{"id":28213,"date":"2023-04-25T06:41:24","date_gmt":"2023-04-24T23:41:24","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=28213"},"modified":"2023-05-02T09:09:50","modified_gmt":"2023-05-02T02:09:50","slug":"phuc-hoi-rang-da-dieu-tri-tuy-tong-quan-chung","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/phuc-hoi-rang-da-dieu-tri-tuy-tong-quan-chung\/","title":{"rendered":"Ph\u1ee5c h\u1ed3i r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb tu\u1ef7 &#8211; T\u1ed5ng quan chung."},"content":{"rendered":"<p><strong>Ph\u1ee5c h\u1ed3i r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha c\u00f3 th\u1ec3 quan tr\u1ecdng gi\u1ed1ng nh\u01b0 vi\u1ec7c tr\u00e1m b\u00edt \u1ed1ng t\u1ee7y v\u00e0 c\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u00e1ng k\u1ec3 \u0111\u1ebfn m\u1ee5c ti\u00eau cu\u1ed1i c\u00f9ng l\u00e0 lo\u1ea1i tr\u1eeb vi khu\u1ea9n \u2013 nguy\u00ean nh\u00e2n ch\u1ee7 y\u1ebfu c\u1ee7a b\u1ec7nh l\u00fd n\u1ed9i nha. Do \u0111\u00f3, nh\u1eefng nha s\u0129 th\u1ef1c hi\u1ec7n ph\u1ee5c h\u1ed3i r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha c\u00f3 tr\u00e1ch nhi\u1ec7m \u0111\u1ea3m b\u1ea3o r\u1eb1ng m\u1ed7i giai \u0111o\u1ea1n c\u1ee7a \u0111i\u1ec1u tr\u1ecb \u0111\u1ec1u ph\u1ea3i ph\u00f9 h\u1ee3p, \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n t\u1ed1t v\u00e0 k\u1ecbp th\u1eddi. B\u00e0i vi\u1ebft n\u00e0y t\u00f3m l\u01b0\u1ee3c t\u1ed5ng quan chung v\u00e0 gi\u1ea3i th\u00edch ng\u1eafn g\u1ecdn li\u00ean quan \u0111\u1ebfn kh\u00e1i ni\u1ec7m ph\u1ee5c h\u1ed3i r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha. C\u00f9ng t\u00ecm hi\u1ec3u.<\/strong><\/p>\n<h2>1. T\u1ed5ng quan chung<\/h2>\n<p>Vi\u1ec7c ph\u1ee5c h\u1ed3i cho r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha ph\u1ea3i \u0111\u01b0\u1ee3c l\u00ean k\u1ebf ho\u1ea1ch tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb. Nh\u1eefng ph\u1ee5c h\u1ed3i t\u1ea1m th\u1eddi trong su\u1ed1t qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb t\u1ee7y gi\u00fap b\u1ea3o v\u1ec7 h\u1ec7 th\u1ed1ng \u1ed1ng t\u1ee7y kh\u1ecfi s\u1ef1 x\u00e2m nh\u1eadp c\u1ee7a vi khu\u1ea9n, bao g\u1ed3m zinc oxide eugenol ho\u1eb7c calcium sulfate \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong th\u1eddi gian ng\u1eafn v\u00e0 glass ionomer ho\u1eb7c glass ionomer lai nh\u1ef1a (resin-modifed glass-ionomer) trong nh\u1eefng kho\u1ea3ng th\u1eddi gian d\u00e0i h\u01a1n. L\u00fd t\u01b0\u1edfng nh\u1ea5t l\u00e0 t\u00e1i t\u1ea1o c\u00f9i v\u00e0o th\u1eddi \u0111i\u1ec3m tr\u00e1m b\u00edt \u1ed1ng t\u1ee7y, tr\u01b0\u1edbc khi th\u00e1o b\u1ecf \u0111\u1ec3 cao su. Ti\u00ean l\u01b0\u1ee3ng tr\u00ean nh\u1eefng r\u0103ng tr\u01b0\u1edfng th\u00e0nh \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n nh\u1edd s\u1ef1 b\u1ea3o t\u1ed3n c\u1ea5u tr\u00fac r\u0103ng, tr\u00e1nh \u0111\u1eb7t ch\u1ed1t khi c\u00f3 th\u1ec3, tr\u00e1nh \u0111\u1ec3 l\u1ea1i nh\u1eefng kho\u1ea3ng h\u1edf gi\u1eefa gutta percha v\u00e0 b\u1ec1 m\u1eb7t c\u00f9i c\u0169ng nh\u01b0 l\u00e0m ph\u1ee5c h\u1ed3i to\u00e0n di\u1ec7n \u1edf c\u00e1c r\u0103ng tr\u01b0\u1edbc v\u00e0 ph\u1ee5c h\u1ed3i b\u00e1n ph\u1ea7n \u1edf c\u00e1c r\u0103ng sau. Nh\u1eefng b\u1eb1ng ch\u1ee9ng g\u1ea7n \u0111\u00e2y cho th\u1ea5y, ph\u01b0\u01a1ng ph\u00e1p ti\u1ebfp c\u1eadn b\u1ea3o t\u1ed3n, t\u00e1i t\u1ea1o tr\u1ef1c ti\u1ebfp b\u1eb1ng composite h\u1ee9a h\u1eb9n kh\u1ea3 n\u0103ng ph\u1ee5c h\u1ed3i t\u1ed1t cho nh\u1eefng r\u0103ng sau nguy\u00ean v\u1eb9n. Ch\u1ed1t s\u1ee3i li\u00ean quan \u0111\u1ebfn th\u1ea5t b\u1ea1i ph\u1ee5c h\u1ed3i cao h\u01a1n ch\u1ed1t kim lo\u1ea1i, nh\u01b0ng \u00edt li\u00ean quan \u0111\u1ebfn n\u1ee9t g\u00e3y h\u01a1n. Khi ch\u1ec9 \u0111\u1ecbnh \u0111\u1eb7t ch\u1ed1t th\u00ec n\u00ean s\u1eeda so\u1ea1n b\u1ea3o t\u1ed3n, l\u1ea5y \u0111i \u00edt nh\u1ea5t l\u01b0\u1ee3ng c\u1ea5u tr\u00fac ch\u00e2n r\u0103ng c\u00f3 th\u1ec3. Tr\u00e1m composite cho r\u0103ng ch\u01b0a tr\u01b0\u1edfng th\u00e0nh ch\u01b0a \u0111\u00f3ng ch\u00f3p l\u00e0m t\u0103ng t\u1ef7 l\u1ec7 t\u1ed3n t\u1ea1i l\u00e2u d\u00e0i c\u1ee7a r\u0103ng h\u01a1n so v\u1edbi ph\u1ee5c h\u1ed3i b\u1eb1ng m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9 l\u00e0m s\u1eb5n. Ch\u1ea5t l\u01b0\u1ee3ng ph\u1ee5c h\u1ed3i quan tr\u1ecdng v\u1edbi c\u1ea3 ph\u1ee5c h\u1ed3i t\u1ea1m v\u00e0 ph\u1ee5c h\u1ed3i sau c\u00f9ng; nhi\u1ec5m tr\u00f9ng ph\u1ea3i \u0111\u01b0\u1ee3c lo\u1ea1i b\u1ecf ho\u00e0n to\u00e0n. L\u00fd do ch\u00ednh ph\u1ea3i nh\u1ed5 c\u00e1c r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng ph\u1ea3i do \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha th\u1ea5t b\u1ea1i m\u00e0 l\u00e0 do s\u00e2u r\u0103ng, ph\u1ee5c h\u1ed3i kh\u00f4ng h\u1ee3p l\u00fd, b\u1ec7nh l\u00fd nha chu v\u00e0 n\u1ee9t g\u00e3y ch\u00e2n r\u0103ng.<\/p>\n<h2>2. Ph\u1ee5c h\u1ed3i r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha l\u00e0 g\u00ec?<\/h2>\n<p>Ph\u1ee5c h\u1ed3i cho r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha (endodontically treated teeth \u2013 ETT) th\u01b0\u1eddng \u0111\u01b0\u1ee3c xem l\u00e0 \u0111\u1ed9c l\u1eadp v\u1edbi \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha (RCT). Tuy nhi\u00ean, c\u1ea3 hai kh\u00f4ng th\u1ec3 t\u00e1ch r\u1eddi khi l\u1eadp k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb, th\u1ef1c hi\u1ec7n qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb v\u00e0 ti\u00ean l\u01b0\u1ee3ng \u0111i\u1ec1u tr\u1ecb. Ph\u1ee5c h\u1ed3i r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha c\u00f3 th\u1ec3 quan tr\u1ecdng gi\u1ed1ng nh\u01b0 vi\u1ec7c tr\u00e1m b\u00edt \u1ed1ng t\u1ee7y v\u00e0 c\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u00e1ng k\u1ec3 \u0111\u1ebfn m\u1ee5c ti\u00eau cu\u1ed1i c\u00f9ng l\u00e0 lo\u1ea1i tr\u1eeb vi khu\u1ea9n \u2013 nguy\u00ean nh\u00e2n ch\u1ee7 y\u1ebfu c\u1ee7a b\u1ec7nh l\u00fd n\u1ed9i nha. Do \u0111\u00f3, nh\u1eefng nha s\u0129 th\u1ef1c hi\u1ec7n ph\u1ee5c h\u1ed3i r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha c\u00f3 tr\u00e1ch nhi\u1ec7m \u0111\u1ea3m b\u1ea3o r\u1eb1ng m\u1ed7i giai \u0111o\u1ea1n c\u1ee7a \u0111i\u1ec1u tr\u1ecb \u0111\u1ec1u ph\u1ea3i ph\u00f9 h\u1ee3p, \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n t\u1ed1t v\u00e0 k\u1ecbp th\u1eddi.<br \/>\nVi\u1ec7c ph\u1ee5c h\u1ed3i cho nh\u1eefng r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha tr\u01b0\u1edfng th\u00e0nh \u0111\u00e3 \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u r\u1ed9ng r\u00e3i, v\u00e0 hi\u1ec7n c\u00f3 r\u1ea5t nhi\u1ec1u t\u00e0i li\u1ec7u v\u1edbi ph\u1ea1m vi r\u1ed9ng l\u1edbn c\u1ee7a c\u00e1c k\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng. Tuy nhi\u00ean, r\u1ea5t \u00edt d\u1eef li\u1ec7u k\u1ebft qu\u1ea3 l\u00e2m s\u00e0ng c\u00f3 ch\u1ea5t l\u01b0\u1ee3ng cao. H\u01a1n n\u1eefa, nhi\u1ec1u th\u00f4ng tin s\u1eb5n c\u00f3 \u0111\u00e3 l\u1ed7i th\u1eddi, ch\u1ec9 \u00e1p d\u1ee5ng \u0111\u01b0\u1ee3c cho nh\u1eefng t\u00ecnh hu\u1ed1ng c\u1ee5 th\u1ec3, ho\u1eb7c b\u1ecb l\u00e0m sai b\u1edfi nh\u1eefng bi\u1ebfn s\u1ed1 quan tr\u1ecdng, l\u00e0m cho vi\u1ec7c gi\u1ea3i th\u00edch c\u00e1c k\u1ebft qu\u1ea3 tr\u1edf n\u00ean kh\u00f3 kh\u0103n. Kh\u00f4ng c\u00f3 g\u00ec \u0111\u00e1ng ng\u1ea1c nhi\u00ean khi nha s\u0129 v\u1eabn kh\u00f4ng nh\u1ea5t qu\u00e1n trong vi\u1ec7c quy\u1ebft \u0111\u1ecbnh l\u1ef1a ch\u1ecdn ph\u1ee5c h\u1ed3i khi \u0111i\u1ec1u tr\u1ecb. V\u00ec th\u1ebf, c\u1ea7n \u0111\u00e1nh gi\u00e1 c\u00e1c k\u1ebft qu\u1ea3 d\u1eef li\u1ec7u d\u1ef1a tr\u00ean b\u1eb1ng ch\u1ee9ng, cung c\u1ea5p h\u01b0\u1edbng d\u1eabn th\u1ef1c h\u00e0nh cho c\u00e1c nha s\u0129 ph\u1ee5c h\u1ed3i v\u00e0 t\u1eadp trung v\u00e0o nh\u1eefng y\u1ebfu t\u1ed1 ti\u00ean l\u01b0\u1ee3ng ph\u1ee5c h\u1ed3i c\u00f3 \u1ea3nh h\u01b0\u1edfng t\u1ed1t \u0111\u1ebfn hi\u1ec7u qu\u1ea3 l\u00e2u d\u00e0i c\u1ee7a r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha.<\/p>\n<p>Ph\u1ee5c h\u1ed3i l\u00e0 m\u1ed9t ph\u1ea7n kh\u00f4ng th\u1ec3 t\u00e1ch r\u1eddi c\u1ee7a \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha. Ch\u1ea5t l\u01b0\u1ee3ng ph\u1ee5c h\u1ed3i l\u00e0 \u0111i\u1ec1u v\u00f4 c\u00f9ng quan tr\u1ecdng cho c\u1ea3 ph\u1ee5c h\u1ed3i t\u1ea1m v\u00e0 ph\u1ee5c h\u1ed3i sau c\u00f9ng v\u1edbi m\u1ee5c ti\u00eau ch\u00ednh l\u00e0 lo\u1ea1i b\u1ecf vi sinh v\u1eadt kh\u1ecfi h\u1ec7 th\u1ed1ng \u1ed1ng t\u1ee7y ch\u00e2n r\u0103ng. Ph\u1ee5c h\u1ed3i sau c\u00f9ng n\u00ean \u0111\u01b0\u1ee3c \u0111\u1eb7t c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t, t\u1ed1t h\u01a1n h\u1ebft l\u00e0 t\u1ea1i th\u1eddi \u0111i\u1ec3m tr\u00e1m b\u00edt \u1ed1ng t\u1ee7y v\u00e0 tr\u01b0\u1edbc khi th\u00e1o \u0111\u1ec3 cao su. C\u1ea5u tr\u00fac r\u0103ng ph\u1ea3i \u0111\u01b0\u1ee3c b\u1ea3o t\u1ed3n. R\u0103ng v\u0129nh vi\u1ec5n ch\u01b0a tr\u01b0\u1edfng th\u00e0nh c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u1ee5c h\u1ed3i theo l\u1ed1i b\u1ea3o t\u1ed3n b\u1eb1ng vi\u1ec7c t\u00e1i t\u1ea1o composite tr\u1ef1c ti\u1ebfp cho \u0111\u1ebfn khi k\u1ebft th\u00fac giai \u0111o\u1ea1n m\u1ecdc r\u0103ng chuy\u1ec3n ti\u1ebfp, khi \u0111\u00f3 1 ph\u1ee5c h\u00ecnh t\u1eebng ph\u1ea7n \u0111\u01b0\u1ee3c ch\u1ebf t\u1ea1o gi\u00e1n ti\u1ebfp m\u1edbi \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh. R\u0103ng ph\u00eda tr\u01b0\u1edbc kh\u00f4ng n\u00ean l\u00e0m ph\u1ee5c h\u00ecnh to\u00e0n ph\u1ea7n n\u1ebfu c\u00f2n nguy\u00ean v\u1eb9n c\u1ea5u tr\u00fac sau \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha v\u00e0 l\u1ed7 m\u1edf t\u1ee7y b\u1ea3o t\u1ed3n m\u00f4 r\u0103ng. Nh\u1eefng r\u0103ng ph\u00eda sau c\u00f3 l\u01b0\u1ee3ng l\u1edbn m\u00f4 r\u0103ng nguy\u00ean v\u1eb9n th\u00ec c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u1ee5c h\u1ed3i b\u1eb1ng composite trong th\u1eddi gian ng\u1eafn h\u1ea1n; tuy nhi\u00ean m\u00e3o to\u00e0n ph\u1ea7n s\u1ebd mang l\u1ea1i l\u1ee3i \u00edch cho nh\u1eefng tr\u01b0\u1eddng h\u1ee3p m\u1ea5t c\u1ea5u tr\u00fac r\u0103ng \u0111\u00e1ng k\u1ec3 \u0111\u1ec3 b\u1ea3o v\u1ec7 ch\u00fang tr\u00e1nh nguy c\u01a1 n\u1ee9t g\u00e3y ch\u00e2n r\u0103ng v\u00e0 m\u00fai r\u0103ng.<\/p>\n<p>Ch\u1ed1t kh\u00f4ng l\u00e0m t\u0103ng \u0111\u1ed9 b\u1ec1n c\u1ee7a r\u0103ng, ch\u00fang ch\u1ec9 n\u00ean \u0111\u01b0\u1ee3c \u0111\u1eb7t khi kh\u00f4ng th\u1ec3 s\u1eed d\u1ee5ng c\u00e1ch th\u1ee9c kh\u00e1c \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o s\u1ee9c kh\u00e1ng v\u00e0 s\u1ee9c l\u01b0u gi\u1eef c\u1ee7a r\u0103ng. H\u1ea7u h\u1ebft c\u00e1c r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha b\u1ecb nh\u1ed5 l\u00e0 do s\u00e2u r\u0103ng, b\u1ec7nh l\u00fd nha chu, th\u1ea5t b\u1ea1i ph\u1ee5c h\u1ed3i, v\u00e0 n\u1ee9t g\u00e3y ch\u00e2n r\u0103ng; nh\u1eefng y\u1ebfu t\u1ed1 ngo\u1ea1i lai n\u00e0y c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c xem x\u00e9t k\u0129. Vi l\u1eadu x\u1ea3y ra \u1edf ph\u1ee5c h\u1ed3i l\u00e0m \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn k\u1ebft qu\u1ea3 v\u00e0 th\u00e0nh c\u00f4ng c\u1ee7a m\u1ecdi \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha. D\u00f9 cho b\u1ea5t k\u00ec h\u1ec7 th\u1ed1ng ch\u1ed1t v\u00e0 c\u00f9i n\u00e0o \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng th\u00ec s\u1ef1 k\u1ebft h\u1ee3p m\u1ed9t v\u00e0nh \u0111ai ng\u00e0 th\u00edch h\u1ee3p trong thi\u1ebft k\u1ebf m\u00e3o r\u0103ng s\u1ebd l\u00e0m t\u0103ng t\u1ec9 l\u1ec7 th\u00e0nh c\u00f4ng. Quan tr\u1ecdng nh\u1ea5t l\u00e0 vi\u1ec7c b\u1ea3o t\u1ed3n c\u1ea5u tr\u00fac th\u00e2n r\u0103ng l\u00e0m t\u0103ng ti\u00ean l\u01b0\u1ee3ng l\u00e2u d\u00e0i v\u00e0 l\u01b0u gi\u1eef c\u00e1c r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha.<\/p>\n<p><em>Ngu\u1ed3n: <span class=\"c-bibliographic-information__value\">Clinical Guide for Optimal Treatment Outcome &#8211; Springer International Publishing Switzerland 2017<\/span><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Ph\u1ee5c h\u1ed3i r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha c\u00f3 th\u1ec3 quan tr\u1ecdng gi\u1ed1ng nh\u01b0 vi\u1ec7c tr\u00e1m b\u00edt \u1ed1ng t\u1ee7y v\u00e0 c\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u00e1ng k\u1ec3 \u0111\u1ebfn m\u1ee5c ti\u00eau cu\u1ed1i c\u00f9ng l\u00e0 lo\u1ea1i tr\u1eeb vi khu\u1ea9n \u2013 nguy\u00ean nh\u00e2n ch\u1ee7 y\u1ebfu c\u1ee7a b\u1ec7nh l\u00fd n\u1ed9i nha. Do \u0111\u00f3, nh\u1eefng nha s\u0129 th\u1ef1c hi\u1ec7n ph\u1ee5c h\u1ed3i r\u0103ng [&hellip;]<\/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":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ph\u1ee5c h\u1ed3i r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb tu\u1ef7 - T\u1ed5ng quan chung. - Vinmec<\/title>\n<meta name=\"description\" content=\"B\u00e0i vi\u1ebft n\u00e0y t\u00f3m l\u01b0\u1ee3c t\u1ed5ng quan chung v\u00e0 gi\u1ea3i th\u00edch ng\u1eafn g\u1ecdn li\u00ean quan \u0111\u1ebfn kh\u00e1i ni\u1ec7m ph\u1ee5c h\u1ed3i r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha. 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