{"id":27820,"date":"2023-04-24T11:13:14","date_gmt":"2023-04-24T04:13:14","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=27820"},"modified":"2023-05-02T09:31:53","modified_gmt":"2023-05-02T02:31:53","slug":"sua-soan-loi-vao-trong-qua-trinh-mo-tuy-lam-sang-tong-quan","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/24\/sua-soan-loi-vao-trong-qua-trinh-mo-tuy-lam-sang-tong-quan\/","title":{"rendered":"S\u1eeda so\u1ea1n l\u1ed1i v\u00e0o trong qu\u00e1 tr\u00ecnh m\u1edf tu\u1ef7 l\u00e2m s\u00e0ng – T\u1ed5ng quan."},"content":{"rendered":"

\u0110i\u1ec1u tr\u1ecb n\u1ed9i nha l\u00e2m s\u00e0ng lu\u00f4n b\u1eaft \u0111\u1ea7u v\u1edbi vi\u1ec7c m\u1edf t\u1ee7y. M\u1ee5c \u0111\u00edch c\u1ee7a vi\u1ec7c m\u1edf t\u1ee7y l\u00e0 x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed t\u1ea5t c\u1ea3 c\u00e1c l\u1ed7 v\u00e0o \u1ed1ng t\u1ee7y c\u1ee7a r\u0103ng \u0111ang \u0111i\u1ec1u tr\u1ecb nh\u1eb1m m\u1ee5c \u0111\u00edch lo\u1ea1i b\u1ecf m\u1ea3nh v\u1ee5n m\u00f4, b\u01a1m r\u1eeda, kh\u1eed tr\u00f9ng v\u00e0 tr\u00e1m b\u00edt m\u1ed9t c\u00e1ch th\u00edch h\u1ee3p. Tr\u01b0\u1edbc khi t\u1ea1o \u0111\u01b0\u1eddng v\u00e0o b\u00ean trong bu\u1ed3ng t\u1ee7y, t\u1ea5t c\u1ea3 m\u00f4 r\u0103ng s\u00e2u v\u00e0 ph\u1ea7n ph\u1ee5c h\u1ed3i b\u1ecb h\u01b0 h\u1ecfng ph\u1ea3i \u0111\u01b0\u1ee3c lo\u1ea1i b\u1ecf h\u1ebft \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o k\u1ef9 thu\u1eadt v\u00f4 tr\u00f9ng v\u00e0 \u0111\u1ec3 tr\u00e1nh r\u00f2 r\u1ec9 t\u1eeb th\u00e2n r\u0103ng gi\u1eefa c\u00e1c l\u1ea7n h\u1eb9n. B\u00e0i vi\u1ebft n\u00e0y cung c\u1ea5p cho Nha s\u0129 m\u1ed9t c\u00e1i nh\u00ecn t\u1ed5ng quan nh\u1ea5t v\u1ec1 nguy\u00ean t\u1eafc s\u1eeda so\u1ea1n l\u1ed1i v\u00e0o bu\u1ed3ng tu\u1ef7, \u0111\u1ed3ng th\u1eddi so s\u00e1nh gi\u1eefa qu\u00e1 tr\u00ecnh m\u1edf tu\u1ef7 truy\u1ec1n th\u1ed1ng v\u00e0 qu\u00e1 tr\u00ecnh m\u1edf tu\u1ef7 theo ph\u01b0\u01a1ng ph\u00e1p b\u1ea3o t\u1ed3n. C\u00f9ng t\u00ecm hi\u1ec3u k\u1ef9 h\u01a1n trong b\u00e0i vi\u1ebft sau.<\/strong><\/p>\n

1. Nguy\u00ean t\u1eafc m\u1edf t\u1ee7y<\/h2>\n

\u0110i\u1ec1u tr\u1ecb n\u1ed9i nha l\u00e2m s\u00e0ng lu\u00f4n b\u1eaft \u0111\u1ea7u v\u1edbi vi\u1ec7c m\u1edf t\u1ee7y. M\u1ee5c \u0111\u00edch c\u1ee7a vi\u1ec7c m\u1edf t\u1ee7y l\u00e0 x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed t\u1ea5t c\u1ea3 c\u00e1c l\u1ed7 v\u00e0o \u1ed1ng t\u1ee7y c\u1ee7a r\u0103ng \u0111ang \u0111i\u1ec1u tr\u1ecb nh\u1eb1m m\u1ee5c \u0111\u00edch lo\u1ea1i b\u1ecf m\u1ea3nh v\u1ee5n m\u00f4, b\u01a1m r\u1eeda, kh\u1eed tr\u00f9ng v\u00e0 tr\u00e1m b\u00edt m\u1ed9t c\u00e1ch th\u00edch h\u1ee3p. Tr\u01b0\u1edbc khi t\u1ea1o \u0111\u01b0\u1eddng v\u00e0o b\u00ean trong bu\u1ed3ng t\u1ee7y, t\u1ea5t c\u1ea3 m\u00f4 r\u0103ng s\u00e2u v\u00e0 ph\u1ea7n ph\u1ee5c h\u1ed3i b\u1ecb h\u01b0 h\u1ecfng ph\u1ea3i \u0111\u01b0\u1ee3c lo\u1ea1i b\u1ecf h\u1ebft \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o k\u1ef9 thu\u1eadt v\u00f4 tr\u00f9ng v\u00e0 \u0111\u1ec3 tr\u00e1nh r\u00f2 r\u1ec9 t\u1eeb th\u00e2n r\u0103ng gi\u1eefa c\u00e1c l\u1ea7n h\u1eb9n. Nhi\u1ec1u ng\u01b0\u1eddi cho r\u1eb1ng vi\u1ec7c lo\u1ea1i b\u1ecf t\u1ea5t c\u1ea3 c\u00e1c ph\u1ee5c h\u1ed3i hi\u1ec7n c\u00f3 c\u1ee7a r\u0103ng \u0111ang \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha l\u00e0 r\u1ea5t c\u1ea7n thi\u1ebft \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o lo\u1ea1i b\u1ecf ho\u00e0n to\u00e0n m\u00f4 r\u0103ng s\u00e2u, ph\u00e1t hi\u1ec7n c\u00e1c v\u1ebft n\u1ee9t g\u00e3y v\u00e0 \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 ch\u00ednh x\u00e1c kh\u1ea3 n\u0103ng ph\u1ee5c h\u1ed3i c\u1ee7a r\u0103ng v\u1ec1 sau.<\/p>\n

2. So s\u00e1nh vi\u1ec7c s\u1eeda so\u1ea1n l\u1ed1i v\u00e0o b\u1ea3o t\u1ed3n v\u1edbi l\u1ed1i v\u00e0o truy\u1ec1n th\u1ed1ng<\/h2>\n

Theo truy\u1ec1n th\u1ed1ng, thu\u1eadt ng\u1eef h\u00ecnh th\u1ec3 ngo\u00e0i (outline form) v\u00e0 h\u00ecnh th\u1ec3 thu\u1eadn ti\u1ec7n (convenience form) \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 m\u00f4 t\u1ea3 h\u00ecnh d\u1ea1ng y\u00eau c\u1ea7u c\u1ee7a l\u1ed1i v\u00e0o xoang t\u1ee7y. Nh\u1eefng h\u00ecnh d\u1ea1ng l\u1ed1i v\u00e0o n\u00e0y l\u00e0 h\u00ecnh chi\u1ebfu c\u1ee7a gi\u1ea3i ph\u1eabu b\u00ean trong bu\u1ed3ng t\u1ee7y ra b\u00ean ngo\u00e0i b\u1ec1 m\u1eb7t r\u0103ng, cho ph\u00e9p t\u1ea1o l\u1ed1i v\u00e0o tr\u1ef1c ti\u1ebfp. K\u1ebft qu\u1ea3 l\u00e0 b\u00e1c s\u0129 l\u00e2m s\u00e0ng c\u00f3 th\u1ec3 quan s\u00e1t \u0111\u01b0\u1ee3c t\u1ea5t c\u1ea3 c\u00e1c mi\u1ec7ng \u1ed1ng t\u1ee7y c\u00f9ng m\u1ed9t l\u00fac m\u00e0 kh\u00f4ng c\u1ea7n ph\u1ea3i nghi\u00eang g\u01b0\u01a1ng. D\u01b0\u1eddng nh\u01b0 ta c\u00f3 th\u1ec3 c\u00f3 c\u01a1 h\u1ed9i b\u1ea3o t\u1ed3n m\u1ed9t l\u01b0\u1ee3ng ng\u00e0 \u0111\u00e1ng k\u1ec3 trong khi v\u1eabn \u0111\u1ea3m b\u1ea3o kh\u1ea3 n\u0103ng \u0111\u1ecbnh v\u1ecb t\u1ea5t c\u1ea3 c\u00e1c mi\u1ec7ng \u1ed1ng t\u1ee7y trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p s\u1eeda so\u1ea1n l\u1ed1i v\u00e0o b\u1ea3o t\u1ed3n h\u01a1n.<\/p>\n

G\u1ea7n \u0111\u00e2y, c\u00e1c h\u00ecnh d\u1ea1ng l\u1ed1i v\u00e0o t\u1ee7y truy\u1ec1n th\u1ed1ng \u0111\u00e3 ch\u1ea5p nh\u1eadn tr\u01b0\u1edbc kia \u0111\u01b0\u1ee3c \u0111\u1eb7t v\u1ea5n \u0111\u1ec1 b\u1edfi v\u00ec s\u1ef1 suy y\u1ebfu r\u0103ng do lo\u1ea1i b\u1ecf qu\u00e1 nhi\u1ec1u ng\u00e0 r\u0103ng l\u00e0m cho r\u0103ng d\u1ec5 b\u1ecb g\u00e3y v\u1ee1 d\u01b0\u1edbi l\u1ef1c ch\u1ee9c n\u0103ng theo th\u1eddi gian. N\u1ee9t g\u00e3y r\u0103ng sau n\u1ed9i nha th\u01b0\u1eddng do c\u1ea5u tr\u00fac r\u0103ng suy y\u1ebfu b\u1edfi s\u00e2u r\u0103ng v\u00e0 c\u00e1c ph\u1ee5c h\u1ed3i sau \u0111\u00f3, do t\u1ea1o \u0111\u01b0\u1eddng v\u00e0o qu\u00e1 l\u1edbn, m\u1edf r\u1ed9ng \u1ed1ng t\u1ee7y qu\u00e1 m\u1ee9c c\u1ea7n thi\u1ebft, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf m\u1ed9t ph\u1ea7n ba c\u1ed5 r\u0103ng v\u00e0 nh\u1eefng vi\u1ec7c s\u1eeda so\u1ea1n sau \u0111\u00f3. B\u1eb1ng c\u00e1ch thay \u0111\u1ed5i sang c\u00e1c thi\u1ebft k\u1ebf h\u00ecnh d\u1ea1ng l\u1ed1i v\u00e0o b\u1ea3o t\u1ed3n h\u01a1n, m\u1ed9t l\u01b0\u1ee3ng ng\u00e0 \u0111\u00e1ng k\u1ec3 \u0111\u01b0\u1ee3c gi\u1eef l\u1ea1i, do \u0111\u00f3 l\u00e0m t\u0103ng kh\u1ea3 n\u0103ng kh\u00e1ng g\u00e3y c\u1ee7a c\u00e1c r\u0103ng c\u1ed1i nh\u1ecf v\u00e0 r\u0103ng c\u1ed1i l\u1edbn h\u00e0m d\u01b0\u1edbi.<\/p>\n

\"sua-soan-loi-vao-1\"
L\u1ed1i v\u00e0o t\u1ee7y b\u1ea3o t\u1ed3n tr\u00ean r\u0103ng #2.<\/figcaption><\/figure>\n
\"sua-soan-loi-vao-2\"
L\u1ed1i v\u00e0o t\u1ee7y b\u1ea3o t\u1ed3n tr\u00ean r\u0103ng #2.<\/figcaption><\/figure>\n
\"\"
(a) Phim X-quang sau tr\u00e1m b\u00edt minh h\u1ecda l\u1ed1i v\u00e0o t\u1ee7y b\u1ea3o t\u1ed3n tr\u00ean r\u0103ng #30. (b) R\u0103ng #19 minh ho\u1ea1 “c\u1ee5m l\u1ed1i v\u00e0o”.<\/figcaption><\/figure>\n

Do \u0111\u00f3, kh\u00e1i ni\u1ec7m “n\u1ed9i nha x\u00e2m l\u1ea5n t\u1ed1i thi\u1ec3u” (minimally invasive endodontic) \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o t\u1eeb \u0111i\u1ec3n, v\u1edbi m\u1ee5c \u0111\u00edch b\u1ea3o v\u1ec7 t\u1ed1i \u0111a m\u00f4 r\u0103ng l\u00e0nh m\u1ea1nh trong su\u1ed1t th\u1ee7 thu\u1eadt n\u1ed9i nha, nh\u1eb1m l\u00e0m t\u0103ng kh\u1ea3 n\u0103ng t\u1ed3n t\u1ea1i l\u00e2u d\u00e0i c\u1ee7a r\u0103ng. Theo kh\u00e1i ni\u1ec7m n\u00e0y, c\u00e1c l\u1ed7 m\u1edf t\u1ee7y ph\u1ea3i \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n v\u1edbi m\u1ee5c ti\u00eau b\u1ea3o t\u1ed3n c\u1ea5u tr\u00fac r\u0103ng l\u00e0nh m\u1ea1nh, quan tr\u1ecdng nh\u1ea5t l\u00e0 ng\u0103n ng\u1eeba s\u1ef1 \u0111\u00e2m th\u1ee7ng c\u1ed5 r\u0103ng theo chi\u1ec1u ngang ho\u1eb7c v\u00e0o b\u00ean trong s\u00e0n t\u1ee7y khi s\u1eed d\u1ee5ng tay khoan si\u00eau t\u1ed1c v\u1edbi m\u0169i khoan tr\u00f2n l\u1edbn. Ph\u1ea3i c\u00f3 s\u1ef1 c\u00e2n b\u1eb1ng gi\u1eefa m\u1ed9t l\u1ed1i v\u00e0o b\u1ea3o t\u1ed3n h\u1ee3p l\u00fd v\u1edbi m\u1ed9t l\u1ed1i v\u00e0o qu\u00e1 nh\u1ecf c\u00f3 th\u1ec3 ng\u0103n c\u1ea3n vi\u1ec7c x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed c\u1ee7a t\u1ea5t c\u1ea3 c\u00e1c mi\u1ec7ng \u1ed1ng t\u1ee7y v\u00e0 d\u1eabn \u0111\u1ebfn n\u1ed9i nha th\u1ea5t b\u1ea1i. Vi\u1ec7c lo\u1ea1i b\u1ecf qu\u00e1 m\u1ee9c ng\u00e0 r\u0103ng b\u00ean trong mi\u1ec7ng \u1ed1ng t\u1ee7y b\u1eb1ng c\u00e1c m\u0169i Peeso l\u1edbn, m\u0169i Gates \u2013 Glidden v\u00e0 c\u00e1c d\u1ee5ng c\u1ee5 m\u1edf r\u1ed9ng l\u1ed7 \u1ed1ng t\u1ee7y qu\u00e1 l\u1edbn c\u1ea7n ph\u1ea3i \u0111\u1eb7t v\u1ea5n \u0111\u1ec1 v\u00e0 ch\u00fang c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c thay b\u1eb1ng c\u00e1c d\u1ee5ng c\u1ee5 quay nh\u1ecf h\u01a1n (\u0111\u1ed9 thu\u00f4n 0,04 ho\u1eb7c 0,06).<\/p>\n

3. Gi\u1ea3i ph\u1eabu bu\u1ed3ng t\u1ee7y v\u00e0 v\u1ecb tr\u00ed \u1ed1ng t\u1ee7y<\/h2>\n

Ng\u01b0\u1eddi ta \u0111\u00e3 bi\u1ebft r\u1eb1ng gi\u1ea3i ph\u1eabu c\u00e1c th\u00e0nh v\u00e0 s\u00e0n bu\u1ed3ng t\u1ee7y s\u1ebd h\u01b0\u1edbng d\u1eabn x\u00e1c \u0111\u1ecbnh h\u00ecnh th\u00e1i h\u1ecdc th\u1ef1c s\u1ef1. Trong m\u1ed9t nghi\u00ean c\u1ee9u \u0111\u00e1nh gi\u00e1 500 r\u0103ng \u0111\u00e3 nh\u1ed5, ng\u01b0\u1eddi ta \u0111\u00e3 x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c r\u1eb1ng \u0111\u01b0\u1eddng n\u1ed1i men \u2013 cement l\u00e0 m\u1ed1c gi\u1ea3i ph\u1eabu quan tr\u1ecdng nh\u1ea5t \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed c\u1ee7a bu\u1ed3ng t\u1ee7y v\u00e0 c\u00e1c mi\u1ec7ng \u1ed1ng t\u1ee7y. Nghi\u00ean c\u1ee9u c\u00f2n ch\u1ee9ng minh s\u1ef1 t\u1ed3n t\u1ea1i c\u1ee7a c\u00e1c th\u00e0nh v\u00e0 s\u00e0n bu\u1ed3ng t\u1ee7y \u0111\u1eb7c bi\u1ec7t v\u00e0 ph\u00f9 h\u1ee3p v\u1edbi nhau, c\u00e1c t\u00e1c gi\u1ea3 \u0111\u00e3 \u0111\u1ec1 xu\u1ea5t c\u00e1c quy lu\u1eadt gi\u00fap b\u00e1c s\u0129 l\u00e2m s\u00e0ng x\u00e1c \u0111\u1ecbnh \u0111\u00fang h\u00ecnh th\u00e1i \u1ed1ng t\u1ee7y. C\u00e1c m\u1ed1i li\u00ean h\u1ec7 \u0111\u01b0\u1ee3c th\u1ec3 hi\u1ec7n trong c\u00e1c “lu\u1eadt” n\u00e0y x\u1ea3y ra \u1edf 95% r\u0103ng \u0111\u01b0\u1ee3c ki\u1ec3m tra v\u00e0 n\u00f3 \u0111\u1eb7c bi\u1ec7t h\u1eefu \u00edch trong vi\u1ec7c \u0111\u1ecbnh v\u1ecb c\u00e1c \u1ed1ng t\u1ee7y b\u1ecb canxi h\u00f3a. S\u1ef1 hi\u1ec3u bi\u1ebft \u0111\u1ea7y \u0111\u1ee7 v\u1ec1 gi\u1ea3i ph\u1eabu h\u1ec7 th\u1ed1ng \u1ed1ng t\u1ee7y ch\u00e2n r\u0103ng l\u00e0 b\u01b0\u1edbc \u0111\u1ea7u ti\u00ean trong vi\u1ec7c \u0111i\u1ec1u tr\u1ecb t\u1ed1i \u01b0u cho b\u1ec7nh nh\u00e2n n\u1ed9i nha. Tr\u00ean th\u1ef1c t\u1ebf, m\u1ed7i b\u01b0\u1edbc ti\u1ebfp theo trong quy tr\u00ecnh l\u00e2m s\u00e0ng \u0111\u01b0\u1ee3c x\u00e2y d\u1ef1ng d\u1ef1a tr\u00ean ch\u1ea5t l\u01b0\u1ee3ng k\u0129 thu\u1eadt c\u1ee7a b\u01b0\u1edbc tr\u01b0\u1edbc \u0111\u00f3. Tuy nhi\u00ean, thay \u0111\u1ed5i vi\u1ec7c s\u1eeda so\u1ea1n xoang t\u1ee7y v\u00e0 \u0111\u1eb7c bi\u1ec7t l\u00e0 v\u1ecb tr\u00ed c\u1ee7a \u1ed1ng tu\u1ef7 n\u00ean \u0111\u01b0\u1ee3c ki\u1ec3m tra l\u1ea1i v\u00e0 \u0111i\u1ec1u ch\u1ec9nh t\u00f9y theo t\u00ecnh hu\u1ed1ng l\u00e2m s\u00e0ng.<\/p>\n

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

\u0110i\u1ec1u tr\u1ecb n\u1ed9i nha l\u00e2m s\u00e0ng lu\u00f4n b\u1eaft \u0111\u1ea7u v\u1edbi vi\u1ec7c m\u1edf t\u1ee7y. M\u1ee5c \u0111\u00edch c\u1ee7a vi\u1ec7c m\u1edf t\u1ee7y l\u00e0 x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed t\u1ea5t c\u1ea3 c\u00e1c l\u1ed7 v\u00e0o \u1ed1ng t\u1ee7y c\u1ee7a r\u0103ng \u0111ang \u0111i\u1ec1u tr\u1ecb nh\u1eb1m m\u1ee5c \u0111\u00edch lo\u1ea1i b\u1ecf m\u1ea3nh v\u1ee5n m\u00f4, b\u01a1m r\u1eeda, kh\u1eed tr\u00f9ng v\u00e0 tr\u00e1m b\u00edt m\u1ed9t c\u00e1ch th\u00edch h\u1ee3p. […]<\/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":"\nS\u1eeda so\u1ea1n l\u1ed1i v\u00e0o trong qu\u00e1 tr\u00ecnh m\u1edf tu\u1ef7 l\u00e2m s\u00e0ng - T\u1ed5ng quan.<\/title>\n<meta name=\"description\" content=\"B\u00e0i vi\u1ebft cung c\u1ea5p cho Nha s\u0129 v\u1ec1 nguy\u00ean t\u1eafc s\u1eeda so\u1ea1n l\u1ed1i v\u00e0o bu\u1ed3ng tu\u1ef7, so s\u00e1nh ph\u01b0\u01a1ng ph\u00e1p truy\u1ec1n th\u1ed1ng v\u00e0 ph\u01b0\u01a1ng ph\u00e1p b\u1ea3o t\u1ed3n. 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