{"id":27937,"date":"2023-04-24T16:15:51","date_gmt":"2023-04-24T09:15:51","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=27937"},"modified":"2023-05-02T09:25:26","modified_gmt":"2023-05-02T02:25:26","slug":"bom-rua-ong-tuy-danh-gia-ve-cac-loai-hoa-chat-su-dung","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/24\/bom-rua-ong-tuy-danh-gia-ve-cac-loai-hoa-chat-su-dung\/","title":{"rendered":"B\u01a1m r\u1eeda \u1ed1ng tu\u1ef7 – \u0110\u00e1nh gi\u00e1 v\u1ec1 c\u00e1c lo\u1ea1i ho\u00e1 ch\u1ea5t s\u1eed d\u1ee5ng."},"content":{"rendered":"

B\u01b0\u1edbc quan tr\u1ecdng nh\u1ea5t trong \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha li\u00ean quan \u0111\u1ebfn kh\u1eed tr\u00f9ng l\u00e0 s\u1eeda so\u1ea1n c\u01a1 \u2013 h\u00f3a h\u1ecdc (t\u1ea1o h\u00ecnh v\u00e0 b\u01a1m r\u1eeda \u1ed1ng tu\u1ef7). B\u00ean c\u1ea1nh kh\u1ea3 n\u0103ng lo\u1ea1i b\u1ecf vi khu\u1ea9n kh\u1ecfi \u1ed1ng t\u1ee7y nh\u1edd t\u00e1c \u0111\u1ed9ng c\u01a1 h\u1ecdc v\u00e0 h\u00f3a h\u1ecdc, vi\u1ec7c b\u01a1m r\u1eeda c\u00f2n c\u00f3 nhi\u1ec1u t\u00e1c d\u1ee5ng kh\u00e1c trong qu\u00e1 tr\u00ecnh s\u1eeda so\u1ea1n, v\u00ec n\u00f3 r\u1eeda tr\u00f4i m\u1ea3nh v\u1ee5n m\u00f4, m\u00f4 t\u1ee7y vi\u00eam v\u00e0 ho\u1ea1i t\u1eed, ph\u00e2n h\u1ee7y m\u00f4 m\u1ec1m, ho\u1ea1t \u0111\u1ed9ng nh\u01b0 m\u1ed9t ch\u1ea5t b\u00f4i tr\u01a1n \u0111\u1ec3 \u0111\u01b0a d\u1ee5ng c\u1ee5 v\u00e0o d\u1ec5 d\u00e0ng, ng\u0103n ng\u1eeba s\u1ef1 t\u00edch t\u1ee5 v\u1ee5n ng\u00e0 t\u1ee7y trong l\u1ed7 ch\u00f3p v\u00e0 lo\u1ea1i b\u1ecf l\u1edbp m\u00f9n. B\u00e0i vi\u1ebft n\u00e0y t\u1eadp trung \u0111\u1ec1 c\u1eadp \u0111\u1ebfn c\u00e1c lo\u1ea1i ho\u00e1 ch\u1ea5t s\u1eed d\u1ee5ng trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb N\u1ed9i nha. C\u00f9ng t\u00ecm hi\u1ec3u.<\/strong><\/p>\n

1. T\u1ed5ng quan v\u1ec1 c\u00e1c ch\u1ea5t b\u01a1m r\u1eeda \u1ed1ng tu\u1ef7 trong \u0111i\u1ec1u tr\u1ecb N\u1ed9i nha<\/h2>\n

B\u01b0\u1edbc quan tr\u1ecdng nh\u1ea5t trong \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha li\u00ean quan \u0111\u1ebfn kh\u1eed tr\u00f9ng l\u00e0 s\u1eeda so\u1ea1n c\u01a1 \u2013 h\u00f3a h\u1ecdc (t\u1ea1o h\u00ecnh v\u00e0 b\u01a1m r\u1eeda) v\u00e0 b\u0103ng thu\u1ed1c gi\u1eefa c\u00e1c l\u1ea7n h\u1eb9n. S\u1eeda so\u1ea1n \u0111\u00f3ng vai tr\u00f2 then ch\u1ed1t trong vi\u1ec7c kh\u1eed tr\u00f9ng \u1ed1ng t\u1ee7y, v\u00ec vi\u1ec7c t\u1ea1o h\u00ecnh v\u00e0 b\u01a1m r\u1eeda ho\u1ea1t \u0111\u1ed9ng tr\u01b0\u1edbc h\u1ebft \u1edf c\u00e1c \u1ed1ng t\u1ee7y ch\u00ednh, l\u00e0 v\u00f9ng r\u1ed9ng nh\u1ea5t c\u1ee7a c\u1ea3 h\u1ec7 th\u1ed1ng \u1ed1ng t\u1ee7y, do \u0111\u00f3 c\u0169ng l\u00e0 n\u01a1i tr\u00fa ng\u1ee5 c\u1ee7a nhi\u1ec1u vi khu\u1ea9n nh\u1ea5t. M\u1ed9t l\u01b0\u1ee3ng l\u1edbn vi khu\u1ea9n s\u1ebd \u0111\u01b0\u1ee3c lo\u1ea1i b\u1ecf kh\u1ecfi \u1ed1ng t\u1ee7y nh\u1edd vi\u1ec7c s\u1eeda so\u1ea1n c\u01a1 h\u1ecdc v\u00e0 t\u00e1c \u0111\u1ed9ng r\u1eeda tr\u00f4i c\u1ee7a ch\u1ea5t b\u01a1m r\u1eeda trong su\u1ed1t qu\u00e1 tr\u00ecnh s\u1eeda so\u1ea1n, tuy nhi\u00ean trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m tr\u00f9ng n\u1eb7ng th\u00ec c\u1ea7n s\u1eed d\u1ee5ng ch\u1ea5t b\u01a1m r\u1eeda c\u00f3 t\u00ednh kh\u00e1ng khu\u1ea9n. B\u00ean c\u1ea1nh kh\u1ea3 n\u0103ng lo\u1ea1i b\u1ecf vi khu\u1ea9n kh\u1ecfi \u1ed1ng t\u1ee7y nh\u1edd t\u00e1c \u0111\u1ed9ng c\u01a1 h\u1ecdc v\u00e0 h\u00f3a h\u1ecdc, vi\u1ec7c b\u01a1m r\u1eeda c\u00f2n c\u00f3 nhi\u1ec1u t\u00e1c d\u1ee5ng kh\u00e1c trong qu\u00e1 tr\u00ecnh s\u1eeda so\u1ea1n, v\u00ec n\u00f3 r\u1eeda tr\u00f4i m\u1ea3nh v\u1ee5n m\u00f4, m\u00f4 t\u1ee7y vi\u00eam v\u00e0 ho\u1ea1i t\u1eed, ph\u00e2n h\u1ee7y m\u00f4 m\u1ec1m, ho\u1ea1t \u0111\u1ed9ng nh\u01b0 m\u1ed9t ch\u1ea5t b\u00f4i tr\u01a1n \u0111\u1ec3 \u0111\u01b0a d\u1ee5ng c\u1ee5 v\u00e0o d\u1ec5 d\u00e0ng, ng\u0103n ng\u1eeba s\u1ef1 t\u00edch t\u1ee5 v\u1ee5n ng\u00e0 t\u1ee7y trong l\u1ed7 ch\u00f3p v\u00e0 lo\u1ea1i b\u1ecf l\u1edbp m\u00f9n.<\/p>\n

2. \u0110\u00e1nh gi\u00e1 v\u1ec1 c\u00e1c lo\u1ea1i ho\u00e1 ch\u1ea5t s\u1eed d\u1ee5ng trong qu\u00e1 tr\u00ecnh<\/h2>\n

Natri Hypochlorite (NaOCl)<\/strong><\/p>\n

NaOCl l\u00e0 h\u1ee3p ch\u1ea5t b\u01a1m r\u1eeda \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn nh\u1ea5t trong th\u1ef1c h\u00e0nh n\u1ed9i nha, v\u00e0 \u0111\u1ebfn nay v\u1eabn ch\u01b0a c\u00f3 nghi\u00ean c\u1ee9u n\u00e0o t\u00ecm ra m\u1ed9t ch\u1ea5t kh\u00e1c hi\u1ec7u qu\u1ea3 h\u01a1n n\u00f3 trong vi\u1ec7c kh\u1eed tr\u00f9ng. Dung d\u1ecbch b\u01a1m r\u1eeda \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o c\u00f3 n\u1ed3ng \u0111\u1ed9 t\u1eeb 0.5% \u0111\u1ebfn 8%.<\/p>\n

NaOCl l\u00e0 ch\u1ea5t kh\u00e1ng khu\u1ea9n ph\u1ed5 r\u1ed9ng, ti\u00eau di\u1ec7t nhanh vi khu\u1ea9n, b\u00e0o t\u1eed, n\u1ea5m, t\u1ea3o v\u00e0 virus. H\u1ea7u h\u1ebft c\u00e1c vi khu\u1ea9n trong mi\u1ec7ng \u0111\u1ec1u b\u1ecb ti\u00eau di\u1ec7t nhanh ch\u00f3ng sau khi ti\u1ebfp x\u00fac v\u1edbi NaOCl. T\u00ednh kh\u00e1ng khu\u1ea9n c\u1ee7a NaOCl ch\u1ee7 y\u1ebfu l\u00e0 do n\u00f3 t\u1ea1o ra s\u1ef1 oxi h\u00f3a kh\u00f4ng \u0111\u1ea3o ng\u01b0\u1ee3c \u1edf c\u00e1c nh\u00f3m sulfhydryl c\u00f3 trong c\u00e1c enzyme thi\u1ebft y\u1ebfu cho s\u1ef1 s\u1ed1ng c\u1ee7a vi khu\u1ea9n.<\/p>\n

Chlorhexidine (CHX)<\/strong><\/p>\n

CHX l\u00e0 m\u1ed9t h\u1ee3p ch\u1ea5t bis-biguanic ion d\u01b0\u01a1ng, \u0111\u01b0\u1ee3c d\u00f9ng r\u1ed9ng r\u00e3i trong vi\u1ec7c kh\u1eed tr\u00f9ng t\u1ea1i ch\u1ed7. CHX c\u00f3 hi\u1ec7u qu\u1ea3 cao \u0111\u1ed1i v\u1edbi m\u1ed9t v\u00e0i ch\u1ee7ng vi khu\u1ea9n trong mi\u1ec7ng. N\u00f3 c\u0169ng c\u00f3 t\u00e1c d\u1ee5ng tr\u00ean ng\u00e0 r\u0103ng v\u00e0 c\u00f3 t\u00ednh t\u01b0\u01a1ng h\u1ee3p sinh h\u1ecdc ch\u1ea5p nh\u1eadn \u0111\u01b0\u1ee3c. Nh\u1edd nh\u1eefng \u0111\u1eb7c t\u00ednh \u0111\u00f3, CHX \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u01b0 m\u1ed9t ch\u1ea5t b\u01a1m r\u1eeda v\u00e0 thu\u1ed1c \u0111\u1eb7t gi\u1eefa c\u00e1c l\u1ea7n h\u1eb9n. Khi \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng v\u1edbi n\u1ed3ng \u0111\u1ed9 cao, CHX \u0111i v\u00e0o t\u1ebf b\u00e0o ch\u1ea5t nh\u1edd l\u1edbp m\u00e0ng t\u1ebf b\u00e0o b\u1ecb ph\u00e1 h\u1ee7y, l\u00e0m k\u1ebft t\u1ee7a c\u00e1c th\u00e0nh ph\u1ea7n trong t\u1ebf b\u00e0o ch\u1ea5t, \u0111\u1eb7c bi\u1ec7t l\u00e0 phosphate v\u00e0 d\u1eabn t\u1edbi k\u1ebft qu\u1ea3 l\u00e0m ch\u1ebft t\u1ebf b\u00e0o.<\/p>\n

Hi\u1ec7u qu\u1ea3 di\u1ec7t khu\u1ea9n trong \u1ed1ng t\u1ee7y c\u1ee7a c\u00e1c ch\u1ea5t b\u01a1m r\u1eeda<\/strong><\/p>\n

Vi\u1ec7c s\u1eed d\u1ee5ng NaOCl l\u00e0 ch\u1ea5t b\u01a1m r\u1eeda ch\u00ednh l\u00e0m t\u0103ng hi\u1ec7u qu\u1ea3 kh\u1eed tr\u00f9ng n\u1ed9i t\u1ee7y so v\u1edbi b\u01a1m r\u1eeda b\u1eb1ng n\u01b0\u1edbc mu\u1ed1i. Qu\u00e1 tr\u00ecnh s\u1eeda so\u1ea1n c\u01a1 \u2013 h\u00f3a h\u1ecdc v\u00e0 b\u01a1m r\u1eeda b\u1eb1ng NaOC1 2.5% l\u00e0m gi\u1ea3m 10 \u0111\u1ebfn 105l\u1ea7n s\u1ed1 l\u01b0\u1ee3ng vi khu\u1ea9n, v\u1edbi m\u1ee9c gi\u1ea3m t\u1ed5ng c\u1ed9ng t\u1edbi 95%. Sau khi b\u01a1m r\u1eeda v\u1edbi NaOCl (n\u1ed3ng \u0111\u1ed9 t\u1eeb 0.5% \u0111\u1ebfn 5%) kho\u1ea3ng 40% \u0111\u1ebfn 60% \u1ed1ng t\u1ee7y kh\u00f4ng t\u00ecm th\u1ea5y vi khu\u1ea9n s\u1ed1ng.<\/p>\n

Trong m\u00f4i tr\u01b0\u1eddng \u1ed1ng t\u1ee7y, t\u0103ng n\u1ed3ng \u0111\u1ed9 NaOCl kh\u00f4ng l\u00e0m t\u0103ng \u0111\u00e1ng k\u1ec3 hi\u1ec7u qu\u1ea3 di\u1ec7t khu\u1ea9n. Quan tr\u1ecdng nh\u1ea5t l\u00e0, th\u01b0\u1eddng xuy\u00ean thay \u0111\u1ed5i v\u00e0 s\u1eed d\u1ee5ng m\u1ed9t l\u01b0\u1ee3ng l\u1edbn ch\u1ea5t b\u01a1m r\u1eeda s\u1ebd gi\u00fap duy tr\u00ec hi\u1ec7u qu\u1ea3 kh\u00e1ng khu\u1ea9n c\u1ee7a dung d\u1ecbch NaOCI, thay v\u00ec ph\u1ea3i d\u00f9ng v\u1edbi n\u1ed3ng \u0111\u1ed9 l\u1edbn.<\/p>\n

3. B\u01a1m r\u1eeda \u0111\u1ec3 lo\u1ea1i b\u1ecf l\u1edbp m\u00f9n trong \u0111i\u1ec1u tr\u1ecb N\u1ed9i nha<\/h2>\n

L\u1edbp m\u00f9n bao g\u1ed3m nh\u1eefng ch\u1ea5t v\u00f4 c\u01a1 v\u00e0 h\u1eefu c\u01a1, \u0111\u01b0\u1ee3c h\u00ecnh th\u00e0nh \u1edf m\u00f4 r\u0103ng kho\u00e1ng h\u00f3a b\u1ea5t c\u1ee9 khi n\u00e0o ch\u00fang \u0111\u01b0\u1ee3c c\u1eaft b\u1eb1ng d\u1ee5ng c\u1ee5 tay hay d\u1ee5ng c\u1ee5 quay.<\/p>\n

\"bom-rua-ong-tuy-1\"
H\u00ecnh \u1ea3nh l\u1edbp m\u00f9n tr\u00ean th\u00e0nh \u1ed1ng t\u1ee7y tr\u00ean k\u00ednh hi\u1ec3n vi qu\u00e9t (a) v\u00e0 sau khi l\u1edbp m\u00f9n \u0111\u01b0\u1ee3c lo\u1ea1i b\u1ecf (b).<\/figcaption><\/figure>\n

L\u1edbp m\u00f9n bao ph\u1ee7 th\u00e0nh \u1ed1ng t\u1ee7y \u0111\u00e3 s\u1eeda so\u1ea1n c\u00f3 \u0111\u1ed9 d\u00e0y kho\u1ea3ng 1-2 micromet v\u00e0 c\u0169ng c\u00f3 th\u1ec3 quan s\u00e1t th\u1ea5y \u1edf m\u1ed9t s\u1ed1 v\u00f9ng nh\u01b0 nh\u1eefng n\u00fat ch\u1eb7n trong \u1ed1ng ng\u00e0, \u0111\u00f4i khi \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 n\u00fat m\u00f9n. Vi\u1ec7c lo\u1ea1i b\u1ecf l\u1edbp m\u00f9n l\u00e0 r\u1ea5t c\u1ea7n thi\u1ebft \u0111\u1ec3 t\u0103ng c\u01b0\u1eddng kh\u1ea3 n\u0103ng kh\u1eed tr\u00f9ng \u1ed1ng t\u1ee7y, v\u00ec l\u1edbp m\u00f9n n\u00e0y c\u00f3 th\u1ec3 ch\u1ee9a vi khu\u1ea9n v\u00e0 ch\u1ea5t n\u1ec1n c\u00f2n s\u00f3t c\u00f3 th\u1ec3 l\u00e0 ngu\u1ed3n g\u1ed1c ti\u1ec1m \u1ea9n g\u00e2y nhi\u1ec5m tr\u00f9ng dai d\u1eb3ng trong \u1ed1ng t\u1ee7y. B\u00ean c\u1ea1nh \u0111\u00f3, l\u1edbp m\u00f9n c\u00f2n l\u00e0m ch\u1eadm s\u1ef1 khu\u1ebfch t\u00e1n c\u1ee7a thu\u1ed1c kh\u00e1ng khu\u1ea9n t\u1eeb khoang t\u1ee7y r\u0103ng v\u00e0o c\u00e1c \u1ed1ng ng\u00e0, l\u00e0m gi\u1ea3m t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c.<\/p>\n

Th\u00e0nh ph\u1ea7n v\u00f4 c\u01a1 c\u1ee7a l\u1edbp m\u00f9n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c lo\u1ea1i b\u1ecf nh\u1edd c\u00e1c ch\u1ea5t kh\u1eed kho\u00e1ng, nh\u01b0 ethylene diamine tetra acetic acid (EDTA), citric acid v\u00e0 nh\u1eefng s\u1ea3n ph\u1ea9m c\u00f3 ch\u1ee9a doxycycline (BioPure MTAD, Dentsply, Tulsa, OK, v\u00e0 Tetraclean, Ogna Laboratori Farmaceutici, Milano, Italy).<\/p>\n

EDTA kh\u00f4ng t\u00e1c d\u1ee5ng t\u1ee9c th\u00ec ngay khi ti\u1ebfp x\u00fac v\u1edbi m\u00f4 kho\u00e1ng, m\u00e0 ph\u1ea3i m\u1ea5t v\u00e0i ph\u00fat \u0111\u1ec3 c\u00f3 t\u00e1c d\u1ee5ng chelat h\u00f3a. M\u1eb7c d\u00f9 EDTA c\u0169ng c\u00f3 m\u1ed9t v\u00e0i ho\u1ea1t t\u00ednh kh\u00e1ng khu\u1ea9n nh\u01b0ng ng\u01b0\u1eddi ta kh\u00f4ng mong \u0111\u1ee3i n\u00f3 gi\u00fap c\u1ea3i thi\u1ec7n vi\u1ec7c kh\u1eed tr\u00f9ng, khi m\u00e0 vi\u1ec7c \u0111\u00f3 \u0111\u00e3 \u0111\u1ea1t \u0111\u01b0\u1ee3c b\u1eb1ng b\u01a1m r\u1eeda tr\u01b0\u1edbc \u0111\u00f3 v\u1edbi NaOCl hay CHX. V\u00ec v\u1eady m\u1ee5c \u0111\u00edch ch\u00ednh c\u1ee7a vi\u1ec7c s\u1eed d\u1ee5ng EDTA trong \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha l\u00e0 lo\u1ea1i b\u1ecf l\u1edbp m\u00f9n ng\u00e0.<\/p>\n

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

B\u01b0\u1edbc quan tr\u1ecdng nh\u1ea5t trong \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha li\u00ean quan \u0111\u1ebfn kh\u1eed tr\u00f9ng l\u00e0 s\u1eeda so\u1ea1n c\u01a1 \u2013 h\u00f3a h\u1ecdc (t\u1ea1o h\u00ecnh v\u00e0 b\u01a1m r\u1eeda \u1ed1ng tu\u1ef7). B\u00ean c\u1ea1nh kh\u1ea3 n\u0103ng lo\u1ea1i b\u1ecf vi khu\u1ea9n kh\u1ecfi \u1ed1ng t\u1ee7y nh\u1edd t\u00e1c \u0111\u1ed9ng c\u01a1 h\u1ecdc v\u00e0 h\u00f3a h\u1ecdc, vi\u1ec7c b\u01a1m r\u1eeda c\u00f2n c\u00f3 nhi\u1ec1u t\u00e1c d\u1ee5ng […]<\/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":"\nB\u01a1m r\u1eeda \u1ed1ng tu\u1ef7 - \u0110\u00e1nh gi\u00e1 v\u1ec1 c\u00e1c lo\u1ea1i ho\u00e1 ch\u1ea5t s\u1eed d\u1ee5ng. - Vinmec<\/title>\n<meta name=\"description\" content=\"B\u00e0i vi\u1ebft n\u00e0y t\u1eadp trung \u0111\u1ec1 c\u1eadp \u0111\u1ebfn c\u00e1c lo\u1ea1i ho\u00e1 ch\u1ea5t b\u01a1m r\u1eeda \u1ed1ng tu\u1ef7 s\u1eed d\u1ee5ng trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb N\u1ed9i nha. 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