{"id":27943,"date":"2023-04-24T17:17:40","date_gmt":"2023-04-24T10:17:40","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=27943"},"modified":"2023-05-02T09:23:50","modified_gmt":"2023-05-02T02:23:50","slug":"tong-quan-ve-thuoc-dat-noi-nha-goc-nhin-ve-calcium-hydroxide","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/24\/tong-quan-ve-thuoc-dat-noi-nha-goc-nhin-ve-calcium-hydroxide\/","title":{"rendered":"T\u1ed5ng quan v\u1ec1 thu\u1ed1c \u0111\u1eb7t N\u1ed9i nha – G\u00f3c nh\u00ecn v\u1ec1 Calcium hydroxide."},"content":{"rendered":"

Trong qu\u00e1 tr\u00ecnh s\u1eeda so\u1ea1n \u1ed1ng tu\u1ef7, cho d\u00f9 Nha s\u0129 \u0111\u00e3 s\u1eed d\u1ee5ng c\u00e1c lo\u1ea1i ho\u00e1 ch\u1ea5t chuy\u00ean d\u1ee5ng nh\u1eb1m r\u1eeda tr\u00f4i m\u00f9n ng\u00e0 nhi\u1ec5m khu\u1ea9n v\u00e0 di\u1ec7t t\u00e1c nh\u00e2n g\u00e2y h\u1ea1i n\u00e0y, th\u00ec m\u1ed9t s\u1ed1 v\u00f9ng trong h\u1ec7 th\u1ed1ng \u1ed1ng tu\u1ef7 v\u1eabn kh\u00f4ng th\u1ec3 l\u00e0m s\u1ea1ch h\u1ebft \u0111\u01b0\u1ee3c. V\u00ec th\u1ebf, ng\u01b0\u1eddi ta m\u1edbi cho ra \u0111\u1eddi c\u00e1c lo\u1ea1i thu\u1ed1c d\u00f9ng trong \u1ed1ng tu\u1ef7 c\u00f3 t\u00e1c d\u1ee5ng di\u1ec7t khu\u1ea9n. B\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y t\u00f3m t\u1eaft s\u01a1 l\u01b0\u1ee3c v\u00e0 \u0111\u1ed3ng th\u1eddi ch\u1ec9 ra \u01b0u \u0111i\u1ec3m c\u1ee7a Calcium hydroxide, m\u1ed9t lo\u1ea1i h\u1ee3p ch\u1ea5t r\u1ea5t ph\u1ed5 bi\u1ebfn trong \u0111i\u1ec1u tr\u1ecb N\u1ed9i nha. C\u00f9ng t\u00ecm hi\u1ec3u.<\/strong><\/p>\n

1. Nh\u1eefng lo\u1ea1i thu\u1ed1c c\u00f3 t\u00e1c d\u1ee5ng kh\u00e1ng khu\u1ea9n trong h\u1ec7 th\u1ed1ng \u1ed1ng tu\u1ef7<\/h2>\n

Nh\u1eefng vi khu\u1ea9n tr\u00e1nh \u0111\u01b0\u1ee3c t\u00e1c \u0111\u1ed9ng c\u1ee7a vi\u1ec7c s\u1eeda so\u1ea1n c\u01a1 \u2013 h\u00f3a h\u1ecdc th\u01b0\u1eddng n\u1eb1m \u1edf nh\u1eefng v\u00f9ng m\u00e0 d\u1ee5ng c\u1ee5 s\u1eeda so\u1ea1n v\u00e0 ch\u1ea5t b\u01a1m r\u1eeda kh\u00f4ng th\u1ec3 t\u1edbi \u0111\u01b0\u1ee3c. Nh\u1eefng v\u00f9ng kh\u00f4ng b\u1ecb \u1ea3nh h\u01b0\u1edfng n\u00e0y bao g\u1ed3m \u1ed1ng ng\u00e0, eo t\u1ee7y, \u1ed1ng t\u1ee7y b\u00ean, ch\u00f3p ph\u00e2n nh\u00e1nh v\u00e0 th\u1eadm ch\u00ed c\u1ea3 nh\u1eefng v\u00f9ng c\u1ee7a \u1ed1ng t\u1ee7y ch\u00ednh m\u00e0 d\u1ee5ng c\u1ee5 kh\u00f4ng th\u1ec3 \u0111\u01b0a t\u1edbi.<\/p>\n

\"Calcium-hydroxide-1\"
Nhi\u1ec5m tr\u00f9ng \u1ed1ng t\u1ee7y c\u00f3 th\u1ec3 lan ra nh\u1eefng v\u00f9ng kh\u00f3 l\u00e0m s\u1ea1ch. (a) M\u1ed9t l\u1edbp biofilm ph\u1ee7 l\u00ean nh\u1eefng th\u00e0nh \u1ed1ng t\u1ee7y b\u1ea5t th\u01b0\u1eddng v\u00e0 nh\u1eefng \u1ed1ng ng\u00e0 ph\u00eda d\u01b0\u1edbi b\u1ecb vi khu\u1ea9n trong biofilm x\u00e2m nh\u1eadp. (b) H\u00ecnh ch\u1eef nh\u1eadt \u1edf (a) \u0111\u01b0\u1ee3c ph\u00f3ng l\u1edbn.<\/figcaption><\/figure>\n
\"Calcium-hydroxide-2\"
Nh\u1eefng v\u00f9ng kh\u00f3 l\u00e0m s\u1ea1ch (a v\u00e0 b). Nhi\u1ec5m tr\u00f9ng \u1ed1ng t\u1ee7y lan r\u1ed9ng \u0111\u1ebfn \u1ed1ng t\u1ee7y b\u00ean v\u00e0 v\u00f9ng ph\u00e2n nh\u00e1nh \u1edf ph\u00eda ch\u00f3p. L\u01b0u \u00fd s\u1ef1 h\u00ecnh th\u00e0nh biofilm kh\u00f4ng ch\u1ec9 \u1edf \u1ed1ng t\u1ee7y ch\u00ednh m\u00e0 c\u00f2n \u1edf nh\u1eefng v\u00f9ng chia nh\u00e1nh. Vi khu\u1ea9n \u1edf nh\u1eefng v\u00f9ng n\u00e0y v\u1eabn c\u00f3 th\u1ec3 t\u1ed3n t\u1ea1i d\u00f9 \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eeda so\u1ea1n v\u00e0 b\u01a1m r\u1eeda.<\/figcaption><\/figure>\n

M\u1eb7c d\u00f9 nh\u1eefng ch\u1ea5t b\u01a1m r\u1eeda nh\u01b0 NaOCl hay Chlorhexidine c\u00f3 t\u00ednh kh\u00e1ng khu\u1ea9n m\u1ea1nh nh\u01b0ng hi\u1ec7u qu\u1ea3 c\u1ee7a ch\u00fang ph\u1ea7n l\u1edbn ch\u1ec9 gi\u1edbi h\u1ea1n trong \u1ed1ng t\u1ee7y ch\u00ednh. Do v\u1eady, c\u00e1c ch\u1ea5t b\u01a1m r\u1eeda c\u1ea7n \u0111\u01b0\u1ee3c b\u1ed5 sung th\u01b0\u1eddng xuy\u00ean v\u00e0 duy tr\u00ec trong th\u1eddi gian th\u00edch h\u1ee3p \u0111\u1ec3 hi\u1ec7u qu\u1ea3 kh\u00e1ng khu\u1ea9n c\u00f3 t\u00e1c d\u1ee5ng l\u00ean \u0111\u01b0\u1ee3c nh\u1eefng v\u00f9ng kh\u00f4ng th\u1ec3 s\u1eeda so\u1ea1n b\u1eb1ng d\u1ee5ng c\u1ee5. Trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng, c\u00e1c ch\u1ea5t b\u01a1m r\u1eeda n\u00ean \u0111\u01b0\u1ee3c khu\u1ebfch t\u00e1n \u0111\u1ebfn nh\u1eefng v\u00f9ng n\u00f3i tr\u00ean, nh\u01b0ng th\u1eddi gian ch\u00fang \u1edf trong \u1ed1ng t\u1ee7y r\u1ea5t ng\u1eafn, g\u00e2y ra nh\u1eefng gi\u1edbi h\u1ea1n \u0111\u00e1ng k\u1ec3. C\u00f3 th\u1ec3 so s\u00e1nh nh\u01b0 sau, ch\u1ea5t b\u01a1m r\u1eeda t\u00e1c \u0111\u1ed9ng trong \u1ed1ng t\u1ee7y t\u1eeb 10 \u0111\u1ebfn 30 ph\u00fat, c\u00f2n vi\u1ec7c b\u0103ng thu\u1ed1c th\u00ec c\u00f3 th\u1ec3 k\u00e9o d\u00e0i \u0111\u1ebfn v\u00e0i ng\u00e0y. Do v\u1eady, vi\u1ec7c b\u0103ng thu\u1ed1c n\u1ed9i t\u1ee7y l\u00e0m t\u0103ng kh\u1ea3 n\u0103ng khu\u1ebfch t\u00e1n, x\u00e2m nh\u1eadp v\u00e0 ti\u00eau di\u1ec7t vi khu\u1ea9n \u1edf nh\u1eefng v\u00f9ng kh\u00f3 ti\u1ebfp c\u1eadn. Qua nhi\u1ec1u n\u0103m, trong s\u1ed1 r\u1ea5t nhi\u1ec1u h\u1ee3p ch\u1ea5t \u0111\u01b0\u1ee3c \u0111\u1ec1 ngh\u1ecb s\u1eed d\u1ee5ng th\u00ec calcium hydroxide v\u1eabn \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn nh\u1ea5t.<\/p>\n

2. Calcium hydroxide – H\u1ee3p ch\u1ea5t kh\u00f4ng th\u1ec3 thi\u1ebfu trong \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha<\/h2>\n

Calcium hydroxide l\u00e0 m\u1ed9t h\u1ee3p ch\u1ea5t v\u00f4 c\u01a1 c\u00f3 c\u00f4ng th\u1ee9c Ca(OH)2 v\u00e0 c\u00f3 \u0111\u1ed9 pH ki\u1ec1m m\u1ea1nh (x\u1ea5p x\u1ec9 12.4). Trong dung d\u1ecbch n\u00f3 ph\u00e2n ly th\u00e0nh ion hydroxyl v\u00e0 ion canxi, v\u00e0 h\u1ea7u h\u1ebft t\u00e1c d\u1ee5ng sinh h\u1ecdc c\u1ee7a n\u00f3 \u0111\u1ec1u c\u00f3 li\u00ean quan \u0111\u1ebfn c\u1ea5u t\u1ea1o n\u00e0y. Calcium hydroxide nguy\u00ean ch\u1ea5t c\u00f3 d\u1ea1ng b\u1ed9t, nh\u01b0ng n\u00f3 n\u00ean \u0111\u01b0\u1ee3c tr\u1ed9n v\u1edbi ch\u1ea5t l\u1ecfng, gel hay ch\u1ea5t n\u1ec1n d\u1ea1ng kem (ho\u1eb7c t\u00e1 d\u01b0\u1ee3c l\u1ecfng) \u0111\u1ec3 d\u1ec5 d\u00e0ng \u0111\u01b0a v\u00e0o \u1ed1ng t\u1ee7y v\u00e0 t\u0103ng c\u01b0\u1eddng ho\u1ea1t t\u00ednh kh\u00e1ng khu\u1ea9n. V\u00ec hi\u1ec7u qu\u1ea3 c\u1ee7a calcium hydroxide ph\u1ee5 thu\u1ed9c v\u00e0o \u0111\u1ed9 pH n\u00ean t\u00e1 d\u01b0\u1ee3c l\u1ecfng l\u00fd t\u01b0\u1edfng ph\u1ea3i l\u00e0 lo\u1ea1i cho ph\u00e9p n\u00f3 ph\u00e2n ly ra ion. S\u1ef1 ph\u00e2n ly n\u00e0y thay \u0111\u1ed5i t\u00f9y theo lo\u1ea1i t\u00e1 d\u01b0\u1ee3c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng. C\u00e2u h\u1ecfi \u0111\u01b0\u1ee3c \u0111\u1eb7t ra l\u00e0 li\u1ec7u t\u00e1 d\u01b0\u1ee3c c\u00f3 t\u00ednh nh\u1eddn ho\u1eb7c tr\u01a1n c\u00f3 t\u00e1c d\u1ee5ng hay kh\u00f4ng, v\u00ec ch\u00fang kh\u00f4ng cho ph\u00e9p s\u1ef1 ph\u00e2n ly m\u1ea1nh v\u00e0 do \u0111\u00f3 s\u1ebd kh\u00f4ng gi\u1ea3i ph\u00f3ng ion hydroxyl.<\/p>\n

\u0110a s\u1ed1 c\u00e1c ch\u1ee7ng vi khu\u1ea9n th\u01b0\u1eddng th\u1ea5y trong \u1ed1ng t\u1ee7y b\u1ecb nhi\u1ec5m tr\u00f9ng \u0111\u1ec1u b\u1ecb lo\u1ea1i b\u1ecf sau m\u1ed9t th\u1eddi gian ng\u1eafn ti\u1ebfp x\u00fac v\u1edbi pH cao c\u1ee7a calcium hydroxide trong \u1ed1ng nghi\u1ec7m. Hi\u1ec7u qu\u1ea3 di\u1ec7t khu\u1ea9n c\u1ee7a ion hydroxyl l\u00ean t\u1ebf b\u00e0o vi khu\u1ea9n l\u00e0 t\u1ed5ng h\u1ee3p c\u1ee7a c\u00e1c t\u00e1c \u0111\u1ed9ng l\u00ean lipid, protein v\u00e0 DNA, h\u1eadu qu\u1ea3 l\u00e0 ph\u00e1 h\u1ee7y b\u1ed9 m\u00e1y t\u1ebf b\u00e0o v\u00e0 l\u00e0m bi\u1ebfn \u0111\u1ed5i m\u1ea1nh m\u1ebd ch\u1ee9c n\u0103ng t\u1ebf b\u00e0o. Calcium hydroxide c\u0169ng \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 c\u00f3 l\u00e0m b\u1ea5t ho\u1ea1t c\u00e1c y\u1ebfu t\u1ed1 \u0111\u1ed9c l\u1ef1c c\u1ee7a vi khu\u1ea9n, nh\u01b0 lipopolisaccharide (n\u1ed9i \u0111\u1ed9c t\u1ed1) v\u00e0 lipoteichoic acid, l\u00e0 th\u00e0nh ph\u1ea7n t\u01b0\u01a1ng \u1ee9ng c\u1ee7a m\u00e0ng t\u1ebf b\u00e0o vi khu\u1ea9n gram \u00e2m v\u00e0 gram d\u01b0\u01a1ng. T\u00e1c d\u1ee5ng kh\u00e1ng khu\u1ea9n c\u1ee7a calcium hydroxide ph\u1ee5 thu\u1ed9c v\u00e0o ion hydroxyl trong dung d\u1ecbch, t\u00e1c d\u1ee5ng n\u00e0y s\u1ebd cao h\u01a1n khi s\u1eed d\u1ee5ng Ca(OH)2 d\u1ea1ng paste (\u1edf \u1ed1ng t\u1ee7y ch\u00ednh). N\u1ebfu h\u1ee3p ch\u1ea5t n\u00e0y c\u1ea7n \u0111\u01b0\u1ee3c khu\u1ebfch t\u00e1n v\u00e0o m\u00f4 v\u00e0 n\u1ed3ng \u0111\u1ed9 hydroxyl gi\u1ea3m do t\u00e1c \u0111\u1ed9ng c\u1ee7a h\u1ec7 th\u1ed1ng \u0111\u1ec7m c\u1ee7a m\u00f4 (h\u1ec7 \u0111\u1ec7m bicarbonate v\u00e0 phosphate), acid, protein, carbon dioxide th\u00ec hi\u1ec7u qu\u1ea3 kh\u00e1ng khu\u1ea9n c\u1ee7a n\u00f3 c\u00f3 th\u1ec3 b\u1ecb gi\u1ea3m hay th\u1eadm ch\u00ed b\u1ecb v\u00f4 hi\u1ec7u. H\u01a1n n\u1eefa, nhi\u1ec1u ch\u1ee7ng vi khu\u1ea9n nh\u01b0 Enterococcus faecalis v\u00e0 v\u00e0i nh\u00f3m Candida \u0111\u00e3 cho th\u1ea5y t\u00ednh \u0111\u1ec1 kh\u00e1ng v\u1edbi calcium hydroxide.<\/p>\n

3. K\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u v\u1ec1 h\u1ee3p ch\u1ea5t n\u00e0y<\/h2>\n

M\u1eb7c d\u00f9 c\u00f3 nhi\u1ec1u nghi\u00ean c\u1ee9u cho th\u1ea5y s\u1ef1 c\u1ea3i thi\u1ec7n c\u1ee7a vi\u1ec7c kh\u1eed tr\u00f9ng \u1ed1ng t\u1ee7y sau khi b\u0103ng thu\u1ed1c gi\u1eefa c\u00e1c l\u1ea7n h\u1eb9n, nh\u01b0ng l\u1ea1i kh\u00f4ng c\u00f3 nhi\u1ec1u nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng so s\u00e1nh t\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng gi\u1eefa vi\u1ec7c \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha \u1ed1ng t\u1ee7y r\u0103ng nhi\u1ec5m tr\u00f9ng trong m\u1ed9t v\u1edbi nhi\u1ec1u l\u1ea7n h\u1eb9n. M\u1ed9t v\u00e0i nghi\u00ean c\u1ee9u cho th\u1ea5y \u0111i\u1ec1u tr\u1ecb qua hai hay nhi\u1ec1u l\u1ea7n h\u1eb9n v\u1edbi ch\u1ea5t b\u0103ng thu\u1ed1c n\u1ed9i t\u1ee7y l\u00e0 calcium hydroxide l\u00e0m t\u0103ng t\u1ec9 l\u1ec7 th\u00e0nh c\u00f4ng th\u00eam 10-20% so v\u1edbi \u0111i\u1ec1u tr\u1ecb m\u1ed9t l\u1ea7n h\u1eb9n. M\u1eb7t kh\u00e1c, c\u0169ng c\u00f3 nhi\u1ec1u nghi\u00ean c\u1ee9u cho bi\u1ebft h\u1ea7u nh\u01b0 kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t \u0111\u00e1ng k\u1ec3 n\u00e0o ho\u1eb7c th\u1eadm ch\u00ed l\u00e0 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha m\u1ed9t l\u1ea7n h\u1eb9n th\u00e0nh c\u00f4ng cao h\u01a1n 10%. C\u00e1c k\u1ebft qu\u1ea3 tr\u00e1i ng\u01b0\u1ee3c tr\u00ean c\u00f3 th\u1ec3 do s\u1ed1 li\u1ec7u c\u00f3 \u0111\u01b0\u1ee3c kh\u00f4ng \u0111\u1ea7y \u0111\u1ee7 \u0111\u1ec3 \u0111i \u0111\u1ebfn k\u1ebft lu\u1eadn, l\u00e0m cho vi\u1ec7c ph\u00e2n t\u00edch th\u1ed1ng k\u00ea kh\u00f4ng ch\u00ednh x\u00e1c. M\u1ed9t nghi\u00ean c\u1ee9u s\u1eed d\u1ee5ng c\u1ee1 m\u1eabu l\u1edbn l\u00e0 nh\u1eefng ca \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1edfi c\u00f9ng m\u1ed9t b\u00e1c s\u0129 cho th\u1ea5y t\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng cao h\u01a1n \u0111\u00e1ng k\u1ec3 \u0111\u1ed1i v\u1edbi r\u0103ng b\u1ecb nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb trong 2 ho\u1eb7c nhi\u1ec1u l\u1ea7n h\u1eb9n c\u00f3 s\u1eed d\u1ee5ng calcium hydroxide khi so s\u00e1nh v\u1edbi nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb trong m\u1ed9t l\u1ea7n h\u1eb9n.<\/p>\n

\u0110\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb t\u1ed1t nh\u1ea5t, b\u00e1c s\u0129 l\u00e2m s\u00e0ng c\u1ea7n c\u00f3 ki\u1ebfn th\u1ee9c s\u00e2u r\u1ed9ng v\u1ec1 gi\u1ea3i ph\u1eabu h\u1ec7 th\u1ed1ng \u1ed1ng t\u1ee7y, n\u1eafm r\u00f5 nh\u1eefng nguy\u00ean t\u1eafc l\u00e0m s\u1ea1ch, t\u1ea1o h\u00ecnh v\u00e0 s\u1eed d\u1ee5ng c\u00e1c ch\u1ea5t kh\u00e1ng khu\u1ea9n trong \u1ed1ng t\u1ee7y m\u1ed9t c\u00e1ch h\u1ee3p l\u00fd.<\/p>\n

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

Trong qu\u00e1 tr\u00ecnh s\u1eeda so\u1ea1n \u1ed1ng tu\u1ef7, cho d\u00f9 Nha s\u0129 \u0111\u00e3 s\u1eed d\u1ee5ng c\u00e1c lo\u1ea1i ho\u00e1 ch\u1ea5t chuy\u00ean d\u1ee5ng nh\u1eb1m r\u1eeda tr\u00f4i m\u00f9n ng\u00e0 nhi\u1ec5m khu\u1ea9n v\u00e0 di\u1ec7t t\u00e1c nh\u00e2n g\u00e2y h\u1ea1i n\u00e0y, th\u00ec m\u1ed9t s\u1ed1 v\u00f9ng trong h\u1ec7 th\u1ed1ng \u1ed1ng tu\u1ef7 v\u1eabn kh\u00f4ng th\u1ec3 l\u00e0m s\u1ea1ch h\u1ebft \u0111\u01b0\u1ee3c. V\u00ec th\u1ebf, ng\u01b0\u1eddi ta m\u1edbi […]<\/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":"\nT\u1ed5ng quan v\u1ec1 thu\u1ed1c \u0111\u1eb7t N\u1ed9i nha - G\u00f3c nh\u00ecn v\u1ec1 Calcium hydroxide.<\/title>\n<meta name=\"description\" content=\"B\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y t\u00f3m t\u1eaft s\u01a1 l\u01b0\u1ee3c v\u00e0 \u0111\u1ed3ng th\u1eddi ch\u1ec9 ra \u01b0u \u0111i\u1ec3m c\u1ee7a Calcium hydroxide, m\u1ed9t lo\u1ea1i h\u1ee3p ch\u1ea5t ph\u1ed5 bi\u1ebfn trong N\u1ed9i nha. 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