{"id":28267,"date":"2023-04-25T13:05:01","date_gmt":"2023-04-25T06:05:01","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=28267"},"modified":"2023-05-02T08:48:14","modified_gmt":"2023-05-02T01:48:14","slug":"phuc-hoi-rang-vinh-vien-chua-truong-thanh-sau-dieu-tri-noi-nha","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/phuc-hoi-rang-vinh-vien-chua-truong-thanh-sau-dieu-tri-noi-nha\/","title":{"rendered":"Ph\u1ee5c h\u1ed3i r\u0103ng v\u0129nh vi\u1ec5n ch\u01b0a tr\u01b0\u1edfng th\u00e0nh sau \u0111i\u1ec1u tr\u1ecb N\u1ed9i nha."},"content":{"rendered":"

B\u00e0i vi\u1ebft n\u00e0y n\u00f3i v\u1ec1 c\u00e1c m\u1ee5c ti\u00eau c\u01a1 b\u1ea3n trong ph\u1ee5c h\u1ed3i r\u0103ng v\u0129nh vi\u1ec5n ch\u01b0a tr\u01b0\u1edfng th\u00e0nh, \u0111\u1ed3ng th\u1eddi ti\u1ebfn h\u00e0nh \u0111\u00e1nh gi\u00e1, ph\u00e2n t\u00edch c\u00e1c v\u1ea5n \u0111\u1ec1 li\u00ean quan t\u1edbi v\u1eadt li\u1ec7u trong qu\u00e1 tr\u00ecnh ph\u1ee5c h\u1ed3i sau qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha. C\u00f9ng t\u00ecm hi\u1ec3u th\u00eam.<\/strong><\/p>\n

1. M\u1ee5c ti\u00eau c\u01a1 b\u1ea3n trong ph\u1ee5c h\u1ed3i r\u0103ng v\u0129nh vi\u1ec5n ch\u01b0a tr\u01b0\u1edfng th\u00e0nh<\/h2>\n

B\u1ea3o t\u1ed3n c\u1ea5u tr\u00fac r\u0103ng l\u00e0 m\u1ee5c ti\u00eau c\u01a1 b\u1ea3n trong ph\u1ee5c h\u1ed3i r\u0103ng v\u0129nh vi\u1ec5n ch\u01b0a tr\u01b0\u1edfng th\u00e0nh \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha \u1edf tr\u1ebb em. B\u1ec7nh nh\u00e2n tr\u1ebb ti\u1ebfp nh\u1eadn m\u1ed9t \u0111i\u1ec1u tr\u1ecb t\u1ee7y b\u1ea3o t\u1ed3n (vital pulp therapy) ho\u1eb7c \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha th\u00f4ng th\u01b0\u1eddng (RCT) th\u01b0\u1eddng c\u00f3 r\u0103ng b\u1ecb m\u1ea5t ch\u1ea5t l\u1edbn, do h\u1eadu qu\u1ea3 c\u1ee7a s\u00e2u r\u0103ng, ch\u1ea5n th\u01b0\u01a1ng, ho\u1eb7c c\u00e1c b\u1ea5t th\u01b0\u1eddng trong qu\u00e1 tr\u00ecnh ph\u00e1t tri\u1ec3n.<\/p>\n

\"chua-truong-thanh-1\"
X quang c\u1eadn ch\u00f3p c\u1ee7a m\u1ed9t r\u0103ng c\u1ed1i 1 h\u00e0m d\u01b0\u1edbi b\u00ean tr\u00e1i \u1edf m\u1ed9t b\u1ec7nh nh\u00e2n 7 tu\u1ed5i, c\u00f3 l\u1ed7 s\u00e2u l\u1edbn \u1edf th\u00e2n r\u0103ng v\u00e0 ch\u00f3p r\u0103ng m\u1edf. Th\u1eed t\u1ee7y cho th\u1ea5y r\u0103ng \u0111\u00e1p \u1ee9ng b\u00ecnh th\u01b0\u1eddng.<\/figcaption><\/figure>\n

Ph\u1ea7n l\u1edbn nh\u1eefng r\u0103ng v\u0129nh vi\u1ec5n n\u00e0y \u0111\u1ec1u c\u00f3 ch\u00e2n r\u0103ng ph\u00e1t tri\u1ec3n ch\u01b0a ho\u00e0n t\u1ea5t v\u00e0 ch\u00f3p r\u0103ng m\u1edf \u0111\u00f2i h\u1ecfi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng th\u1ee7 thu\u1eadt \u0111\u00f3ng ch\u00f3p ho\u1eb7c t\u1ea1o ch\u00f3p. Nh\u1eefng \u0111\u1eb7c \u0111i\u1ec3m kh\u00e1c bi\u1ec7t n\u00e0y \u0111\u00f2i h\u1ecfi m\u1ed9t k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb ph\u1ee5c h\u1ed3i nh\u00ecn nh\u1eadn \u0111\u01b0\u1ee3c s\u1ef1 m\u1ecfng manh c\u1ee7a r\u0103ng v\u0129nh vi\u1ec5n ch\u01b0a tr\u01b0\u1edfng th\u00e0nh m\u00e0 v\u1eabn \u0111\u1ea3m b\u1ea3o gi\u1eef l\u1ea1i r\u0103ng. Vi\u1ec7c \u0111i\u1ec1u tr\u1ecb c\u00f2n \u0111\u00f2i h\u1ecfi ph\u1ea3i duy tr\u00ec ch\u1ee9c n\u0103ng nhai b\u00ecnh th\u01b0\u1eddng, ch\u1ed1ng r\u00f2 r\u1ec9 v\u00e0 b\u1ea3o v\u1ec7 r\u0103ng kh\u1ecfi n\u1ee9t g\u00e3y. Nh\u1eefng ti\u1ebfn b\u1ed9 trong c\u00f4ng ngh\u1ec7 k\u1ebft d\u00ednh nha khoa \u0111\u00e3 \u0111\u01b0\u1ee3c d\u00f9ng l\u00e0m c\u00f4ng c\u1ee5 cung c\u1ea5p c\u00e1c ph\u01b0\u01a1ng ph\u00e1p ph\u1ee5c h\u1ed3i nh\u1eb1m b\u1ea3o t\u1ed3n c\u1ea5u tr\u00fac r\u0103ng th\u1eadt, cho ph\u00e9p r\u0103ng ti\u1ebfp t\u1ee5c ph\u00e1t tri\u1ec3n trong khi v\u1eabn g\u00f3p ph\u1ea7n c\u1ea3i thi\u1ec7n t\u1ed3n t\u1ea1i l\u00e2u d\u00e0i c\u1ee7a r\u0103ng.<\/p>\n

T\u1ed5n th\u01b0\u01a1ng s\u00e2u r\u0103ng \u1edf nh\u1eefng r\u0103ng c\u1ed1i l\u1edbn ch\u01b0a tr\u01b0\u1edfng th\u00e0nh c\u00f3 th\u1ec3 ti\u1ebfn tri\u1ec3n nhanh, l\u00e0m cho c\u1ea5u tr\u00fac r\u0103ng suy y\u1ebfu sau khi lo\u1ea1i b\u1ecf ng\u00e0 \u0111\u1ec3 m\u1edf r\u1ed9ng l\u1ed7 s\u00e2u, \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha v\u00e0 th\u1ef1c hi\u1ec7n c\u00e1c ph\u1ee5c h\u1ed3i truy\u1ec1n th\u1ed1ng. Do \u0111\u00f3, nh\u1eefng r\u0103ng n\u00e0y c\u00f3 nguy c\u01a1 n\u1ee9t g\u00e3y cao h\u01a1n do c\u1ea5u tr\u00fac men kh\u00f4ng \u0111\u01b0\u1ee3c n\u00e2ng \u0111\u1ee1, t\u1ee7y r\u0103ng r\u1ed9ng v\u00e0 th\u00e0nh r\u0103ng m\u1ecfng.<\/p>\n

\"chua-truong-thanh-2\"
X quang ch\u1ee5p l\u00fac t\u00e1i kh\u00e1m c\u1ee7a m\u1ed9t r\u0103ng c\u1ed1i l\u1edbn 1 h\u00e0m d\u01b0\u1edbi b\u00ean tr\u00e1i \u1edf m\u1ed9t b\u1ec7nh nh\u00e2n 18 tu\u1ed5i \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u00ec vi\u00eam quanh ch\u00f3p c\u00f3 tri\u1ec7u ch\u1ee9ng. R\u0103ng c\u00f3 m\u1ed9t m\u00e3o kim lo\u1ea1i l\u00e0m s\u1eb5n ho\u1eb7c m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9 k\u00e9m ch\u1ea5t l\u01b0\u1ee3ng v\u00e0 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n l\u00e0 g\u00e3y d\u1ecdc ch\u00e2n xa.<\/figcaption><\/figure>\n

C\u00e1c y\u1ebfu t\u1ed1 ph\u1ee9c t\u1ea1p nh\u01b0 k\u00e9m kho\u00e1ng h\u00f3a, thi\u1ec3u s\u1ea3n men, ch\u1ea5n th\u01b0\u01a1ng c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn t\u00ednh to\u00e0n v\u1eb9n c\u1ee7a r\u0103ng, kh\u1ea3 n\u0103ng kh\u00e1ng g\u00e3y. Do nh\u1eefng \u0111\u1eb7c \u0111i\u1ec3m l\u00e2m s\u00e0ng n\u00e0y m\u00e0 m\u1ed9t v\u00e0i t\u00e1c gi\u1ea3 \u0111\u00e3 \u1ee7ng h\u1ed9 vi\u1ec7c \u0111\u1eb7t m\u1ed9t m\u00e3o kim lo\u1ea1i l\u00e0m s\u1eb5n ho\u1eb7c m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9 (preformed metal crown ho\u1eb7c stainless steel crown \u2013 PMC\/SSC) sau khi \u0111i\u1ec1u tr\u1ecb t\u1ee7y \u0111\u1ec3 duy tr\u00ec r\u0103ng nh\u01b0 l\u00e0 m\u1ed9t b\u1ed9 gi\u1eef kho\u1ea3ng cho \u0111\u1ebfn khi th\u1ef1c hi\u1ec7n implant. Tuy nhi\u00ean, c\u00e1c k\u0129 thu\u1eadt tr\u00e1m b\u00edt m\u1edbi v\u00e0 k\u0129 thu\u1eadt t\u00e1i t\u1ea1o s\u1eed d\u1ee5ng MTA v\u00e0 c\u00e1c cement canxi silicate (calcium silicate-based cement) ho\u1eb7c s\u1ee9 sinh h\u1ecdc khuy\u1ebfn kh\u00edch s\u1ef1 ti\u1ebfp t\u1ee5c ph\u00e1t tri\u1ec3n ch\u00e2n r\u0103ng \u1edf nh\u1eefng r\u0103ng ch\u01b0a tr\u01b0\u1edfng th\u00e0nh b\u1ecb ho\u1ea1i t\u1eed t\u1ee7y \u0111ang d\u1ea7n l\u00e0m thay \u0111\u1ed5i nh\u1eefng chi\u1ebfn l\u01b0\u1ee3c ph\u1ee5c h\u1ed3i \u0111\u01b0\u1ee3c ch\u1ea5p nh\u1eadn hi\u1ec7n nay. Nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb m\u1edbi d\u1ef1a tr\u00ean sinh h\u1ecdc n\u00e0y c\u00f3 th\u1ec3 l\u00e0m t\u0103ng t\u00ednh to\u00e0n v\u1eb9n c\u1ea5u tr\u00fac r\u0103ng c\u1ee7a nh\u1eefng r\u0103ng ch\u01b0a tr\u01b0\u1edfng th\u00e0nh b\u1eb1ng c\u00e1ch l\u00e0m t\u0103ng chi\u1ec1u d\u00e0i v\u00e0 \u0111\u1ed9 d\u00e0y th\u00e0nh ch\u00e2n r\u0103ng.<\/p>\n

2. C\u00e1c v\u1ea5n \u0111\u1ec1 li\u00ean quan \u0111\u1ebfn v\u1eadt li\u1ec7u ph\u1ee5c h\u1ed3i<\/h2>\n

R\u0103ng ch\u01b0a tr\u01b0\u1edfng th\u00e0nh \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha th\u01b0\u1eddng c\u00f3 c\u1ea5u tr\u00fac th\u00e2n r\u0103ng b\u1ecb m\u1ea5t ch\u1ea5t l\u1edbn th\u00ec th\u01b0\u1eddng \u0111\u01b0\u1ee3c t\u00e1i t\u1ea1o v\u1edbi c\u00f9i b\u1eb1ng amalgam theo l\u1ed1i truy\u1ec1n th\u1ed1ng. Tuy nhi\u00ean, s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 m\u00f4-\u0111un \u0111\u00e0n h\u1ed3i gi\u1eefa amalgam (28 \u2013 60 GPa) v\u00e0 ng\u00e0 r\u0103ng (12 \u2013 18 GPa) c\u00f3 th\u1ec3 g\u00f3p ph\u1ea7n l\u00e0m t\u0103ng nguy c\u01a1 g\u00e3y th\u00e2n v\u00e0 ch\u00e2n r\u0103ng \u1edf nh\u1eefng r\u0103ng b\u1ecb h\u01b0 h\u1ea1i n\u1eb7ng n\u00e0y.<\/p>\n

\"chua-truong-thanh-3\"
X quang ch\u1ee5p l\u00fac t\u00e1i kh\u00e1m sau 3 n\u0103m c\u1ee7a m\u1ed9t r\u1eb1ng c\u1ed1i l\u1edbn v\u0129nh vi\u1ec5n sau \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha th\u00f4ng th\u01b0\u1eddng. R\u0103ng \u0111\u01b0\u1ee3c t\u00e1i t\u1ea1o v\u1edbi c\u00f9i b\u1eb1ng amalgam ch\u1ee9 kh\u00f4ng l\u00e0m m\u00e3o b\u1eb1ng th\u00e9p kh\u00f4ng g\u1ec9, \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n tr\u00ean l\u00e2m s\u00e0ng l\u00e0 g\u00e3y d\u1ecdc ch\u00e2n r\u0103ng.<\/figcaption><\/figure>\n

V\u1eadt li\u1ec7u c\u00f3 m\u00f4-\u0111un \u0111\u00e0n h\u1ed3i cao h\u01a1n ng\u00e0 r\u0103ng th\u00ec c\u00f3 th\u1ec3 kh\u00f4ng cung c\u1ea5p kh\u1ea3 n\u0103ng b\u1ecbt k\u00edn l\u00ed t\u01b0\u1edfng ch\u1ed1ng l\u1ea1i s\u1ef1 r\u00f2 r\u1ec9 v\u00e0 x\u00e2m nh\u1eadp c\u1ee7a vi khu\u1ea9n. Do v\u1eady, c\u00e1c m\u00e3o kim lo\u1ea1i l\u00e0m s\u1eb5n ho\u1eb7c m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9 \u0111\u01b0\u1ee3c \u1ee7ng h\u1ed9 s\u1eed d\u1ee5ng v\u1edbi m\u1ee5c ti\u00eau ng\u0103n ng\u1eeba n\u1ee9t g\u00e3y th\u00e2n r\u0103ng, g\u00e3y v\u1ee1 m\u00fai r\u0103ng v\u00e0 ho\u1ea1t \u0111\u1ed9ng nh\u01b0 m\u1ed9t h\u00e0ng r\u00e0o th\u1ee9 ph\u00e1t ch\u1ed1ng l\u1ea1i s\u1ef1 r\u00f2 r\u1ec9 vi khu\u1ea9n tr\u00ean nh\u1eefng r\u0103ng b\u1ecb suy y\u1ebfu n\u00e0y.<\/p>\n

C\u00e1c m\u00e3o kim lo\u1ea1i l\u00e0m s\u1eb5n ho\u1eb7c m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9 ban \u0111\u1ea7u ch\u1ee7 y\u1ebfu \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 ph\u1ee5c h\u1ed3i r\u0103ng s\u1eefa v\u00e0 v\u1ec1 sau ng\u01b0\u1eddi ta th\u1ea5y ch\u00fang l\u00e0 l\u1ef1a ch\u1ecdn ph\u1ee5c h\u1ed3i \u0111\u00e1ng tin c\u1eady \u0111\u1ed1i v\u1edbi c\u1ea3 r\u0103ng v\u0129nh vi\u1ec5n. Ch\u00fang c\u0169ng \u0111\u1ed3ng th\u1eddi \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o cho nh\u1eefng r\u0103ng c\u1ed1i l\u1edbn v\u0129nh vi\u1ec5n c\u00f3 c\u1ea5u tr\u00fac b\u1ecb h\u01b0 h\u1ea1i nhi\u1ec1u \u1edf b\u1ec7nh nh\u00e2n tr\u1ebb em nh\u01b0 l\u00e0 m\u1ed9t ph\u1ee5c h\u1ed3i t\u1ea1m trong su\u1ed1t th\u1eddi k\u00ec m\u1ecdc r\u0103ng chuy\u1ec3n ti\u1ebfp, cho \u0111\u1ebfn khi c\u00f3 th\u1ec3 \u0111\u1eb7t ph\u1ee5c h\u1ed3i v\u0129nh vi\u1ec5n. C\u00e1c nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng cho th\u1ea5y m\u00e3o kim lo\u1ea1i l\u00e0m s\u1eb5n ho\u1eb7c m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9 kh\u00edt s\u00e1t v\u00e0 \u0111\u01b0\u1ee3c g\u1eafn cement t\u1ed1t th\u00ec th\u1ea5y \u00edt ho\u1eb7c l\u00e0 kh\u00f4ng th\u1ea5y t\u1ed5n th\u01b0\u01a1ng nghi\u00eam tr\u1ecdng l\u00ean m\u00f4 nha chu. Tuy nhi\u00ean, m\u00e3o kim lo\u1ea1i l\u00e0m s\u1eb5n ho\u1eb7c m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9 v\u1edbi \u0111\u01b0\u1eddng vi\u1ec1n k\u00e9m s\u00e1t th\u00ec d\u1ec5 d\u1eabn \u0111\u1ebfn vi\u00eam n\u01b0\u1edbu, v\u00e0 c\u00f9ng v\u1edbi vi\u1ec7c v\u1ec7 sinh r\u0103ng mi\u1ec7ng k\u00e9m s\u1ebd l\u00e0m t\u0103ng nguy c\u01a1 m\u1eafc c\u00e1c b\u1ec7nh nha chu.<\/p>\n

\"\"
H\u00ecnh \u1ea3nh l\u00e2m s\u00e0ng m\u00f4 n\u01b0\u1edbu ph\u00f9 n\u1ec1 v\u00e0 t\u0103ng s\u1ea3n li\u00ean quan \u0111\u1ebfn m\u1ed9t m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9 kh\u00f4ng kh\u00edt s\u00e1t tr\u00ean m\u1ed9t c\u00f9i r\u0103ng b\u1eb1ng composite.<\/figcaption><\/figure>\n

V\u00ec nh\u1eefng m\u00e3o r\u0103ng n\u00e0y \u0111\u01b0\u1ee3c l\u00e0m s\u1eb5n n\u00ean ch\u00fang kh\u00f4ng ph\u1ea3i lu\u00f4n lu\u00f4n \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh \u0111\u1ec3 cung c\u1ea5p m\u1ed9t s\u1ef1 kh\u00edt s\u00e1t b\u1edd vi\u1ec1n ch\u00ednh x\u00e1c nh\u01b0 mong mu\u1ed1n. B\u1edd vi\u1ec1n kh\u00f4ng kh\u00edt s\u00e1t c\u1ee7a m\u00e3o kim lo\u1ea1i l\u00e0m s\u1eb5n ho\u1eb7c m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9 v\u00e0 s\u1ef1 r\u00f2 r\u1ec9 cement theo th\u1eddi gian c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn s\u00e2u r\u0103ng th\u1ee9 ph\u00e1t, vi\u00eam n\u01b0\u1edbu, nghi\u00eang l\u1ec7ch r\u0103ng, t\u1ed5n th\u01b0\u01a1ng nha chu v\u00e0 m\u1ea5t r\u0103ng khi r\u0103ng ch\u01b0a tr\u01b0\u1edfng th\u00e0nh.<\/p>\n

\"chua-truong-thanh-4\"
(a) H\u00ecnh \u1ea3nh l\u00e2m s\u00e0ng c\u1ee7a m\u1ed9t m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9 v\u1edbi \u0111\u01b0\u1eddng vi\u1ec1n b\u1ecb h\u1edf sau khi lo\u1ea1i b\u1ecf s\u1ea1ch m\u1ea3nh v\u1ee5n. (b-d) Th\u00e1o m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9 ra kh\u1ecfi c\u00f9i r\u0103ng b\u1eb1ng amalgam cho th\u1ea5y s\u00e2u r\u0103ng th\u1ee9 ph\u00e1t, t\u00edch t\u1ee5 m\u1ea3ng b\u00e1m v\u00e0 vi\u00eam n\u01b0\u1edbu m\u1ee9c \u0111\u1ed9 trung b\u00ecnh.<\/figcaption><\/figure>\n

M\u1eb7c d\u00f9 m\u00e3o kim lo\u1ea1i l\u00e0m s\u1eb5n ho\u1eb7c m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9 \u0111em l\u1ea1i nhi\u1ec1u l\u1ee3i \u00edch, nh\u01b0ng vi\u1ec7c \u0111\u1eb7t n\u00f3 \u0111\u00f2i h\u1ecfi ph\u1ea3i s\u1eeda so\u1ea1n th\u00eam m\u00f4 r\u0103ng v\u00e0 l\u00e0m gi\u1ea3m b\u1edbt l\u01b0\u1ee3ng c\u1ea5u tr\u00fac r\u0103ng th\u1eadt.<\/p>\n

C\u00e1c nha s\u0129 t\u1ed5ng qu\u00e1t v\u00e0 nha s\u0129 chuy\u00ean khoa r\u0103ng tr\u1ebb em th\u01b0\u1eddng s\u1eed d\u1ee5ng m\u00e3o kim lo\u1ea1i l\u00e0m s\u1eb5n ho\u1eb7c m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9 tr\u00ean nh\u1eefng r\u0103ng v\u0129nh vi\u1ec5n ch\u01b0a tr\u01b0\u1edfng th\u00e0nh \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb che tuy tr\u1ef1c ti\u1ebfp v\u00e0 gi\u00e1n ti\u1ebfp, l\u1ea5y t\u1ee7y bu\u1ed3ng b\u00e1n ph\u1ea7n hay to\u00e0n b\u1ed9, gi\u1ea3m kho\u00e1ng h\u00f3a ho\u1eb7c c\u00e1c v\u1ea5n \u0111\u1ec1 thu\u1ed9c qu\u00e1 tr\u00ecnh ph\u00e1t tri\u1ec3n. M\u00e3o kim lo\u1ea1i l\u00e0m s\u1eb5n ho\u1eb7c m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9 \u0111\u00e3 tr\u1edf th\u00e0nh ti\u00eau chu\u1ea9n ph\u1ee5c h\u1ed3i cho nh\u1eefng r\u0103ng v\u0129nh vi\u1ec5n ch\u01b0a tr\u01b0\u1edfng th\u00e0nh m\u00e0 kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng l\u00e2m s\u00e0ng r\u00f5 r\u00e0ng n\u00e0o h\u1ed7 tr\u1ee3 cho vi\u1ec7c ti\u1ebfp t\u1ee5c \u1ee9ng d\u1ee5ng n\u00f3. M\u1eb7c d\u00f9 c\u00e1c d\u1eef li\u1ec7u ch\u1ee9ng minh lo\u1ea1i ph\u1ee5c h\u1ed3i n\u00e0y c\u00f3 t\u1ec9 l\u1ec7 th\u00e0nh c\u00f4ng cao h\u01a1n khi so s\u00e1nh v\u1edbi amalgam \u0111\u01a1n \u0111\u1ed9c \u0111\u1ed1i v\u1edbi nh\u1eefng r\u0103ng s\u1eefa b\u1ecb t\u1ed5n h\u1ea1i, nh\u01b0ng v\u1eabn kh\u00f4ng c\u00f3 nhi\u1ec1u s\u1ef1 hi\u1ec3u bi\u1ebft v\u1ec1 l\u1ee3i \u00edch c\u1ee7a m\u00e3o kim lo\u1ea1i l\u00e0m s\u1eb5n ho\u1eb7c m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9 \u0111\u1ed1i v\u1edbi r\u0103ng c\u1ed1i l\u1edbn v\u0129nh vi\u1ec5n \u1edf tr\u1ebb em sau khi \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha.<\/p>\n

Nh\u00ecn chung, ng\u01b0\u1eddi ta nh\u1eadn th\u1ea5y th\u1eddi gian b\u1ec7nh nh\u00e2n n\u1eb1m tr\u00ean gh\u1ebf \u0111\u1ec3 th\u1ef1c hi\u1ec7n m\u1ed9t m\u00e3o kim lo\u1ea1i l\u00e0m s\u1eb5n cho v\u1eeba v\u1eb7n v\u1edbi m\u1ed9t r\u0103ng c\u1ed1i l\u1edbn v\u0129nh vi\u1ec5n th\u00ec l\u00e2u h\u01a1n nhi\u1ec1u so v\u1edbi m\u00e3o r\u0103ng c\u1ed1i s\u1eefa. C\u00f3 nhi\u1ec1u y\u1ebfu t\u1ed1 g\u00f3p ph\u1ea7n g\u00e2y kh\u00f3 kh\u0103n cho vi\u1ec7c \u0111\u1ea3m b\u1ea3o th\u00e0nh c\u00f4ng c\u1ee7a m\u00e3o kim lo\u1ea1i l\u00e0m s\u1eb5n ho\u1eb7c m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9. Ng\u01b0\u1eddi ta \u01b0\u1edbc t\u00ednh c\u00f3 kho\u1ea3ng 80% th\u1ee7 thu\u1eadt \u0111i\u1ec1u tr\u1ecb nha khoa tr\u1ebb em \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1edfi nha s\u0129 t\u1ed5ng qu\u00e1t, l\u00e0 nh\u1eefng ng\u01b0\u1eddi th\u01b0\u1eddng g\u1eb7p kh\u00f3 kh\u0103n v\u00ec m\u00e3o kim lo\u1ea1i l\u00e0m s\u1eb5n ho\u1eb7c m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9 kh\u00f4ng \u0111\u01b0\u1ee3c t\u1ea1o h\u00ecnh ch\u00ednh x\u00e1c t\u1ea1i m\u1ee9c c\u1ed5 r\u0103ng \u0111\u1ec3 th\u00edch nghi v\u1edbi c\u00e1c thay \u0111\u1ed5i v\u1ec1 chi\u1ec1u d\u00e0i v\u00e0 chi\u1ec1u cao th\u00e2n r\u0103ng g\u1eb7p ph\u1ea3i trong su\u1ed1t giai \u0111o\u1ea1n m\u1ecdc r\u0103ng chuy\u1ec3n ti\u1ebfp.<\/p>\n

\"\"
(a v\u00e0 b) Phim c\u1eafn v\u00e0 phim c\u1eadn ch\u00f3p c\u1ee7a r\u0103ng c\u1ed1i l\u1edbn 1 h\u00e0m tr\u00ean b\u00ean ph\u1ea3i sau khi \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha. (c) H\u00ecnh \u1ea3nh l\u00e2m s\u00e0ng c\u1ee7a r\u0103ng sau khi lo\u1ea1i b\u1ecf m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9 cho th\u1ea5y s\u1ef1 t\u00edch t\u1ee5 m\u1ea3nh v\u1ee5n m\u00f4. (d) H\u00ecnh \u1ea3nh c\u00f9i r\u0103ng amalgam sau khi th\u00e1o b\u1ecf m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9 v\u00e0 cement g\u1eafn cho th\u1ea5y vi\u00eam n\u01b0\u1edbu, s\u00e2u r\u0103ng v\u00e0 \u0111\u1ed5i m\u00e0u th\u00e2n r\u0103ng l\u00e2m s\u00e0ng.<\/figcaption><\/figure>\n

Nh\u1eefng ph\u1ee5c h\u1ed3i l\u00e0m s\u1eb5n n\u00e0y c\u0169ng c\u00f3 th\u1ec3 g\u00e2y ra v\u1ea5n \u0111\u1ec1 trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p an th\u1ea7n, khi m\u00e0 s\u1ef1 mong mu\u1ed1n v\u1ec1 m\u00e3o r\u0103ng l\u00e0 m\u1ed9t nguy c\u01a1 c\u00f3 th\u1ec3 g\u00e2y \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ee9c kh\u1ecfe c\u1ee7a tr\u1ebb.<\/p>\n

M\u00e3o kim lo\u1ea1i l\u00e0m s\u1eb5n ho\u1eb7c m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9 kh\u00f4ng kh\u00edt s\u00e1t c\u00f3 th\u1ec3 g\u00e2y ra s\u1ef1 m\u1ecdc r\u0103ng nghi\u00eang l\u1ec7ch ho\u1eb7c m\u1ea5t kho\u1ea3ng Leeway d\u1eabn \u0111\u1ebfn c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 ch\u1ec9nh nha \u1edf b\u1ed9 r\u0103ng h\u1ed7n h\u1ee3p. H\u01a1n th\u1ebf n\u1eefa, m\u00e3o kim lo\u1ea1i l\u00e0m s\u1eb5n ho\u1eb7c m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9 c\u00f2n ph\u00f3ng th\u00edch niken, crom v\u00e0 s\u1eaft \u0111\u01b0\u1ee3c h\u1ea5p th\u1ee5 b\u1edfi cement ch\u00e2n r\u0103ng \u1edf t\u1ec9 l\u1ec7 cao h\u01a1n nhi\u1ec1u so v\u1edbi c\u00e1c r\u0103ng c\u1ed1i nguy\u00ean v\u1eb9n. M\u1ed9t m\u1ed1i quan t\u00e2m l\u1edbn kh\u00e1c \u1edf nh\u1eefng r\u0103ng \u0111\u01b0\u1ee3c t\u00e1i t\u1ea1o c\u00f9i b\u1eb1ng amalgam v\u00e0 m\u00e3o kim lo\u1ea1i l\u00e0m s\u1eb5n ho\u1eb7c m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9 l\u00e0 ch\u00fang c\u00f3 khuynh h\u01b0\u1edbng khi\u1ebfn cho b\u1ec7nh nh\u00e2n ph\u1ea3i th\u1ef1c hi\u1ec7n nhi\u1ec1u th\u1ee7 thu\u1eadt h\u1ed3i ph\u1ee5c kh\u00e1c trong t\u01b0\u01a1ng lai, bao g\u1ed3m \u0111\u1eb7t ch\u1ed1t, t\u00e1i t\u1ea1o c\u00f9i l\u1ea1i, l\u00e0m d\u00e0i th\u00e2n r\u0103ng v\u00e0 ph\u1ee5c h\u1ed3i m\u1edf r\u1ed9ng m\u00e3o to\u00e0n di\u1ec7n \u1edf b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i. Nh\u1eefng th\u1ee7 thu\u1eadt n\u00e0y l\u00e0m gi\u1ea3m c\u1ea5u tr\u00fac r\u0103ng th\u1eadt v\u00e0 c\u00f3 th\u1ec3 l\u00e0m t\u0103ng kh\u1ea3 n\u0103ng m\u1ea5t r\u0103ng th\u00f4ng qua n\u1ee9t g\u00e3y ch\u00e2n r\u0103ng, vi l\u1eadu (microleakage) v\u00e0 nh\u1eefng th\u1ea5t b\u1ea1i kh\u00e1c trong ph\u1ee5c h\u1ed3i. Ng\u01b0\u1eddi ta nh\u1eadn th\u1ea5y nh\u1eefng r\u0103ng \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha m\u00e0 c\u00f3 gi\u1eef l\u1ea1i m\u1ed9t l\u01b0\u1ee3ng c\u1ea5u tr\u00fac th\u00e2n r\u0103ng sau th\u1ee7 thu\u1eadt ph\u1ee5c h\u1ed3i th\u00ec c\u00f3 kh\u1ea3 n\u0103ng kh\u00e1ng n\u1ee9t g\u00e3y t\u1ed1t. V\u1eadt li\u1ec7u c\u00f9i d\u00e1n l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p thay th\u1ebf gi\u00fap b\u1ea3o t\u1ed3n c\u1ea5u tr\u00fac m\u00f4 r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha b\u1ecb suy y\u1ebfu \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n tr\u1ebb.<\/p>\n

\"\"
(a) H\u00ecnh \u1ea3nh l\u00e2m s\u00e0ng c\u1ee7a r\u0103ng c\u1ed1i l\u1edbn 1 h\u00e0m d\u01b0\u1edbi b\u00ean ph\u1ea3i c\u00f3 c\u1ea5u tr\u00fac r\u0103ng b\u1ecb t\u1ed5n h\u1ea1i nghi\u00eam tr\u1ecdng \u1edf m\u1ed9t b\u1ec7nh nh\u00e2n 12 tu\u1ed5i sau khi lo\u1ea1i b\u1ecf m\u00f4 r\u0103ng s\u00e2u v\u00e0 ho\u00e0n t\u1ea5t \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha. (b) R\u0103ng sau khi \u0111\u1eb7t l\u1edbp d\u00e1n ClearfI\u2122 Photo Core v\u00e0 (c) X quang t\u00e1i kh\u00e1m 1 n\u0103m sau \u0111i\u1ec1u tr\u1ecb cho th\u1ea5y chi\u1ec1u cao m\u00e0o x\u01b0\u01a1ng \u1ed5 b\u00ecnh th\u01b0\u1eddng.<\/figcaption><\/figure>\n

Ba bi\u1ebfn th\u1ec3 c\u1ee7a c\u00f9i b\u1eb1ng composite l\u00e0 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p thay th\u1ebf s\u1eb5n c\u00f3 gi\u00fap ph\u1ee5c h\u1ed3i nh\u1eefng r\u0103ng v\u0129nh vi\u1ec5n ch\u01b0a tr\u01b0\u1edfng th\u00e0nh, g\u1ed3m composite quang tr\u00f9ng h\u1ee3p, h\u00f3a tr\u00f9ng h\u1ee3p v\u00e0 tr\u00f9ng h\u1ee3p k\u00e9p. Khi xem x\u00e9t \u0111\u1ebfn c\u00e1c t\u00ednh ch\u1ea5t v\u1eadt l\u00ed, c\u00f9i r\u0103ng composite quang tr\u00f9ng h\u1ee3p c\u00f3 \u0111\u1eb7c t\u00ednh trong m\u1edd s\u1ebd \u0111em l\u1ea1i l\u1ee3i th\u1ebf kh\u00e1c bi\u1ec7t so v\u1edbi c\u00f9i b\u1eb1ng amalgam k\u1ebft h\u1ee3p v\u1edbi b tr\u00ean nh\u1eefng r\u0103ng ch\u01b0a tr\u01b0\u1edfng th\u00e0nh \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha. C\u00f9i b\u1eb1ng composite trong m\u1edd \u0111\u01b0\u1ee3c d\u00e1n tr\u1ef1c ti\u1ebfp v\u00e0o men v\u00e0 ng\u00e0, s\u1ebd l\u00e0m gi\u1ea3m ch\u1ec9 \u0111\u1ecbnh s\u1eeda so\u1ea1n th\u00eam ho\u1eb7c ch\u1ec9 \u0111\u1ecbnh th\u00eam y\u1ebfu t\u1ed1 l\u01b0u gi\u1eef tr\u01b0\u1edbc khi th\u1ef1c hi\u1ec7n. Nh\u1eefng v\u1eadt li\u1ec7u \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u0111\u1eb7c bi\u1ec7t n\u00e0y c\u00f9ng v\u1edbi nh\u1eefng v\u1eadt li\u1ec7u composite kh\u00e1c th\u1ec3 hi\u1ec7n c\u01b0\u1eddng \u0111\u1ed9 n\u00e9n cao, kh\u1ea3 n\u0103ng kh\u00e1ng g\u00e3y v\u00e0 s\u1ee9c c\u0103ng t\u1ed1t h\u01a1n. V\u1eadt li\u1ec7u c\u00f9i c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c quang tr\u00f9ng h\u1ee3p nguy\u00ean kh\u1ed1i l\u1edbn \u1edf h\u1ea7u h\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p m\u00e0 kh\u00f4ng c\u1ea7n \u0111\u1eb7t t\u1eebng l\u1edbp do t\u00ednh trong c\u1ee7a n\u00f3. Nh\u1edd l\u1ef1c d\u00e1n cao khi k\u1ebft h\u1ee3p v\u1edbi nh\u1ef1a hydrophilic t\u1ef1 xoi m\u00f2n th\u1ebf h\u1ec7 th\u1ee9 4 v\u00e0 th\u1ee9 5 n\u00ean s\u1ef1 co c\u1ee7a y\u1ebfu t\u1ed1 C \u0111\u01b0\u1ee3c gi\u1ea3m t\u1ed1i thi\u1ec3u trong giai \u0111o\u1ea1n \u0111\u1ea7u tr\u00f9ng h\u1ee3p khi c\u00e1c v\u1eadt li\u1ec7u c\u00f9i \u0111\u01b0\u1ee3c h\u1ee3p nh\u1ea5t.<\/p>\n

C\u00e1c v\u1eadt li\u1ec7u c\u00f9i hi\u1ec7n t\u1ea1i g\u1ed3m Build-It\u2122, Light-Core\u2122 v\u00e0 ClearfI\u2122 Photo Core. Photo Core cho th\u1ea5y t\u00ednh ch\u1ea5t \u0111\u1ed9c \u0111\u00e1o bao g\u1ed3m m\u1ed9t \u0111\u1ed9 s\u00e2u 8 mm \u0111\u01b0\u1ee3c tr\u00f9ng h\u1ee3p trong v\u00f2ng 20 gi\u00e2y, m\u00f4-\u0111un \u0111\u00e0n h\u1ed3i t\u01b0\u01a1ng \u0111\u01b0\u01a1ng ng\u00e0 r\u0103ng (12\u00b11.2GPa), \u0111\u1ed9 u\u1ed1n d\u1ebbo cao (125 +12MPa) v\u00e0 \u0111\u1ed9 ch\u1ecbu n\u00e9n ngang v\u1edbi amalgam (334 MPa). Lo\u1ea1i v\u1eadt li\u1ec7u n\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng v\u00e0 d\u00e1n b\u1eb1ng Clearfirm SE Bond, SE Bond 2, ho\u1eb7c SE Protect Bond tr\u00ean nh\u1eefng r\u0103ng v\u0129nh vi\u1ec5n ch\u01b0a tr\u01b0\u1edfng th\u00e0nh b\u1ecb t\u1ed5n th\u01b0\u01a1ng nghi\u00eam tr\u1ecdng sau khi \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha ho\u1eb7c l\u1ea5y t\u1ee7y bu\u1ed3ng. N\u00f3 th\u01b0\u1eddng c\u00f3 \u0111\u1ed9 t\u1ed3n t\u1ea1i l\u00e2u d\u00e0i ch\u1ea5p nh\u1eadn \u0111\u01b0\u1ee3c tr\u01b0\u1edbc khi th\u1ef1c hi\u1ec7n m\u1ed9t ph\u1ee5c h\u1ed3i v\u0129nh vi\u1ec5n.<\/p>\n

\"\"
X quang c\u1eadn ch\u00f3p tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb c\u1ee7a r\u0103ng c\u1ed1i l\u1edbn 1 h\u00e0m d\u01b0\u1edbi b\u00ean ph\u1ea3i c\u00f3 l\u1ed7 ch\u00f3p m\u1edf \u1edf m\u1ed9t b\u1ec7nh nh\u00e2n 9 tu\u1ed5i \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n vi\u00eam t\u1ee7y kh\u00f4ng h\u1ed3i ph\u1ee5c. (b) R\u0103ng c\u1ed1i l\u1edbn sau khi \u0111\u1eb7t MTA. (c) K\u1ebft th\u00fac vi\u1ec7c tr\u00e1m b\u00edt \u1ed1ng t\u1ee7y v\u1edbi gutta-percha n\u00f3ng, sealer v\u00e0 t\u00e1i t\u1ea1o c\u00f9i. (d) X quang c\u1eadn ch\u00f3p r\u0103ng c\u1ed1i l\u1edbn khi t\u00e1i kh\u00e1m 4 n\u0103m 10 th\u00e1ng sau \u0111i\u1ec1u tr\u1ecb cho th\u1ea5y x\u01b0\u01a1ng \u1ed5 r\u0103ng b\u00ecnh th\u01b0\u1eddng v\u00e0 th\u00e2n r\u0103ng v\u1eabn nguy\u00ean v\u1eb9n.<\/figcaption><\/figure>\n

H\u01a1n th\u1ebf n\u1eefa, r\u0103ng ch\u01b0a tr\u01b0\u1edfng th\u00e0nh \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb che t\u1ee7y tr\u1ef1c ti\u1ebfp, gi\u00e1n ti\u1ebfp hay l\u1ea5y t\u1ee7y bu\u1ed3ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c t\u00e1i t\u1ea1o b\u1eb1ng c\u00e1c lo\u1ea1i composite opaque ph\u1ee5c h\u1ed3i tr\u1ef1c ti\u1ebfp c\u00f3 s\u1eb5n khi ph\u01b0\u01a1ng th\u1ee9c \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u00fang. Ph\u1ee5c h\u1ed3i composite d\u00e1n hi\u1ec7n \u0111ang \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i \u0111\u1ec3 t\u00e1i t\u1ea1o nh\u1eefng r\u0103ng s\u00e2u c\u00f2n t\u1ee7y s\u1ed1ng \u1edf tr\u1ebb em thay v\u00ec l\u00e0 amalgam. Xu h\u01b0\u1edbng ph\u1ee5c h\u1ed3i cho th\u1ea5y glass ionomer v\u00e0 composite \u0111ang d\u1ea7n d\u1ea7n thay th\u1ebf amalgam trong vi\u1ec7c ph\u1ee5c h\u1ed3i nh\u1eefng r\u0103ng s\u1eefa c\u00f2n t\u1ee7y s\u1ed1ng. Tuy m\u1ed9t v\u00e0i nghi\u00ean c\u1ee9u cho th\u1ea5y t\u1ec9 l\u1ec7 l\u00e2u d\u00e0i c\u1ee7a amalgam l\u00e0 cao h\u01a1n khi s\u1eed d\u1ee5ng v\u1edbi nh\u1eefng r\u0103ng t\u1ee7y s\u1ed1ng, nh\u01b0ng th\u1eddi gian t\u1ed3n t\u1ea1i c\u1ee7a composite \u0111ang d\u1ea7n \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n khi s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a c\u00e1c lo\u1ea1i v\u1eadt li\u1ec7u \u0111ang ng\u00e0y c\u00e0ng gia t\u0103ng.<\/p>\n

Thu\u1eadn l\u1ee3i ch\u1ee7 y\u1ebfu khi t\u00e1i t\u1ea1o c\u00f9i b\u1eb1ng composite d\u00e1n \u1edf nh\u1eefng r\u0103ng c\u1ed1i l\u1edbn v\u0129nh vi\u1ec5n ch\u01b0a tr\u01b0\u1edfng th\u00e0nh l\u00e0 gi\u00fap b\u1ea3o t\u1ed3n c\u1ea5u tr\u00fac r\u0103ng h\u01a1n so v\u1edbi c\u00f9i b\u1eb1ng amalgam v\u00e0 \u0111\u1eb7t m\u00e3o kim lo\u1ea1i l\u00e0m s\u1eb5n ho\u1eb7c m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9. C\u00f9i composite d\u00e1n c\u00f3 th\u1ec3 cung c\u1ea5p s\u1ef1 kh\u00e1ng r\u00f2 r\u1ec9 cao t\u1ea1i b\u1ec1 m\u1eb7t gutta-percha, m\u00e3o kim lo\u1ea1i l\u00e0m s\u1eb5n ho\u1eb7c m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9, b\u1ea3o v\u1ec7 v\u1eadt li\u1ec7u tr\u00e1m b\u00edt \u1ed1ng t\u1ee7y kh\u1ecfi nhi\u1ec5m tr\u00f9ng v\u00e0 cho ph\u00e9p ch\u00e2n r\u0103ng ti\u1ebfp t\u1ee5c ph\u00e1t tri\u1ec3n.<\/p>\n

\"chua-truong-thanh-4\"
(a) Phim c\u1eadn ch\u00f3p c\u1ee7a r\u0103ng c\u1eeda gi\u1eefa h\u00e0m tr\u00ean b\u00ean ph\u1ea3i sau khi b\u1ecb b\u1eadt ra v\u00e0 \u0111\u01b0\u1ee3c c\u1eafm l\u1ea1i v\u00e0o \u1ed5 r\u0103ng tr\u00ean m\u1ed9t b\u1ec7nh nh\u00e2n 7 tu\u1ed5i. Th\u1eddi gian \u1edf ngo\u00e0i mi\u1ec7ng c\u1ee7a r\u0103ng l\u00e0 15 ph\u00fat. (b) X quang cho th\u1ea5y r\u0103ng ngay sau khi tr\u00e1m b\u00edt MTA v\u00e0 t\u00e1i t\u1ea1o c\u00f9i v\u00e0o xoang t\u1ee7y. (c) X quang khi t\u00e1i kh\u00e1m sau 3 n\u0103m cho th\u1ea5y ch\u00e2n r\u0103ng ph\u00e1t tri\u1ec3n. (d) X quang khi t\u00e1i kh\u00e1m sau 14.5 n\u0103m cho th\u1ea5y s\u1ef1 \u0111\u00f3ng ch\u00f3p ho\u00e0n t\u1ea5t (m\u0169i t\u00ean). R\u0103ng c\u00f3 \u0111\u1ed9 di \u0111\u1ed9ng b\u00ecnh th\u01b0\u1eddng v\u00e0 th\u1ef1c hi\u1ec7n t\u1ed1t ch\u1ee9c n\u0103ng.<\/figcaption><\/figure>\n

H\u01a1n th\u1ebf n\u1eefa, tr\u00e1nh th\u1ef1c hi\u1ec7n m\u00e3o kim lo\u1ea1i l\u00e0m s\u1eb5n ho\u1eb7c m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9 c\u00f3 th\u1ec3 b\u1ea3o t\u1ed3n m\u00f4 nha chu v\u00e0 chi\u1ec1u cao m\u00e0o x\u01b0\u01a1ng \u1ed5 trong nhi\u1ec1u giai \u0111o\u1ea1n kh\u00e1c nhau c\u1ee7a b\u1ed9 r\u0103ng chuy\u1ec3n ti\u1ebfp. C\u00f9i r\u0103ng composite d\u00e1n \u0111\u00f2i h\u1ecfi \u00edt th\u1eddi gian \u0111i\u1ec1u tr\u1ecb tr\u00ean gh\u1ebf v\u00e0 ti\u1ebft ki\u1ec7m chi ph\u00ed h\u01a1n so v\u1edbi c\u00e1c v\u1eadt li\u1ec7u kh\u00e1c khi \u0111\u00f2i h\u1ecfi l\u1ea7n h\u1eb9n th\u1ee9 2 \u0111\u1ec3 \u0111\u1eb7t m\u00e3o kim lo\u1ea1i l\u00e0m s\u1eb5n ho\u1eb7c m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9. R\u0103ng v\u0129nh vi\u1ec5n ch\u01b0a tr\u01b0\u1edfng th\u00e0nh c\u00f3 c\u1ea5u tr\u00fac r\u0103ng b\u1ecb t\u1ed5n h\u1ea1i nghi\u00eam tr\u1ecdng, khi \u0111\u01b0\u1ee3c b\u00edt \u1ed1ng t\u1ee7y ho\u1eb7c l\u1ea5y t\u1ee7y bu\u1ed3ng v\u1eabn c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c duy tr\u00ec th\u00e0nh c\u00f4ng cho \u0111\u1ebfn khi b\u1ec7nh nh\u00e2n \u0111\u1ea1t \u0111\u1ebfn m\u1ed9t \u0111i\u1ec3m \u1ed5n \u0111\u1ecbnh trong s\u1ef1 ph\u00e1t tri\u1ec3n \u0111\u1ea7u m\u1eb7t v\u00e0 m\u00e3o to\u00e0n ph\u1ea7n \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh. N\u1ebfu r\u0103ng v\u0129nh vi\u1ec5n ch\u01b0a tr\u01b0\u1edfng th\u00e0nh \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u1ee5c h\u1ed3i m\u00e0 kh\u00f4ng c\u1ea7n \u0111\u1ebfn m\u00e3o kim lo\u1ea1i l\u00e0m s\u1eb5n ho\u1eb7c m\u00e3o th\u00e9p kh\u00f4ng g\u1ec9 th\u00ec s\u1ebd mang l\u1ea1i l\u1ee3i \u00edch cho c\u1ea3 b\u1ec7nh nh\u00e2n v\u00e0 nha s\u0129 \u0111i\u1ec1u tr\u1ecb trong vi\u1ec7c t\u1ed1i \u01b0u h\u00f3a tu\u1ed5i th\u1ecd v\u00e0 duy tr\u00ec r\u0103ng.<\/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 m\u1ee5c ti\u00eau c\u01a1 b\u1ea3n trong ph\u1ee5c h\u1ed3i r\u0103ng v\u0129nh vi\u1ec5n ch\u01b0a tr\u01b0\u1edfng th\u00e0nh, \u0111\u1ed3ng th\u1eddi ti\u1ebfn h\u00e0nh \u0111\u00e1nh gi\u00e1, ph\u00e2n t\u00edch c\u00e1c v\u1ea5n \u0111\u1ec1 li\u00ean quan t\u1edbi v\u1eadt li\u1ec7u trong qu\u00e1 tr\u00ecnh ph\u1ee5c h\u1ed3i sau qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha. C\u00f9ng t\u00ecm hi\u1ec3u th\u00eam. 1. 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