\u1ebfu, v\u00e0 kh\u1ea3 n\u0103ng ch\u1ecbu l\u1ef1c nhai k\u00e9m h\u01a1n.<\/span><\/p>\n

Nghi\u00ean c\u1ee9u c\u1ee7a Sedgley v\u00e0 Messer (1992) kh\u00f4ng t\u00ecm th\u1ea5y s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 \u0111\u1eb7c t\u00ednh c\u01a1 h\u1ecdc gi\u1eefa r\u0103ng \u0111\u00e3 n\u1ed9i nha v\u00e0 r\u0103ng s\u1ed1ng, l\u00e0m c\u1ee7ng c\u1ed1 cho quan \u0111i\u1ec3m l\u00e0 r\u0103ng \u0111\u00e3 n\u1ed9i nha th\u00ec kh\u00f4ng tr\u1edf n\u00ean \u201cgi\u00f2n\u201d h\u01a1n. H\u01a1n n\u1eefa, r\u0103ng \u0111\u00e3 n\u1ed9i nha c\u00f3 th\u1ec3 b\u1ecb y\u1ebfu do s\u1ef1 m\u1ea5t c\u1ea5u tr\u00fac r\u0103ng sau do s\u00e2u r\u0103ng v\u00e0 do vi\u1ec7c s\u1eeda so\u1ea1n c\u01a1 h\u1ecdc. Ngo\u00e0i ra, s\u1ef1 ph\u00e2n b\u1ed1 th\u1ea7n kinh trong t\u1ee7y r\u0103ng v\u00e0 d\u00e2y ch\u1eb1ng nha chu \u0111\u01b0\u1ee3c cho l\u00e0 \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 s\u1ef1 nh\u1eadn bi\u1ebft l\u1ef1c nhai t\u1ee9c th\u00ec, vi\u1ec7c m\u1ea5t \u0111i m\u00f4 t\u1ee7y s\u1ed1ng cho ph\u00e9p sinh ra l\u1ef1c nhai qu\u00e1 m\u1ee9c trong vi\u1ec7c th\u1ef1c hi\u1ec7n ch\u1ee9c n\u0103ng b\u00ecnh th\u01b0\u1eddng, c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn g\u00e3y ch\u00e2n r\u0103ng. Thi\u1ebfu h\u1ee5t h\u1ec7 th\u1ed1ng c\u1ea3m nh\u1eadn \u0111au \u1edf nh\u1eefng r\u0103ng ch\u1ebft l\u00e0m cho nh\u1eefng r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb tr\u1edf n\u00ean nh\u1ea1y c\u1ea3m h\u01a1n v\u1edbi s\u00e2u r\u0103ng t\u00e1i ph\u00e1t, l\u00e0 m\u1ed9t trong nh\u1eefng nguy\u00ean nh\u00e2n ch\u00ednh d\u1eabn \u0111\u1ebfn th\u1ea5t b\u1ea1i \u1edf nh\u1eefng r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha. S\u1ef1 t\u00e1i t\u1ea1o ng\u00e0 \u2013 t\u1ee7y v\u1ec1 m\u1eb7t l\u00fd thuy\u1ebft, s\u1ebd t\u00e1i t\u1ea1o ch\u1ee9c n\u0103ng c\u1ee7a ph\u1ee9c h\u1ee3p ng\u00e0 \u2013 t\u1ee7y, n\u00ean s\u1ebd l\u00e0m t\u0103ng kh\u1ea3 n\u0103ng b\u1ea3o t\u1ed3n c\u1ea5u tr\u00fac r\u0103ng th\u00f4ng qua vi\u1ec7c t\u1ed5ng h\u1ee3p ng\u00e0 \u0111\u00e3 kho\u00e1ng h\u00f3a v\u00e0 ng\u00e0 ph\u1ea3n \u1ee9ng (ng\u00e0 th\u1ee9 ba), kh\u1ea3 n\u0103ng c\u1ea3m th\u1ee5 b\u1ea3n th\u1ec3 v\u00e0 c\u01a1 ch\u1ebf h\u00e0ng r\u00e0o mi\u1ec5n d\u1ecbch. \u0110i\u1ec1u \u0111\u1eb7c bi\u1ec7t l\u00e0, k\u0129 thu\u1eadt n\u1ed9i nha t\u00e1i sinh kh\u00f4ng li\u00ean quan \u0111\u1ebfn vi\u1ec7c b\u00edt \u1ed1ng t\u1ee7y b\u1eb1ng c\u00e1c v\u1eadt li\u1ec7u tr\u00e1m, nh\u01b0 Gutta percha hay bioceramic, do \u0111\u00f3 gi\u00fap gi\u1ea3m thi\u1ec3u vi\u1ec7c t\u1ea1o h\u00ecnh \u1ed1ng t\u1ee7y, \u0111\u1ec3 l\u1ea1i nhi\u1ec1u m\u00f4 ng\u00e0 l\u00e0nh m\u1ea1nh h\u01a1n trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb. V\u00ec v\u1eady, t\u00e1i t\u1ea1o ng\u00e0 \u2013 t\u1ee7y thay v\u00ec \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 l\u00e0 l\u0129nh v\u1ef1c quan tr\u1ecdng s\u1eafp t\u1edbi trong n\u1ed9i nha. S\u1ef1 t\u00e1i t\u1ea1o th\u00e0nh c\u00f4ng t\u1ee7y r\u0103ng gi\u00fap m\u1edf r\u1ed9ng v\u00e0 c\u1ea3i thi\u1ec7n c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha trong t\u01b0\u01a1ng lai cho nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 r\u0103ng ch\u1ebft t\u1ee7y.<\/span><\/p>\n

N\u00f3i chung, k\u0129 thu\u1eadt n\u1ed9i nha t\u00e1i sinh g\u1ed3m \u201cb\u1ed9 ba\u201d y\u1ebfu t\u1ed1 then ch\u1ed1t, \u0111\u00f3 l\u00e0 khung s\u01b0\u1eddn, t\u00edn hi\u1ec7u bi\u1ec7t h\u00f3a t\u0103ng tr\u01b0\u1edfng v\u00e0 c\u00e1c t\u1ebf b\u00e0o g\u1ed1c c\u1ee7a trung m\u00f4. Nguy\u00ean t\u1eafc n\u00e0y c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng \u0111\u1ed1i v\u1edbi s\u1ef1 t\u00e1i t\u1ea1o c\u1ee7a h\u1ea7u h\u1ebft c\u00e1c m\u00f4, ch\u1eb3ng h\u1ea1n nh\u01b0 x\u01b0\u01a1ng v\u00e0 s\u1ee5n. Tuy nhi\u00ean, s\u1ef1 t\u00e1i t\u1ea1o m\u00f4 t\u1ee7y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c xem l\u00e0 m\u1ed9t th\u00e1ch th\u1ee9c v\u00ec m\u00f4 li\u00ean k\u1ebft th\u1ef1c hi\u1ec7n c\u00e1c ch\u1ee9c n\u0103ng chuy\u00ean bi\u1ec7t, bao g\u1ed3m c\u1ea3m th\u1ee5 b\u1ea3n th\u1ec3 c\u01a1 h\u1ecdc, bao g\u1ed3m s\u1ef1 t\u1ea3i l\u1ef1c nhai, s\u1ef1 h\u1ee3p nh\u1ea5t c\u00e1c th\u00e0nh ph\u1ea7n c\u00f2n l\u1ea1i c\u1ee7a r\u0103ng v\u1edbi c\u00e1c c\u1ea5u tr\u00fac h\u1ed7 tr\u1ee3. Vi\u1ec7c n\u00e0y \u0111\u00f2i h\u1ecfi ph\u1ea3i t\u00e1i t\u1ea1o m\u00f4 sinh h\u1ecdc \u1edf trong kho\u1ea3ng \u1ed1ng t\u1ee7y \u0111\u00e3 \u0111\u01b0\u1ee3c kh\u1eed tr\u00f9ng, v\u1ed1n l\u00e0 n\u01a1i \u1ea9n n\u00e1u c\u1ee7a vi khu\u1ea9n trong biofilm. V\u00ec nh\u1eefng l\u00ed do tr\u00ean, b\u1ed9 ba k\u0129 thu\u1eadt t\u00e1i t\u1ea1o n\u00ean bao g\u1ed3m, v\u1eadt li\u1ec7u sinh h\u1ecdc, ki\u1ec3m so\u00e1t nhi\u1ec5m tr\u00f9ng v\u00e0 t\u1ebf b\u00e0o g\u1ed1c trung m\u00f4.<\/span><\/p>\n

\"noi-nha-tai-sinh-2\"
\u201cB\u1ed9 ba\u201d c\u1ee7a n\u1ed9i nha t\u00e1i sinh. T\u00e1i t\u1ea1o ph\u1ee9c h\u1ee3p ng\u00e0 \u2013 t\u1ee7y \u0111\u00f2i h\u1ecfi ki\u1ec3m so\u00e1t nhi\u1ec5m tr\u00f9ng, v\u1eadt li\u1ec7u sinh h\u1ecdc v\u00e0 t\u1ebf b\u00e0o g\u1ed1c. Lo\u1ea1i tr\u1eeb tri\u1ec7t \u0111\u1ec3 nhi\u1ec5m tr\u00f9ng t\u1ee7y r\u0103ng l\u00e0 m\u1ed9t vi\u1ec7c c\u1ea7n thi\u1ebft cho th\u1ee7 thu\u1eadt n\u1ed9i nha t\u00e1i sinh, c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1eb1ng c\u00e1ch b\u0103ng thu\u1ed1c n\u1ed9i t\u1ee7y v\u00e0 b\u01a1m r\u1eeda, s\u1eed d\u1ee5ng Ca(OH)2 v\u1edbi NaOCI. T\u00e1i t\u1ea1o t\u1ee7y r\u0103ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c kh\u1edfi ph\u00e1t b\u1edfi s\u1ef1 xu\u1ea5t hi\u1ec7n c\u1ee7a c\u00e1c lo\u1ea1i v\u1eadt li\u1ec7u sinh h\u1ecdc c\u1ee9ng ch\u1eafc v\u00e0 c\u00f3 kh\u1ea3 n\u0103ng b\u1ecbt k\u00edn, bao g\u1ed3m cement calcium silicate-based hay Bioceramic, MTA. Cu\u1ed1i c\u00f9ng, t\u1ebf b\u00e0o g\u1ed1c trung m\u00f4 ch\u01b0a bi\u1ec7t h\u00f3a t\u1eeb m\u00f4 t\u1ee7y l\u00e0 m\u1ed9t y\u00eau c\u1ea7u c\u1ea7n cho vi\u1ec7c t\u00e1i t\u1ea1o ph\u1ee9c h\u1ee3p ng\u00e0 \u2013 t\u1ee7y. N\u1ebfu kh\u00f4ng c\u00f3 t\u1ebf b\u00e0o g\u1ed1c trung m\u00f4 t\u1ee7y th\u00ec qu\u00e1 tr\u00ecnh t\u00e1i t\u1ea1o kh\u00f4ng th\u1ec3 x\u1ea3y ra.<\/figcaption><\/figure>\n

V\u1eadt li\u1ec7u sinh h\u1ecdc l\u00fd t\u01b0\u1edfng cho k\u0129 thu\u1eadt t\u00e1i t\u1ea1o ph\u1ea3i cung c\u1ea5p m\u1ed9t n\u1ec1n m\u00f3ng c\u1ea5u tr\u00fac c\u1ee9ng ch\u1eafc h\u1ed7 tr\u1ee3 cho v\u1eadt li\u1ec7u tr\u00e1m k\u1ebft th\u00fac \u0111\u1ec3 b\u1ea3o v\u1ec7 cho m\u00f4 \u0111\u00e3 \u0111\u01b0\u1ee3c t\u00e1i t\u1ea1o. Ngo\u00e0i ra, \u0111\u1eb7c t\u00ednh kh\u00e1ng khu\u1ea9n t\u1eeb nh\u1eefng v\u1eadt li\u1ec7u sinh h\u1ecdc n\u00e0y s\u1ebd \u0111em l\u1ea1i th\u00eam l\u1ee3i \u00edch v\u00ec v\u1eadt li\u1ec7u \u0111\u01b0\u1ee3c \u0111\u1eb7t trong m\u1ed9t \u1ed1ng t\u1ee7y \u0111\u00e3 t\u1eebng b\u1ecb b\u1ec7nh nh\u01b0ng \u0111\u00e3 \u0111\u01b0\u1ee3c kh\u1eed tr\u00f9ng. MTA ho\u1eb7c c\u00e1c lo\u1ea1i\u00a0 cement calcium silicate-based t\u01b0\u01a1ng h\u1ee3p sinh h\u1ecdc kh\u00e1c c\u00f3 th\u1ec3 \u0111\u00e1p \u1ee9ng nh\u1eefng y\u00eau c\u1ea7u n\u00f3i tr\u00ean v\u00ec ch\u00fang d\u00ednh t\u1ed1t v\u1edbi ng\u00e0 r\u0103ng v\u00e0 c\u00f3 t\u00ednh t\u01b0\u01a1ng h\u1ee3p sinh h\u1ecdc cao.<\/span><\/p>\n

Ki\u1ec3m so\u00e1t nhi\u1ec5m tr\u00f9ng trong h\u1ec7 th\u1ed1ng \u1ed1ng t\u1ee7y r\u00f5 r\u00e0ng l\u00e0 \u0111i\u1ec1u ki\u1ec7n ti\u00ean quy\u1ebft cho k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb th\u00e0nh c\u00f4ng. Tr\u00ean th\u1ef1c t\u1ebf, khi th\u1ef1c hi\u1ec7n k\u0129 thu\u1eadt t\u00e1i t\u1ea1o tr\u00ean r\u0103ng c\u00f3 h\u1ec7 th\u1ed1ng \u1ed1ng t\u1ee7y b\u1ecb nhi\u1ec5m tr\u00f9ng th\u00ec r\u0103ng th\u01b0\u1eddng c\u00f3 t\u1ed5n th\u01b0\u01a1ng quanh ch\u00f3p r\u1ed9ng tr\u00ean phim Xquang, th\u01b0\u1eddng c\u00f3 li\u00ean quan v\u1edbi s\u01b0ng m\u00f4 m\u1ec1m v\u00e0 l\u1ed7 d\u00f2. M\u1ed9t trong nh\u1eefng m\u1ee5c ti\u00eau ch\u00ednh c\u1ee7a k\u0129 thu\u1eadt \u0111i\u1ec1u tr\u1ecb t\u00e1i t\u1ea1o t\u1ee7y l\u00e0 lo\u1ea1i b\u1ecf nhi\u1ec5m tr\u00f9ng \u1ed1ng t\u1ee7y. \u0110i\u1ec1u n\u00e0y cho ph\u00e9p m\u00f4 quanh ch\u00f3p l\u00e0nh th\u01b0\u01a1ng, l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 quan tr\u1ecdng d\u1eabn \u0111\u1ebfn \u0111i\u1ec1u tr\u1ecb th\u00e0nh c\u00f4ng.\u00a0<\/span><\/p>\n

\"noi-nha-tai-sinh-3\"
T\u00e1i t\u1ea1o m\u1ea1ch m\u00e1u lo\u1ea1i tr\u1eeb ho\u00e0n to\u00e0n vi\u00eam quanh ch\u00f3p. (a-c) M\u1ed9t b\u1ec7nh nh\u00e2n 12 tu\u1ed5i v\u1edbi RCN 2 h\u00e0m d\u01b0\u1edbi b\u00ean (P) ho\u1ea1i t\u1eed t\u1ee7y, s\u01b0ng v\u00e0 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n l\u00e0 vi\u00eam quanh ch\u00f3p c\u00f3 tri\u1ec7u ch\u1ee9ng do dens evaginatus (r\u0103ng trong r\u0103ng). (d, e) Lo\u1ea1i b\u1ecf m\u1ea3nh v\u1ee5n trong \u1ed1ng t\u1ee7y v\u00e0 b\u0103ng thu\u1ed1c n\u1ed9i t\u1ee7y v\u1edbi Ca(OH)2. (f) Xquang c\u1eadn ch\u00f3p ngay sau khi k\u1ebft th\u00fac \u0111i\u1ec1u tr\u1ecb v\u00e0 (g) Xquang 5 th\u00e1ng sau \u0111i\u1ec1u tr\u1ecb. Xquang 1 n\u0103m 4 th\u00e1ng sau \u0111i\u1ec1u tr\u1ecb cho th\u1ea5y s\u1ef1 l\u00e0nh th\u01b0\u01a1ng c\u1ee7a m\u00f4 quanh ch\u00f3p, th\u00e0nh \u1ed1ng t\u1ee7y ch\u00e2n r\u0103ng d\u00e0y l\u00ean, l\u00e0m t\u0103ng chi\u1ec1u d\u00e0i ch\u00e2n r\u0103ng v\u00e0 sau \u0111\u00f3 l\u00e0 \u0111\u00f3ng ch\u00f3p.<\/figcaption><\/figure>\n
\"\"
H\u00ecnh \u1ea3nh CBCT cho th\u1ea5y l\u00e0nh th\u01b0\u01a1ng quanh ch\u00f3p sau th\u1ee7 thu\u1eadt t\u00e1i t\u1ea1o m\u1ea1ch m\u00e1u. CBCT RCN 2 h\u00e0m d\u01b0\u1edbi b\u00ean (P) tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb \u1edf h\u00ecnh 5.2 tr\u00ean 3 m\u1eb7t ph\u1eb3ng sagittal, coronal, v\u00e0 axial, t\u01b0\u01a1ng \u1ee9ng v\u1edbi h\u00ecnh a-c. CBCT 16 th\u00e1ng sau \u0111i\u1ec1u tr\u1ecb (d-f) cho th\u1ea5y s\u1ef1 l\u00e0nh th\u01b0\u01a1ng quanh ch\u00f3p \u1edf c\u1ea3 3 m\u1eb7t ph\u1eb3ng, ch\u00e2n r\u0103ng \u0111\u00e3 tr\u01b0\u1edfng th\u00e0nh v\u00e0 ch\u00f3p r\u0103ng \u0111\u00e3 \u0111\u00f3ng.<\/figcaption><\/figure>\n

V\u00ec v\u1eady, ki\u1ec3m so\u00e1t nhi\u1ec5m tr\u00f9ng r\u1ea5t c\u1ea7n thi\u1ebft cho \u0111i\u1ec1u tr\u1ecb t\u00e1i t\u1ea1o. C\u00f3 th\u1ec3 ph\u1ed1i h\u1ee3p v\u1edbi b\u01a1m r\u1eeda trong qu\u00e1 tr\u00ecnh lo\u1ea1i b\u1ecf m\u1ea3nh v\u1ee5n \u1ed1ng t\u1ee7y b\u1eb1ng NaOCl 1.5% v\u00e0 b\u0103ng thu\u1ed1c s\u00e1t khu\u1ea9n, nh\u01b0 Ca(OH)2 ho\u1eb7c kem kh\u00e1ng sinh (triple antibiotic paste).<\/span><\/p>\n

Cu\u1ed1i c\u00f9ng, k\u0129 thu\u1eadt \u0111i\u1ec1u tr\u1ecb t\u00e1i t\u1ea1o c\u00f2n c\u1ea7n \u0111\u1ebfn t\u1ebf b\u00e0o g\u1ed1c trung m\u00f4 t\u1eeb m\u00f4 t\u1ee7y. Nh\u1eefng nghi\u00ean c\u1ee9u tr\u01b0\u1edbc \u0111\u00e2y \u0111\u00e3 ch\u1ee9ng minh r\u1eb1ng t\u1ebf b\u00e0o g\u1ed1c trung m\u00f4 gi\u1eef l\u1ea1i nh\u1eefng \u0111i\u1ec3m \u0111\u1eb7c tr\u01b0ng c\u1ee7a m\u00f4 ban \u0111\u1ea7u. S\u1ef1 c\u1ea5y gh\u00e9p d\u01b0\u1edbi da c\u1ee7a t\u1ebf b\u00e0o g\u1ed1c tu\u1ef7 r\u0103ng, t\u1ebf b\u00e0o g\u1ed1c c\u1ee7a d\u00e2y ch\u1eb3ng nha chu v\u00e0 t\u1ebf b\u00e0o g\u1ed1c trung m\u00f4 c\u00f3 ngu\u1ed3n g\u1ed1c t\u1ee7y x\u01b0\u01a1ng \u1edf nh\u1eefng con chu\u1ed9t b\u1ecb suy gi\u1ea3m mi\u1ec5n d\u1ecbch cho th\u1ea5y s\u1ef1 h\u00ecnh th\u00e0nh c\u1ee7a m\u00f4 l\u1ea7n l\u01b0\u1ee3t gi\u1ed1ng v\u1edbi m\u00f4 t\u1ee7y, cement v\u00e0 x\u01b0\u01a1ng. Do v\u1eady, t\u1ebf b\u00e0o g\u1ed1c trung m\u00f4 t\u1eeb nh\u1eefng m\u00f4 kh\u00e1c nhau \u0111\u01b0\u1ee3c thi\u1ebft l\u1eadp \u0111\u1ec3 bi\u1ec7t h\u00f3a ph\u1ea3n \u00e1nh gi\u1ed1ng v\u1edbi m\u00f4 ban \u0111\u1ea7u. Nhi\u1ec1u nghi\u00ean c\u1ee9u tr\u00ean c\u00e1c lo\u00e0i \u0111\u1ed9ng v\u1eadt tr\u01b0\u1edbc \u0111\u00f3 v\u00e0 b\u00e1o c\u00e1o m\u1ed9t v\u00e0i tr\u01b0\u1eddng h\u1ee3p \u1edf ng\u01b0\u1eddi \u0111\u00e3 cho th\u1ea5y k\u1ebft qu\u1ea3 t\u00e1i t\u1ea1o tu\u1ea7n ho\u00e0n \u0111\u00e3 h\u00ecnh th\u00e0nh x\u01b0\u01a1ng l\u1ea1c ch\u1ed7, cement v\u00e0 m\u00f4 s\u1ee3i \u1edf trong \u1ed1ng t\u1ee7y, m\u00e0 kh\u00f4ng c\u00f3 s\u1ef1 h\u00ecnh th\u00e0nh ph\u1ee9c h\u1ee3p ng\u00e0 \u2013 t\u1ee7y. \u0110i\u1ec1u n\u00e0y ph\u1ea7n n\u00e0o \u0111\u01b0\u1ee3c bi\u1ebft tr\u01b0\u1edbc b\u1edfi v\u00ec t\u00e1i t\u1ea1o m\u1ea1ch m\u00e1u l\u00e0 d\u1ef1a tr\u00ean vi\u1ec7c kh\u1eed tr\u00f9ng \u1ed1ng t\u1ee7y, s\u1eed d\u1ee5ng t\u1ebf b\u00e0o g\u1ed1c trung m\u00f4 n\u1ed9i sinh t\u1eeb m\u00f4 l\u00e2n c\u1eadn b\u1eb1ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p g\u00e2y ch\u1ea3y m\u00e1u n\u1ed9i t\u1ee7y. G\u00e2y ch\u1ea3y m\u00e1u n\u1ed9i t\u1ee7y s\u1ebd l\u1ea5y t\u1ebf b\u00e0o g\u1ed1c trung m\u00f4 t\u1eeb t\u1ee7y x\u01b0\u01a1ng, d\u1eabn \u0111\u1ebfn h\u00ecnh th\u00e0nh x\u01b0\u01a1ng l\u1ea1c ch\u1ed7, v\u00e0 t\u1eeb d\u00e2y ch\u1eb1ng nha chu, d\u1eabn \u0111\u1ebfn h\u00ecnh th\u00e0nh cement v\u00e0 m\u00f4 s\u1ee3i. V\u00ec v\u1eady trong tr\u01b0\u1eddng h\u1ee3p r\u0103ng ho\u1ea1i t\u1eed t\u1ee7y to\u00e0n b\u1ed9 v\u00e0 kh\u00f4ng c\u00f2n t\u1ebf b\u00e0o g\u1ed1c tu\u1ef7 r\u0103ng t\u1ed3n t\u1ea1i, th\u00ec s\u1ef1 s\u1eed d\u1ee5ng t\u1ebf b\u00e0o g\u1ed1c trung m\u00f4 kh\u00e1c lo\u1ea1i t\u1eeb t\u1ee7y x\u01b0\u01a1ng v\u00e0 d\u00e2y ch\u1eb1ng nha chu s\u1ebd d\u1eabn \u0111\u1ebfn k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb t\u00e1i t\u1ea1o th\u1ea5t b\u1ea1i. Trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u00e0y, t\u00e1i t\u1ea1o m\u00f4 t\u1ee7y \u0111\u00f2i h\u1ecfi c\u1ea5y gh\u00e9p t\u1ebf b\u00e0o g\u1ed1c tu\u1ef7 r\u0103ng t\u1ef1 sinh ho\u1eb7c t\u1eeb c\u00e1c t\u1ebf b\u00e0o c\u1ee7a ng\u01b0\u1eddi, \u0111\u00e3 \u0111\u01b0\u1ee3c nu\u00f4i c\u1ea5y, v\u00e0o trong \u1ed1ng t\u1ee7y \u0111\u00e3 \u0111\u01b0\u1ee3c kh\u1eed tr\u00f9ng. V\u1edbi nh\u1eefng ti\u1ebfn b\u1ed9 hi\u1ec7n nay trong c\u00f4ng ngh\u1ec7 v\u1eadt li\u1ec7u t\u01b0\u01a1ng h\u1ee3p sinh h\u1ecdc c\u00f9ng ngu\u1ed3n t\u1ebf b\u00e0o g\u1ed1c s\u1eb5n c\u00f3 th\u00ec trong t\u01b0\u01a1ng lai s\u1ebd c\u00f3 c\u01a1 h\u1ed9i ho\u00e0n th\u00e0nh m\u1ee5c ti\u00eau t\u00e1i t\u1ea1o m\u00f4 t\u1ee7y b\u1eb1ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p sinh h\u1ecdc.<\/span><\/p>\n

\u0110i\u1ec1u quan tr\u1ecdng l\u00e0 ph\u1ea3i gi\u1ea3i \u0111\u00e1p c\u00e2u h\u1ecfi: \u201cC\u00e1c b\u01b0\u1edbc chi ti\u1ebft c\u1ee7a th\u1ee7 thu\u1eadt c\u00f3 quan tr\u1ecdng kh\u00f4ng?\u201d. Nh\u1eefng nghi\u00ean c\u1ee9u hi\u1ec7n nay v\u1ec1 t\u00e1i t\u1ea1o tu\u1ea7n ho\u00e0n t\u1ee7y \u0111\u00e3 ch\u1ee9ng minh l\u00e0nh th\u01b0\u01a1ng t\u1eeb vi\u00eam quanh ch\u00f3p th\u00e0nh c\u00f4ng v\u00e0 ch\u00e2n r\u0103ng \u0111\u01b0\u1ee3c ti\u1ebfp t\u1ee5c ph\u00e1t tri\u1ec3n.\u00a0<\/span><\/p>\n

\"\"
T\u00e1i t\u1ea1o tu\u1ea7n ho\u00e0n th\u00fac \u0111\u1ea9y s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a ch\u00e2n r\u0103ng. (a) H\u00ecnh \u1ea3nh Xquang c\u1ee7a m\u1ed9t b\u1ec7nh nh\u00e2n nam 12 tu\u1ed5i c\u00f3 t\u1ed5n th\u01b0\u01a1ng quanh ch\u00f3p l\u1edbn, ch\u00e2n r\u0103ng ch\u01b0a ph\u00e1t tri\u1ec3n ho\u00e0n t\u1ea5t \u1edf RCN 2 h\u00e0m d\u01b0\u1edbi b\u00ean (P), c\u00f3 gi\u1ea3i ph\u1eabu r\u0103ng trong r\u0103ng. (b) Xquang Panorex cho th\u1ea5y \u0111\u1ea7u cone Gutta percha xuy\u00ean qua l\u1ed7 d\u00f2 m\u1eb7t m\u00e1 \u0111i tr\u1ef1c ti\u1ebfp v\u00e0o t\u1ed5n th\u01b0\u01a1ng quanh ch\u00f3p. (c) Xquang sau \u0111i\u1ec1u tr\u1ecb, khi \u0111\u00e3 lo\u1ea1i b\u1ecf m\u1ea3nh v\u1ee5n m\u00f4, kh\u1eed tr\u00f9ng \u1ed1ng t\u1ee7y v\u1edbi NaOCl v\u00e0 kem kh\u00e1ng sinh (triple antibiotic paste), \u0111\u1eb7t MTA \u1edf ph\u1ea7n th\u00e2n r\u0103ng v\u00e0 tr\u00e1m k\u1ebft th\u00fac. (d) Xquang 6 n\u0103m sau \u0111i\u1ec1u tr\u1ecb cho th\u1ea5y th\u00e0nh ch\u00e2n r\u0103ng d\u00e0y l\u00ean, ch\u00f3p r\u0103ng \u0111\u00f3ng v\u00e0 l\u00e0nh th\u01b0\u01a1ng quanh ch\u00f3p.<\/figcaption><\/figure>\n

Trong th\u1ef1c t\u1ebf, ph\u1ea7n l\u1edbn c\u00e1c tr\u01b0\u1eddng h\u1ee3p \u0111\u01b0\u1ee3c ghi ch\u00e9p trong c\u00e1c t\u00e0i li\u1ec7u ch\u1ee9ng minh t\u1ec9 l\u1ec7 th\u00e0nh c\u00f4ng g\u1ea7n 100% v\u00e0 t\u1ec9 l\u1ec7 \u0111\u00f3ng ch\u00f3p 100%, v\u00e0 nh\u1eefng k\u1ebft qu\u1ea3 \u0111\u00f3 \u0111\u01b0\u1ee3c ghi nh\u1eadn t\u1eeb c\u00e1c nghi\u00ean c\u1ee9u kh\u00e1c nhau v\u1edbi c\u00e1c ph\u01b0\u01a1ng th\u1ee9c \u0111i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 thay \u0111\u1ed5i kh\u00e1c nhau. \u0110\u1ec3 kh\u1eb3ng \u0111\u1ecbnh cho nh\u1eefng b\u1eb1ng ch\u1ee9ng n\u00e0y, Jung v\u00e0 c\u1ed9ng s\u1ef1 \u0111\u00e3 b\u00e1o c\u00e1o c\u00e1c tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh c\u00f3 b\u0103ng thu\u1ed1c n\u1ed9i t\u1ee7y v\u1edbi Ca(OH)2 ho\u1eb7c kem kh\u00e1ng sinh (triple antibiotic paste), trong \u0111\u00f3 c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 ch\u1ea3y m\u00e1u n\u1ed9i t\u1ee7y. T\u1ea5t c\u1ea3 8 tr\u01b0\u1eddng h\u1ee3p trong nghi\u00ean c\u1ee9u \u0111\u1ec1u cho th\u1ea5y l\u00e0nh th\u01b0\u01a1ng v\u00e0 \u0111\u00f3ng ch\u00f3p. Shah v\u00e0 c\u1ed9ng s\u1ef1 (2008) \u0111\u00e3 tr\u00ecnh b\u00e0y 14 tr\u01b0\u1eddng h\u1ee3p t\u00e1i t\u1ea1o m\u1ea1ch m\u00e1u, \u0111\u01b0\u1ee3c b\u0103ng thu\u1ed1c formocresol, tr\u00e1i ng\u01b0\u1ee3c v\u1edbi kem kh\u00e1ng sinh (triple antibiotic paste) hay Ca(OH)2. T\u1ea5t c\u1ea3 c\u00e1c tr\u01b0\u1eddng h\u1ee3p \u0111\u1ec1u cho k\u1ebft qu\u1ea3 l\u00e0nh th\u01b0\u01a1ng quanh ch\u00f3p v\u00e0 \u0111\u00f3ng ch\u00f3p. Th\u00e0nh c\u00f4ng c\u1ee7a t\u00e1i t\u1ea1o m\u1ea1ch m\u00e1u d\u01b0\u1eddng nh\u01b0 ph\u1ee5 thu\u1ed9c nhi\u1ec1u v\u00e0o vi\u1ec7c kh\u1eed tr\u00f9ng \u1ed1ng t\u1ee7y v\u00e0 s\u1eed d\u1ee5ng t\u1ebf b\u00e0o g\u1ed1c trung m\u00f4 h\u01a1n l\u00e0 chi ti\u1ebft k\u0129 thu\u1eadt th\u1ef1c hi\u1ec7n. Do v\u1eady, nh\u1eefng n\u1ed7 l\u1ef1c nghi\u00ean c\u1ee9u trong t\u01b0\u01a1ng lai v\u1ec1 th\u1ee7 thu\u1eadt \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha t\u00e1i sinh n\u00ean t\u1eadp trung v\u00e0o vi\u1ec7c ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng c\u1ee7a m\u00f4 t\u1ee7y \u0111\u01b0\u1ee3c t\u00e1i t\u1ea1o h\u01a1n l\u00e0 k\u0129 thu\u1eadt th\u1ef1c hi\u1ec7n t\u00e1i t\u1ea1o m\u1ea1ch m\u00e1u.<\/span><\/p>\n

Ngu\u1ed3n: Clinical Guide for Optimal Treatment Outcome – Springer International Publishing Switzerland 2017<\/span><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

M\u1ee5c ti\u00eau c\u1ee7a k\u0129 thu\u1eadt n\u1ed9i nha t\u00e1i sinh l\u00e0 tr\u1ea3 l\u1ea1i ch\u1ee9c n\u0103ng b\u00ecnh th\u01b0\u1eddng c\u1ee7a t\u1ee7y r\u0103ng \u1edf nh\u1eefng r\u0103ng ho\u1ea1i t\u1eed, ngh\u0129a l\u00e0 ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng b\u1ea3o v\u1ec7, bao g\u1ed3m kh\u1ea3 n\u0103ng mi\u1ec5n d\u1ecbch b\u1ea9m sinh, s\u1eeda ch\u1eefa th\u00f4ng qua s\u1ef1 kho\u00e1ng h\u00f3a, c\u1ea3m gi\u00e1c \u0111\u01b0\u1ee3c l\u1ef1c nhai v\u00e0 \u0111au. V\u00e0 […]<\/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":[],"yoast_head":"\nN\u1ed9i nha t\u00e1i sinh: Qu\u00e1 tr\u00ecnh ph\u00e1t tri\u1ec3n k\u0129 thu\u1eadt m\u00f4. - Vinmec<\/title>\n<meta name=\"description\" content=\"N\u1ed9i nha t\u00e1i sinh gi\u00fap kh\u00f4i ph\u1ee5c s\u1ef1 s\u1ed1ng t\u1ee7y m\u00e0 c\u00f2n t\u00e1i t\u1ea1o m\u00f4 h\u1ecdc t\u1ee7y r\u0103ng v\u1edbi t\u1ea5t c\u1ea3 c\u00e1c ch\u1ee9c n\u0103ng sinh l\u00fd ban \u0111\u1ea7u. 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