{"id":28025,"date":"2023-04-24T19:07:15","date_gmt":"2023-04-24T12:07:15","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=28025"},"modified":"2023-05-02T09:13:30","modified_gmt":"2023-05-02T02:13:30","slug":"loai-vat-lieu-tram-bit-co-so-nghien-cuu-va-lua-chon-phu-hop","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/24\/loai-vat-lieu-tram-bit-co-so-nghien-cuu-va-lua-chon-phu-hop\/","title":{"rendered":"Lo\u1ea1i v\u1eadt li\u1ec7u tr\u00e1m b\u00edt – C\u01a1 s\u1edf nghi\u00ean c\u1ee9u v\u00e0 l\u1ef1a ch\u1ecdn ph\u00f9 h\u1ee3p."},"content":{"rendered":"

B\u00e0i vi\u1ebft n\u00e0y n\u00f3i v\u1ec1 c\u00e1c nghi\u00ean c\u1ee9u tr\u00ean l\u00e2m s\u00e0ng l\u1eabn trong ph\u00f2ng th\u00ed nghi\u1ec7m li\u00ean quan c\u00e1c lo\u1ea1i v\u1eadt li\u1ec7u s\u1eed d\u1ee5ng trong tr\u00e1m b\u00edt h\u1ec7 th\u1ed1ng \u1ed1ng tu\u1ef7. Vi\u1ec7c n\u1eafm v\u1eefng ki\u1ebfn th\u1ee9c li\u00ean quan \u0111\u1ebfn v\u1eadt li\u1ec7u v\u00e0 \u00e1p d\u1ee5ng ch\u00fang tr\u00ean l\u00e2m s\u00e0ng gi\u00fap \u00edch cho qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb, gi\u1ea3m x\u00e1c su\u1ea5t th\u1ea5t b\u1ea1i v\u00e0 c\u0169ng c\u1ed1 th\u00eam t\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng tr\u00ean b\u1ec7nh nh\u00e2n. C\u00f9ng t\u00ecm hi\u1ec3u.<\/strong><\/p>\n

1. Lo\u1ea1i v\u1eadt li\u1ec7u ch\u00ednh (l\u00f5i \u2013 core material)<\/h2>\n

Nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng:<\/strong> Nh\u1eefng t\u00ednh ch\u1ea5t h\u00f3a h\u1ecdc c\u1ee7a gutta-percha v\u00e0 nh\u1ef1a t\u1ed5ng h\u1ee3p khi d\u00f9ng l\u00e0m v\u1eadt li\u1ec7u ch\u00ednh c\u00f3 \u1ea3nh h\u01b0\u1edfng kh\u00f4ng nhi\u1ec1u \u0111\u1ebfn k\u1ebft qu\u1ea3 l\u00e2m s\u00e0ng c\u0169ng nh\u01b0 tr\u00ean phim X-quang c\u1ee7a vi\u1ec7c \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha v\u00e0 d\u01b0\u1eddng nh\u01b0 ch\u00fang c\u0169ng kh\u00f4ng ph\u1ea3i l\u00e0 \u0111\u1ed1i t\u01b0\u1ee3ng c\u1ee7a b\u1ea5t k\u1ef3 nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng n\u00e0o. V\u00ec sealer h\u1ea7u nh\u01b0 \u0111\u00e3 cung c\u1ea5p nh\u1eefng \u0111\u1eb7c t\u00ednh quan tr\u1ecdng cho vi\u1ec7c tr\u00e1m b\u00edt, n\u00ean v\u1eadt li\u1ec7u ch\u00ednh s\u1ebd \u0111\u00f3ng vai tr\u00f2 c\u01a1 h\u1ecdc nh\u01b0 m\u1ed9t piston \u0111\u1ea9y sealer ra xung quanh \u0111\u1ec3 th\u1ef1c hi\u1ec7n ch\u1ee9c n\u0103ng c\u1ee7a n\u00f3. \u0110\u1ed1i v\u1edbi nh\u1eefng v\u1eadt li\u1ec7u tr\u00e1m b\u00edt ngu\u1ed9i th\u00ec kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t \u0111\u00e1ng k\u1ec3 gi\u1eefa c\u00e1c lo\u1ea1i v\u1edbi nhau. V\u1eadt li\u1ec7u tr\u00e1m b\u00edt \u0111\u01b0\u1ee3c l\u00e0m m\u1ec1m b\u1edfi nhi\u1ec7t th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u01b0a chu\u1ed9ng v\u00ec th\u00fac \u0111\u1ea9y s\u1ef1 l\u00e0m \u0111\u1ea7y c\u01a1 h\u1ecdc trong \u1ed1ng t\u1ee7y \u0111\u00e3 s\u1eeda so\u1ea1n. Tuy nhi\u00ean kh\u00f4ng c\u00f3 \u0111\u1ea7y \u0111\u1ee7 d\u1eef li\u1ec7u \u0111\u1ec3 c\u00f3 th\u1ec3 \u0111\u00e1nh gi\u00e1 hi\u1ec7u qu\u1ea3 l\u00e2m s\u00e0ng c\u1ee7a k\u0129 thu\u1eadt d\u00f9ng c\u00f4n gutta- percha m\u1ec1m.<\/p>\n

Nghi\u00ean c\u1ee9u trong ph\u00f2ng th\u00ed nghi\u1ec7m:<\/strong> D\u1ef1a theo thang ch\u1ee9ng c\u1ee9, nghi\u00ean c\u1ee9u ex vivo (r\u0103ng \u0111\u00e3 nh\u1ed5) hay in vitro (th\u1eed nghi\u1ec7m v\u1eadt li\u1ec7u kh\u00f4ng nh\u1edd l\u00e2m s\u00e0ng) cho th\u1ea5y s\u1ef1 kh\u00e1c bi\u1ec7t gi\u1eefa c\u00e1c v\u1eadt li\u1ec7u v\u00e0 k\u0129 thu\u1eadt \u0111\u00e3 mang l\u1ea1i nhi\u1ec1u k\u1ebft qu\u1ea3 quan tr\u1ecdng t\u1eeb r\u1ea5t l\u00e2u. Gutta-percha ch\u1ee9a ch\u1ee7 y\u1ebfu l\u00e0 oxide k\u1ebdm, l\u00e0 m\u1ed9t h\u1ee3p ch\u1ea5t kh\u00e1ng khu\u1ea9n kh\u00e1 m\u1ea1nh. \u0110i\u1ec1u n\u00e0y cho ph\u00e9p ng\u0103n ch\u1eb7n s\u1ef1 (t\u00e1i) nhi\u1ec5m \u1edf nh\u1eefng \u1ed1ng t\u1ee7y \u0111\u00e3 tr\u00e1m b\u00edt. C\u00f4n gutta-percha c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c b\u1ed5 sung chlorhexidine nh\u01b0 m\u1ed9t ch\u1ea5t kh\u00e1ng khu\u1ea9n, tuy nhi\u00ean n\u00f3 \u0111\u01b0\u1ee3c \u0111\u01b0a ra th\u1ecb tr\u01b0\u1eddng ch\u1ec9 \u0111\u1ec3 s\u1eed d\u1ee5ng t\u1ea1m th\u1eddi. V\u1eadt li\u1ec7u nh\u1ef1a t\u1ed5ng h\u1ee3p c\u0169ng c\u00f3 th\u1ec3 c\u00f3 th\u00eam t\u00e1c nh\u00e2n kh\u00e1ng khu\u1ea9n nh\u01b0 bio-glass ho\u1eb7c c\u00e1c h\u1ee3p ch\u1ea5t kh\u00e1c v\u1edbi \u0111\u1ed9 h\u00f2a tan th\u1ea5p. C\u00f3 r\u1ea5t \u00edt th\u00f4ng tin cho th\u1ea5y hi\u1ec7u qu\u1ea3 kh\u00e1ng khu\u1ea9n t\u01b0\u01a1ng \u0111\u1ed1i c\u1ee7a c\u00e1c v\u1eadt li\u1ec7u ch\u00ednh, v\u00e0 \u1ea3nh h\u01b0\u1edfng tr\u00ean th\u1ef1c t\u1ebf c\u1ee7a nh\u1eefng th\u00e0nh ph\u1ea7n trong v\u1eadt li\u1ec7u v\u1eabn c\u00f2n ch\u01b0a r\u00f5.<\/p>\n

2. Sealer<\/h2>\n

Trong khi gutta-percha v\u1eabn duy tr\u00ec \u01b0u th\u1ebf c\u1ee7a n\u00f3 v\u1edbi vai tr\u00f2 l\u00e0 v\u1eadt li\u1ec7u ch\u00ednh v\u00e0 th\u00e0nh c\u00f4ng trong vi\u1ec7c ch\u1ed1ng l\u1ea1i nh\u1eefng nh\u1eefng th\u00e1ch th\u1ee9c h\u01a1n v\u1eadt li\u1ec7u nh\u1ef1a t\u1ed5ng h\u1ee3p th\u00ec vi\u1ec7c ch\u1ecdn l\u1ef1a v\u00e0 s\u1eed d\u1ee5ng sealer tr\u00e1m b\u00edt l\u1ea1i thay \u0111\u1ed5i r\u1ea5t nhi\u1ec1u qua h\u00e0ng th\u1eadp k\u1ec9. B\u1ea3ng d\u01b0\u1edbi \u0111\u00e2y t\u1ed5ng quan c\u00e1c lo\u1ea1i v\u1eadt li\u1ec7u s\u1eed d\u1ee5ng trong qu\u00e1 tr\u00ecnh tr\u00e1m b\u00edt \u1ed1ng tu\u1ef7.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
V\u1eadt li\u1ec7u<\/span><\/td>\nNh\u00f3m<\/span><\/td>\nNh\u1eefng d\u00f2ng s\u1ea3n ph\u1ea9m ch\u00ednh<\/span><\/td>\nTr\u00e1m ng\u01b0\u1ee3c v\u00e0 s\u1eeda ch\u1eefa<\/span><\/td>\nTr\u00e1m b\u00edt \u1ed1ng tu\u1ef7<\/span><\/td>\n<\/tr>\n
ZnO- eugenol<\/span><\/td>\nGia c\u1ed1<\/span><\/td>\nIRM, Super-EBA<\/span><\/td>\nx<\/span><\/td>\n<\/td>\n<\/tr>\n
D\u00e1n (Sealer)<\/span><\/td>\nProco-Sol, Tubli-Seal<\/span><\/td>\n<\/td>\nx<\/span><\/td>\n<\/tr>\n
Nh\u1ef1a<\/span><\/td>\nEpoxy<\/span><\/td>\nAH26, AH plus<\/span><\/td>\n<\/td>\nx<\/span><\/td>\n<\/tr>\n
Methacrylate<\/span><\/td>\nEndoREZ, Real Seal<\/span><\/td>\n<\/td>\nx<\/span><\/td>\n<\/tr>\n
Composite<\/span><\/td>\nRetroPlast, c\u00e1c composite l\u1ecfng<\/span><\/td>\nx<\/span><\/td>\n<\/td>\n<\/tr>\n
Ca(OH)2<\/span><\/td>\n<\/td>\nApexit, Sealapex<\/span><\/td>\n<\/td>\nx<\/span><\/td>\n<\/tr>\n
Silicone<\/span><\/td>\n<\/td>\nRoekoSeal, GuttaFlow<\/span><\/td>\n<\/td>\nx<\/span><\/td>\n<\/tr>\n
S\u1ee9<\/span><\/td>\nCa-Si<\/span><\/td>\nMTA, Biodentine<\/span><\/td>\nx<\/span><\/td>\n(x)<\/span><\/td>\n<\/tr>\n
Ca-Si-P<\/span><\/td>\nBioaggregate, EndoSequen<\/span><\/td>\nx<\/span><\/td>\nx<\/span><\/td>\n<\/tr>\n
Gutta- percha<\/span><\/td>\nBeta<\/span><\/td>\nC\u00e1c lo\u1ea1i beta<\/span><\/td>\n<\/td>\nx<\/span><\/td>\n<\/tr>\n
Alpha<\/span><\/td>\nGuttaFusion, GuttaCore, Herofill<\/span><\/td>\n<\/td>\nx<\/span><\/td>\n<\/tr>\n
L\u00f5i nh\u1ef1a<\/span><\/td>\nTo\u00e0n b\u1ed9<\/span><\/td>\nResilon<\/span><\/td>\n<\/td>\nx<\/span><\/td>\n<\/tr>\n
Resin ph\u1ee7<\/span><\/td>\nEndoREZ, EndoSequence<\/span><\/td>\n<\/td>\nx<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng:<\/strong> K\u1ebft qu\u1ea3 t\u1eeb c\u00e1c nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng cho th\u1ea5y \u00fd ki\u1ebfn cho r\u1eb1ng hi\u1ec7u su\u1ea5t s\u1ebd cao h\u01a1n n\u1ebfu c\u00f3 b\u1ea5t k\u00ec s\u1ef1 bi\u1ebfn \u0111\u1ed5i h\u00f3a h\u1ecdc n\u00e0o trong c\u00f4ng th\u1ee9c c\u1ee7a sealer \u00edt \u0111\u01b0\u1ee3c \u0111\u1ed3ng t\u00ecnh. Trong m\u1ed9t v\u00e0i th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng ng\u1eabu nhi\u00ean so s\u00e1nh c\u00e1c sealer th\u00ec th\u1ea5y h\u1ea7u nh\u01b0 kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t \u0111\u00e1ng k\u1ec3 n\u00e0o v\u1ec1 k\u1ebft qu\u1ea3 l\u00e2m s\u00e0ng, b\u1ea5t k\u1ec3 ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng l\u00e0 g\u00ec (r\u0103ng s\u1ed1ng hay r\u0103ng nhi\u1ec5m tr\u00f9ng). Do \u0111\u00f3, v\u1eadt li\u1ec7u ch\u1ee9a ZnO-eugenol (c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 Ca(OH)2), nh\u1ef1a epoxy, v\u1eadt li\u1ec7u ch\u1ee9a Ca(OH)2, salicylate, silicone v\u00e0 sealer composite \u0111\u1ec1u cho k\u1ebft qu\u1ea3 l\u00e2m s\u00e0ng nh\u01b0 nhau khi so s\u00e1nh. S\u1ef1 gi\u1ea3m t\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng \u0111\u1ed1i v\u1edbi sealer ch\u1ee9a chloroform c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 d\u1eabn \u0111\u1ebfn vi\u1ec7c lo\u1ea1i b\u1ecf ho\u00e0n to\u00e0n v\u1eadt li\u1ec7u n\u00e0y. V\u1eadt li\u1ec7u s\u1ee9 v\u00e0 s\u1ee9 sinh h\u1ecdc hi\u1ec7n nay kh\u00f4ng c\u00f3 \u0111\u1ee7 d\u1eef li\u1ec7u l\u00e2m s\u00e0ng \u0111\u1ec3 so s\u00e1nh.<\/p>\n

Nghi\u00ean c\u1ee9u trong ph\u00f2ng th\u00ed nghi\u1ec7m:<\/strong> Sealer c\u00f3 th\u00e0nh ph\u1ea7n h\u00f3a h\u1ecdc r\u1ea5t \u0111a d\u1ea1ng. Do \u0111\u00f3 kh\u00f4ng c\u00f3 g\u00ec \u0111\u00e1ng ng\u1ea1c nhi\u00ean khi c\u00e1c th\u1eed nghi\u1ec7m ex vivo v\u00e0 in vitro kh\u00e1c nhau th\u00ec n\u00f3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n kh\u00e1c nhau. Ng\u0103n ng\u1eeba s\u1ef1 r\u00f2 r\u1ec9 l\u00e0 m\u1ee5c ti\u00eau ch\u00ednh c\u1ee7a
\nvi\u1ec7c tr\u00e1m b\u00edt v\u00e0 c\u0169ng l\u00e0 \u0111\u1eb7c t\u00ednh quan tr\u1ecdng c\u1ee7a sealer. Sealer composite \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n d\u1ef1a tr\u00ean c\u00f4ng ngh\u1ec7 b\u00e1m d\u00ednh \u0111\u01b0\u1ee3c d\u00f9ng cho c\u00e1c ch\u1ea5t tr\u00e1m nh\u1ef1a, nh\u01b0ng nh\u1ef1a epoxy truy\u1ec1n th\u1ed1ng c\u0169ng c\u00f3 m\u1ee9c \u0111\u1ed9 b\u00e1m d\u00ednh v\u00e0o ng\u00e0 r\u0103ng t\u01b0\u01a1ng t\u1ef1. H\u01a1n n\u1eefa, s\u1ef1 b\u00e1m d\u00ednh v\u00e0o ng\u00e0 r\u0103ng \u1edf nh\u1eefng th\u1eed nghi\u1ec7m ex vivo nh\u01b0 m\u1ed9t bi\u1ec7n ph\u00e1p ng\u0103n ch\u1eb7n r\u00f2 r\u1ec9 c\u00f3 th\u1ec3 kh\u00f4ng th\u1ef1c t\u1ebf \u0111\u1ed1i v\u1edbi nh\u1eefng t\u00ecnh hu\u1ed1ng l\u00e2m s\u00e0ng, v\u00ec m\u1ed1i li\u00ean k\u1ebft c\u00f3 th\u1ec3 kh\u00f4ng li\u00ean t\u1ee5c tr\u00ean b\u1ec1 m\u1eb7t c\u0169ng nh\u01b0 d\u1ec5 b\u1ecb ph\u00e1 h\u1ee7y do s\u1ef1 tho\u00e1i h\u00f3a h\u00f3a h\u1ecdc v\u00e0 sinh h\u00f3a. B\u00ean c\u1ea1nh \u0111\u00f3, m\u1eb7c d\u00f9 silicone kh\u00f4ng c\u00f3 li\u00ean k\u1ebft h\u00f3a h\u1ecdc v\u1edbi ng\u00e0 r\u0103ng, nh\u01b0ng lo\u1ea1i sealer n\u00e0y v\u1eabn c\u00f3 s\u1ef1 b\u00e1m d\u00ednh c\u01a1 h\u1ecdc v\u1edbi ng\u00e0.<\/p>\n

Vi\u1ec7c ki\u1ec3m tra m\u1ee9c \u0111\u1ed9 r\u00f2 r\u1ec9 tr\u1ef1c ti\u1ebfp tr\u00ean th\u1eed nghi\u1ec7m ex vivo \u0111\u01b0\u1ee3c \u0111\u1ea9y m\u1ea1nh v\u00ec n\u00f3 li\u00ean quan nhi\u1ec1u \u0111\u1ebfn l\u00e2m s\u00e0ng, v\u00e0 ng\u01b0\u1eddi ta c\u00f2n thi\u1ebft l\u1eadp ra test g\u1ecdi l\u00e0 test ch\u1ee9c n\u0103ng r\u00f2 r\u1ec9 (functional test for leakage). Test m\u1ee9c \u0111\u1ed9 x\u00e2m nh\u1eadp c\u1ee7a vi khu\u1ea9n (bacterial penetration test) v\u00e0 test l\u1ecdc d\u1ecbch (fluid filtration test) l\u00e0 c\u01a1 s\u1edf c\u1ee7a quan \u0111i\u1ec3m cho r\u1eb1ng r\u00f2 r\u1ec9 th\u00e2n r\u0103ng l\u00e0 ngu\u1ed3n g\u1ed1c c\u1ee7a nhi\u1ec5m tr\u00f9ng \u1ed1ng t\u1ee7y. C\u00e1c test n\u00e0y r\u1ea5t kh\u00f3 \u0111\u01b0\u1ee3c chu\u1ea9n h\u00f3a, v\u00e0 test \u0111\u1ed9 x\u00e2m nh\u1eadp c\u1ee7a vi khu\u1ea9n \u0111\u01b0\u1ee3c cho l\u00e0 m\u1ed9t k\u0129 thu\u1eadt r\u1ea5t nh\u1ea1y, t\u1ea1o ra r\u1ea5t nhi\u1ec1u k\u1ebft qu\u1ea3 kh\u00e1c nhau.
\nM\u1ed9t \u0111\u1eb7c t\u00ednh kh\u00e1c c\u1ee7a sealer li\u00ean quan \u0111\u1ebfn r\u00f2 r\u1ec9 \u0111\u00f3 l\u00e0 s\u1ef1 th\u1ea9m th\u1ea5u qua c\u00e1c \u1ed1ng ng\u00e0. M\u00f4 t\u1ea3 tr\u00ean k\u00ednh hi\u1ec3n vi cho th\u1ea5y sealer chi\u1ebfm m\u1ed9t kho\u1ea3ng l\u1edbn (l\u00ean t\u1edbi 1 mm) v\u00e0o trong nh\u1eefng \u1ed1ng ng\u00e0 m\u1edf, d\u01b0\u1eddng nh\u01b0 ph\u1ea3n \u00e1nh \u0111\u1eb7c t\u00ednh t\u01b0\u01a1ng t\u1ef1 tr\u00ean l\u00e2m s\u00e0ng, nh\u01b0ng h\u1ea7u h\u1ebft nh\u1eefng lo\u1ea1i sealer \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec1u c\u00f3 m\u1ed9t \u0111\u1ed9 th\u1ea9m th\u1ea5u nh\u1ea5t \u0111\u1ecbnh v\u00e0 \u0111\u1ed9 s\u00e2u th\u00e2m nh\u1eadp kh\u00f4ng ph\u1ea3i l\u00e0 y\u1ebfu t\u1ed1 quy\u1ebft \u0111\u1ecbnh.<\/p>\n

S\u1ef1 hi\u1ec7n di\u1ec7n\/bi\u1ebfn m\u1ea5t c\u1ee7a vi khu\u1ea9n trong nh\u1eefng \u1ed1ng t\u1ee7y \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eeda so\u1ea1n v\u00e0o th\u1eddi \u0111i\u1ec3m tr\u00e1m b\u00edt c\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ef1 th\u00e0nh c\u00f4ng tr\u00ean l\u00e2m s\u00e0ng, v\u00e0 vi\u1ec7c l\u1ea5y m\u1eabu vi khu\u1ea9n \u0111\u01b0\u1ee3c \u0111\u1ec1 xu\u1ea5t nh\u01b0 l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ti\u00ean l\u01b0\u1ee3ng ban \u0111\u1ea7u. Nh\u1eefng nghi\u00ean c\u1ee9u trong ph\u00f2ng th\u00ed nghi\u1ec7m \u0111\u00e3 \u0111i theo kh\u00e1i ni\u1ec7m n\u00e0y b\u1eb1ng c\u00e1ch \u0111\u00e1nh gi\u00e1 s\u1ef1 s\u1ed1ng s\u00f3t c\u1ee7a vi khu\u1ea9n tr\u00ean b\u1ec1 m\u1eb7t ng\u00e0 r\u0103ng v\u00e0 trong c\u1ea3 c\u00e1c \u1ed1ng ng\u00e0 sau khi ti\u1ebfp x\u00fac v\u1edbi sealer. V\u1eadt li\u1ec7u ch\u1ee9a nh\u1ef1a epoxy v\u00e0 ZnO-eugenol d\u01b0\u1eddng nh\u01b0 c\u00f3 kh\u1ea3 n\u0103ng lo\u1ea1i b\u1ecf vi khu\u1ea9n ho\u1eb7c \u1ee9c ch\u1ebf ho\u1ea1t \u0111\u1ed9ng c\u1ee7a ch\u00fang, trong khi \u0111\u00f3 v\u1eadt li\u1ec7u composite th\u00ec th\u1ea5y \u00edt hi\u1ec7u qu\u1ea3 h\u01a1n. Sealer silicone c\u00f3 th\u00eam th\u00e0nh ph\u1ea7n nano b\u1ea1c, v\u00e0 m\u1ed9t v\u00e0i v\u1eadt li\u1ec7u composite hay v\u1eadt li\u1ec7u s\u1ee9 c\u00f3 th\u00eam th\u00e0nh ph\u1ea7n bioglass c\u0169ng \u0111em l\u1ea1i m\u1ee9c \u0111\u1ed9 kh\u00e1ng khu\u1ea9n nh\u1ea5t \u0111\u1ecbnh. V\u00ec c\u1ea3 3 m\u1ee5c \u0111\u00edch ch\u00ednh c\u1ee7a vi\u1ec7c tr\u00e1m b\u00edt \u0111\u1ec1u li\u00ean quan ho\u1ea1t \u0111\u1ed9ng c\u1ee7a vi khu\u1ea9n, n\u00ean c\u00f3 v\u1ebb h\u1ee3p l\u00fd khi cho r\u1eb1ng nh\u1eefng ho\u1ea1t t\u00ednh kh\u00e1ng \u0111\u1ebfn khu\u1ea9n n\u00e0y c\u0169ng \u0111\u1eb7c bi\u1ec7t quan tr\u1ecdng trong \u0111i\u1ec1u tr\u1ecb vi\u00eam quanh ch\u00f3p. Tuy t\u00ednh ch\u1ea5t kh\u00e1ng khu\u1ea9n th\u01b0\u1eddng \u0111i k\u00e8m v\u1edbi t\u00ednh \u0111\u1ed9c t\u1ebf b\u00e0o \u1edf m\u1ee9c \u0111\u1ed9 nh\u1ea5t \u0111\u1ecbnh, nh\u01b0ng \u0111\u1ed9c t\u00ednh n\u00e0y c\u00f3 th\u1ec3 kh\u00f4ng c\u00f3 \u00fd ngh\u0129a l\u00e2m s\u00e0ng \u0111\u00e1ng k\u1ec3 v\u1edbi quy tr\u00ecnh tr\u00e1m b\u00edt th\u00f4ng th\u01b0\u1eddng v\u00ec b\u1ec1 m\u1eb7t ti\u1ebfp x\u00fac c\u1ee7a v\u1eadt li\u1ec7u\/m\u00f4 l\u00e0 r\u1ea5t nh\u1ecf.<\/p>\n

G\u1ea7n \u0111\u00e2y, ng\u01b0\u1eddi ta b\u1eaft \u0111\u1ea7u ch\u00fa \u00fd l\u1ea1i 2 y\u1ebfu t\u1ed1 v\u1ec1 t\u00ecnh tr\u1ea1ng vi khu\u1ea9n trong \u1ed1ng t\u1ee7y r\u1ea5t quan tr\u1ecdng trong m\u1ecdi th\u1ee7 thu\u1eadt n\u1ed9i nha: s\u1ef1 ch\u1ea5p nh\u1eadn cu\u1ed1i c\u00f9ng (d\u00e0i h\u1ea1n) c\u1ee7a vi khu\u1ea9n nh\u01b0 l\u00e0 ngu\u1ed3n g\u1ed1c duy nh\u1ea5t li\u00ean quan \u0111\u1ebfn vi\u00eam quanh ch\u00f3p c\u1ea5p t\u00ednh, m\u1ea1n t\u00ednh tr\u00ean l\u00e2m s\u00e0ng v\u00e0 nh\u1eefng ki\u1ebfn th\u1ee9c ng\u00e0y c\u00e0ng gia t\u0103ng nhanh ch\u00f3ng v\u1ec1 s\u1ef1 h\u00ecnh th\u00e0nh biofilm c\u00f9ng ho\u1ea1t \u0111\u1ed9ng c\u1ee7a ch\u00fang. H\u1ea7u h\u1ebft c\u00e1c kh\u00eda c\u1ea1nh c\u1ee7a vi\u1ec7c \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha \u0111\u1ec1u \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 l\u1ea1i d\u1ef1a tr\u00ean quan \u0111i\u1ec3m x\u1eed l\u00fd biofilm trong \u1ed1ng t\u1ee7y nh\u01b0 th\u1ebf n\u00e0o. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 s\u1ebd tr\u1edf th\u00e0nh v\u1ea5n \u0111\u1ec1 tr\u1ecdng t\u00e2m cho vi\u1ec7c ch\u1ecdn l\u1ef1a v\u1eadt li\u1ec7u tr\u00e1m b\u00edt, tuy nhi\u00ean s\u1ef1 ph\u00e1 v\u1ee1 v\u00e0 b\u1ea5t ho\u1ea1t biofilm ph\u1ee5 thu\u1ed9c nhi\u1ec1u v\u00e0o c\u00e1c y\u1ebfu t\u1ed1 h\u00f2a tan h\u01a1n l\u00e0 v\u1eadt li\u1ec7u tr\u00e1m b\u00edt hi\u1ec7n t\u1ea1i.<\/p>\n

3. V\u1eadt li\u1ec7u tr\u00e1m ng\u01b0\u1ee3c v\u00e0 s\u1eeda ch\u1eefa l\u1ed7 th\u1ee7ng<\/h2>\n

Nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng:<\/strong> K\u0129 thu\u1eadt c\u1eaft ch\u00f3p v\u00e0 tr\u00e1m ng\u01b0\u1ee3c t\u1ea1o ra m\u1ed9t t\u00ecnh hu\u1ed1ng l\u00e2m s\u00e0ng t\u01b0\u01a1ng \u0111\u1ed1i chu\u1ea9n cho ph\u00e9p ch\u00ednh n\u00f3 \u0111\u01b0\u1ee3c d\u1ec5 d\u00e0ng th\u1eed nghi\u1ec7m tr\u00ean l\u00e2m s\u00e0ng \u0111\u1ec3 ki\u1ec3m tra c\u00e1c y\u1ebfu t\u1ed1 ti\u00ean l\u01b0\u1ee3ng kh\u00e1c nhau, bao g\u1ed3m c\u1ea3 v\u1eadt li\u1ec7u. Khi \u00e1p d\u1ee5ng th\u1ee7 thu\u1eadt t\u01b0\u01a1ng t\u1ef1 nhau l\u00ean 2 hay nhi\u1ec1u lo\u1ea1i v\u1eadt li\u1ec7u, ng\u01b0\u1eddi ta cho r\u1eb1ng c\u00e1c d\u1eef li\u1ec7u l\u00e2m s\u00e0ng t\u1ed5ng h\u1ee3p c\u00f3 th\u1ec3 ph\u1ea3n \u00e1nh s\u1ef1 kh\u00e1c bi\u1ec7t th\u1ef1c s\u1ef1 trong k\u1ebft qu\u1ea3. Tuy nhi\u00ean, k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb c\u1ee7a ph\u1eabu thu\u1eadt c\u1eaft ch\u00f3p kh\u00e1 kh\u00e1c bi\u1ec7t gi\u1eefa nh\u1eefng nh\u00e0 ph\u1eabu thu\u1eadt, v\u00ec v\u1eady \u0111\u1ed1i v\u1edbi nh\u1eefng lo\u1ea1i v\u1eadt li\u1ec7u v\u00e0 k\u0129 thu\u1eadt kh\u00e1c nhau th\u00ec ph\u1ea3i c\u00e2n nh\u1eafc \u0111\u1ebfn \u1ea3nh h\u01b0\u1edfng c\u1ee7a ph\u1eabu thu\u1eadt vi\u00ean.<\/p>\n

Nhi\u1ec1u lo\u1ea1i v\u1eadt li\u1ec7u c\u1ed5 \u0111i\u1ec3n v\u00e0 c\u1ea3 nh\u1eefng v\u1eadt li\u1ec7u \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng g\u1ea7n \u0111\u00e2y \u0111\u00e3 \u0111\u01b0\u1ee3c th\u1eed nghi\u1ec7m v\u00e0 so s\u00e1nh trong nh\u1eefng nghi\u00ean c\u1ee9u thu\u1ea7n t\u1eadp kh\u00e1 l\u1edbn v\u00e0 trong m\u1ed9t v\u00e0i th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng ng\u1eabu nhi\u00ean. Vi\u1ec7c \u0111\u01b0a MTA v\u00e0o tr\u00e1m ng\u01b0\u1ee3c \u0111\u00e3 m\u1edf \u0111\u1ea7u cho m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng v\u1ec1 v\u1ea5n \u0111\u1ec1 n\u00e0y. MTA \u0111\u01b0\u1ee3c so s\u00e1nh v\u1edbi IRM, Super-EBA (\u0111\u1ec1u tr\u00ean n\u1ec1n ZnO-eugenol) v\u00e0 RetroPlast, m\u1ed9t lo\u1ea1i composite d\u1ef1a v\u00e0o s\u1ef1 k\u1ebft d\u00ednh v\u1edbi ng\u00e0 r\u0103ng \u0111\u1ec3 duy tr\u00ec vi\u1ec7c tr\u00e1m b\u00edt v\u00e0 ng\u0103n ch\u1eb7n nhi\u1ec5m tr\u00f9ng c\u00f2n s\u00f3t l\u1ea1i. Trong t\u1ea5t c\u1ea3 nh\u1eefng nghi\u00ean c\u1ee9u tr\u00ean, MTA l\u00e0 v\u1eadt li\u1ec7u t\u1ed1t h\u01a1n so v\u1edbi nh\u1eefng lo\u1ea1i \u0111\u01b0\u1ee3c \u0111em ra so s\u00e1nh. K\u00edch c\u1ee1 v\u00e0 t\u1ea7m quan tr\u1ecdng c\u1ee7a c\u00e1c bi\u1ebfn s\u1ed1 c\u00f3 th\u1ec3 kh\u00e1c nhau gi\u1eefa c\u00e1c nghi\u00ean c\u1ee9u, nh\u01b0ng xu h\u01b0\u1edbng chung l\u00e0 s\u1eed d\u1ee5ng MTA l\u00e0m v\u1eadt li\u1ec7u tham kh\u1ea3o cho nh\u1eefng ch\u1ec9 \u0111\u1ecbnh n\u00e0y; tuy nhi\u00ean IRM c\u0169ng cho k\u1ebft qu\u1ea3 l\u00e2m s\u00e0ng t\u1ed1t t\u01b0\u01a1ng t\u1ef1. Th\u1ee7ng ch\u00e2n r\u0103ng c\u00f3 th\u1ec3 t\u1ea1o ra m\u1ed9t m\u00f4i tr\u01b0\u1eddng sinh h\u1ecdc gi\u1ed1ng v\u1edbi ph\u1eabu thu\u1eadt c\u1eaft ch\u00f3p: m\u1ed9t v\u00f9ng l\u1edbn m\u00f4 nha chu b\u1ecb ph\u00e1 h\u1ee7y khi\u1ebfn cho vi\u1ec7c ki\u1ec3m so\u00e1t s\u1ef1 t\u00e1i t\u1ea1o m\u00f4 c\u0169ng nh\u01b0 ki\u1ec3m so\u00e1t nhi\u1ec5m tr\u00f9ng tr\u1edf n\u00ean r\u1ea5t quan tr\u1ecdng. H\u00e0ng lo\u1ea1t c\u00e1c ca l\u00e2m s\u00e0ng \u0111\u00e3 ghi nh\u1eadn k\u1ebft qu\u1ea3 t\u1ed1t khi s\u1eed d\u1ee5ng MTA cho nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u00e0y.<\/p>\n

C\u00e1c d\u1eef li\u1ec7u l\u00e2m s\u00e0ng v\u1ec1 cement calcium-phosphat v\u00e0 nh\u1eefng v\u1eadt li\u1ec7u g\u1ea7n \u0111\u00e2y \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho vi\u1ec7c tr\u00e1m ng\u01b0\u1ee3c v\u1eabn c\u00f2n nhi\u1ec1u thi\u1ebfu s\u00f3t.<\/p>\n

Nghi\u00ean c\u1ee9u trong ph\u00f2ng th\u00ed nghi\u1ec7m:<\/strong> Hi\u1ec7u qu\u1ea3 l\u00e2m s\u00e0ng t\u1ed1t c\u1ee7a MTA ch\u1ee7 y\u1ebfu li\u00ean quan \u0111\u1ebfn 3 y\u1ebfu t\u1ed1: \u0111\u1ed9 pH r\u1ea5t cao t\u01b0\u01a1ng t\u1ef1 \u0111\u1eb7c t\u00ednh l\u00e2m s\u00e0ng t\u1ed1t c\u1ee7a calcium hydroxide, t\u1ea1o ra m\u1ed9t b\u1ec1 m\u1eb7t m\u00e0 vi khu\u1ea9n kh\u00f4ng th\u1ec3 \u1ea9n n\u00e1u, gi\u00fap m\u00f4 li\u00ean k\u1ebft t\u0103ng tr\u01b0\u1edfng v\u00e0 bi\u1ec7t h\u00f3a \u0111\u1ebfn g\u1ea7n b\u1ec1 m\u1eb7t c\u1ee7a n\u00f3. S\u1ef1 ph\u1ed1i h\u1ee3p gi\u1eefa t\u00ednh t\u01b0\u01a1ng h\u1ee3p sinh h\u1ecdc v\u00e0 t\u00ednh kh\u00e1ng khu\u1ea9n, c\u00f3 l\u1ebd do \u0111\u1ed9 ch\u00eanh l\u1ec7ch pH l\u1edbn v\u00e0 do th\u1ef1c t\u1ebf l\u00e0 nh\u1eefng ch\u1ea5t c\u00f3 t\u00ednh kh\u00e1ng khu\u1ea9n th\u00ec th\u01b0\u1eddng \u00eam d\u1ecbu v\u00e0 d\u1ec5 d\u00e0ng t\u01b0\u01a1ng h\u1ee3p v\u1edbi m\u00f4 khi ti\u1ebfp x\u00fac v\u1edbi c\u00e1c t\u1ebf b\u00e0o s\u1ed1ng, th\u1eadm ch\u00ed l\u00e0 \u1edf g\u1ea7n b\u1ec1 m\u1eb7t v\u1eadt li\u1ec7u. C\u00e1c d\u1eef li\u1ec7u l\u00e2m s\u00e0ng v\u1ec1 kh\u1ea3 n\u0103ng t\u01b0\u01a1ng h\u1ee3p sinh h\u1ecdc c\u1ee7a cement calcium-phosphate cho th\u1ea5y ch\u00fang d\u01b0\u1eddng nh\u01b0 t\u01b0\u01a1ng \u0111\u01b0\u01a1ng ho\u1eb7c t\u1ed1t h\u01a1n c\u00e1c s\u1ea3n ph\u1ea9m MTA.<\/p>\n

C\u0169ng nh\u01b0 c\u00e1c lo\u1ea1i sealer, v\u1eadt li\u1ec7u tr\u00e1m ng\u01b0\u1ee3c \u0111\u00e3 \u0111\u01b0\u1ee3c ki\u1ec3m \u0111\u1ecbnh r\u1ed9ng r\u00e3i v\u1ec1 m\u1ee9c \u0111\u1ed9 r\u00f2 r\u1ec9, kh\u1ea3 n\u0103ng b\u00e1m d\u00ednh, v\u00e0 m\u1ed9t v\u00e0i \u0111\u1eb7c t\u00ednh trong th\u1ef1c h\u00e0nh nh\u01b0 th\u1eddi gian thao t\u00e1c, th\u1eddi gian l\u00e0m vi\u1ec7c, \u0111\u1ed9 c\u1ea3n quang, v.v. Trong khi ch\u00fang c\u00f3 th\u1ec3 cho nh\u1eefng k\u1ebft qu\u1ea3 kh\u00e1c nhau \u1edf nh\u1eefng \u0111\u00e1nh gi\u00e1 kh\u00e1c nhau, nh\u01b0ng kh\u00f4ng c\u00f3 m\u1ed9t \u0111\u1eb7c t\u00ednh \u0111\u01a1n thu\u1ea7n n\u00e0o \u0111\u01b0\u1ee3c cho l\u00e0 quy\u1ebft \u0111\u1ecbnh hi\u1ec7u qu\u1ea3 l\u00e2m s\u00e0ng c\u1ee7a ch\u00fang.<\/p>\n

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

B\u00e0i vi\u1ebft n\u00e0y n\u00f3i v\u1ec1 c\u00e1c nghi\u00ean c\u1ee9u tr\u00ean l\u00e2m s\u00e0ng l\u1eabn trong ph\u00f2ng th\u00ed nghi\u1ec7m li\u00ean quan c\u00e1c lo\u1ea1i v\u1eadt li\u1ec7u s\u1eed d\u1ee5ng trong tr\u00e1m b\u00edt h\u1ec7 th\u1ed1ng \u1ed1ng tu\u1ef7. 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