{"id":28317,"date":"2023-04-25T16:00:28","date_gmt":"2023-04-25T09:00:28","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=28317"},"modified":"2023-05-02T08:47:00","modified_gmt":"2023-05-02T01:47:00","slug":"yeu-to-tien-luong-va-ket-qua-tren-rang-da-dieu-tri-noi-nha","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/yeu-to-tien-luong-va-ket-qua-tren-rang-da-dieu-tri-noi-nha\/","title":{"rendered":"Y\u1ebfu t\u1ed1 ti\u00ean l\u01b0\u1ee3ng v\u00e0 k\u1ebft qu\u1ea3 tr\u00ean r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb N\u1ed9i nha."},"content":{"rendered":"

L\u00fd do ch\u00ednh cho vi\u1ec7c nh\u1ed5 b\u1ecf r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng ph\u1ea3i l\u00e0 th\u1ea5t b\u1ea1i c\u1ee7a \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha m\u00e0 l\u00e0 s\u00e2u r\u0103ng, b\u1ec7nh l\u00fd nha chu, y\u1ebfu t\u1ed1 ph\u1ee5c h\u1ed3i v\u00e0 g\u00e3y ch\u00e2n r\u0103ng. V\u00ec th\u1ebf, trong m\u1ed7i tr\u01b0\u1eddng h\u1ee3p l\u00e2m s\u00e0ng, Nha s\u0129 n\u00ean \u0111\u1eb7t y\u1ebfu t\u1ed1 ti\u00ean l\u01b0\u1ee3ng quan tr\u1ecdng h\u01a1n gi\u00fap \u0111\u00e1nh gi\u00e1 t\u1ed1t k\u1ebft qu\u1ea3, \u0111\u1eb7c bi\u1ec7t \u0111\u1ed1i v\u1edbi tr\u01b0\u1eddng h\u1ee3p nh\u1eefng r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb N\u1ed9i nha. C\u00f9ng t\u00ecm hi\u1ec3u th\u00eam.<\/strong><\/p>\n

1. Y\u1ebfu t\u1ed1 ti\u00ean l\u01b0\u1ee3ng tr\u00ean r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb N\u1ed9i nha<\/h2>\n

L\u00fd do ch\u00ednh cho vi\u1ec7c nh\u1ed5 b\u1ecf r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha (Endodontically Treated Teeth – ETT) kh\u00f4ng ph\u1ea3i l\u00e0 th\u1ea5t b\u1ea1i c\u1ee7a \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha m\u00e0 l\u00e0 s\u00e2u r\u0103ng, b\u1ec7nh l\u00fd nha chu, y\u1ebfu t\u1ed1 ph\u1ee5c h\u1ed3i v\u00e0 g\u00e3y ch\u00e2n r\u0103ng. Nh\u1eefng th\u1ea5t b\u1ea1i n\u1ed9i nha c\u00f3 th\u1ec3 x\u1ea3y ra s\u1edbm h\u01a1n th\u1ea5t b\u1ea1i t\u1eeb c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c nh\u01b0 s\u00e2u r\u0103ng, b\u1ec7nh nha chu ho\u1eb7c r\u0103ng gi\u1ea3 h\u01b0; tuy nhi\u00ean, y\u1ebfu t\u1ed1 n\u1ed9i nha \u00edt g\u1eb7p h\u01a1n so v\u1edbi nh\u1eefng nguy\u00ean nh\u00e2n li\u00ean quan kh\u00e1c. R\u00f5 r\u00e0ng l\u00e0 ch\u1ea5t l\u01b0\u1ee3ng c\u1ee7a \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha r\u1ea5t quan tr\u1ecdng, nh\u01b0ng ch\u1ea5t l\u01b0\u1ee3ng c\u1ee7a \u0111i\u1ec1u tr\u1ecb ph\u1ee5c h\u1ed3i c\u0169ng quan tr\u1ecdng kh\u00f4ng k\u00e9m \u0111\u1ed1i v\u1edbi ti\u00ean l\u01b0\u1ee3ng l\u00e2u d\u00e0i c\u1ee7a r\u0103ng.<\/p>\n

Th\u1ef1c hi\u1ec7n ph\u1ee5c h\u1ed3i sau c\u00f9ng \u0111\u00fang l\u00fac gi\u00fap c\u1ea3i thi\u1ec7n \u0111\u1ed9 t\u1ed3n t\u1ea1i l\u00e2u d\u00e0i c\u1ee7a r\u0103ng. C\u00e1c nghi\u00ean c\u1ee9u ch\u1ee9ng minh r\u1eb1ng thi\u1ebfu ph\u1ee5c h\u1ed3i v\u0129nh vi\u1ec5n l\u00e0m gi\u1ea3m \u0111\u00e1ng k\u1ec3 t\u1ef7 l\u1ec7 s\u1ed1ng c\u00f2n c\u1ee7a r\u0103ng. M\u00e3o v\u00e0 ph\u1ee5c h\u1ed3i b\u00e1n ph\u1ea7n gi\u00fap b\u1ea3o v\u1ec7 c\u00e1c r\u0103ng ph\u00eda sau kh\u1ecfi vi\u1ec7c nh\u1ed5. Tuy nhi\u00ean, nhu c\u1ea7u cao v\u1ec1 th\u1ea9m m\u1ef9 v\u00e0 nhu c\u1ea7u b\u1ea3o t\u1ed3n k\u00e8m theo \u0111\u00f2i h\u1ecfi v\u1eadt li\u1ec7u ch\u1ecbu l\u1ef1c nhai ph\u1ea3i c\u1ee9ng h\u01a1n ng\u00e0 r\u0103ng \u0111\u00e3 khi\u1ebfn c\u00e1c nh\u00e0 l\u00e2m s\u00e0ng s\u1eed d\u1ee5ng onlay, m\u00e3o v\u00e0 c\u00e1c ph\u1ee5c h\u1ed3i b\u00e1n ph\u1ea7n to\u00e0n s\u1ee9. Ch\u00fang c\u00f2n bao g\u1ed3m veneer b\u00e1n ph\u1ea7n, onlay v\u00e0 m\u00e3o 3\/4 b\u1eb1ng v\u00e0ng ph\u1ee7 \u0111\u1ec9nh m\u00fai v\u00e0 \u1ed5n \u0111\u1ecbnh c\u00e1c r\u0103ng ETT. Vi\u1ec7c s\u1eed d\u1ee5ng c\u00f9i b\u1eb1ng composite d\u01b0\u1edbi m\u00e3o c\u00f3 t\u00e1c d\u1ee5ng n\u00e2ng \u0111\u1ee1. Nh\u00ecn chung, r\u0103ng \u0111\u01b0\u1ee3c ph\u1ee5c h\u1ed3i v\u1edbi m\u00e3o \u0111\u01a1n l\u1ebb ho\u1eb7c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u01b0 tr\u1ee5 c\u1ea7u c\u00f3 t\u1ef7 l\u1ec7 g\u00e3y v\u1ee1 th\u1ea5p h\u01a1n r\u0103ng \u0111\u01b0\u1ee3c t\u00e1i t\u1ea1o tr\u1ef1c ti\u1ebfp.<\/p>\n

Ph\u1ee5c h\u1ed3i tr\u1ef1c ti\u1ebfp l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u01b0u ti\u00ean c\u1ee7a \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha \u1edf r\u0103ng ETT ph\u00eda tr\u01b0\u1edbc. B\u1ea3o t\u1ed3n c\u1ea5u tr\u00fac r\u0103ng l\u00e0 v\u1ea5n \u0111\u1ec1 r\u1ea5t quan tr\u1ecdng khi khi \u0111\u1ea3m b\u1ea3o s\u1eeda so\u1ea1n l\u1ed1i v\u00e0o t\u1ed1i thi\u1ec3u nh\u01b0ng v\u1eabn t\u1ea1o thu\u1eadn l\u1ee3i cho vi\u1ec7c l\u00e0m s\u1ea1ch, t\u1ea1o h\u00ecnh v\u00e0 tr\u00e1m b\u00edt. S\u1eeda so\u1ea1n m\u00e3o c\u00f3 th\u1ec3 l\u1ea5y \u0111i l\u01b0\u1ee3ng c\u1ea5u tr\u00fac r\u0103ng \u0111\u00e1ng k\u1ec3, ch\u1ee7 y\u1ebfu l\u00e0 \u1edf v\u00f9ng c\u1ed5 r\u0103ng, l\u00e0 v\u1ecb tr\u00ed \u0111\u00f2i h\u1ecfi s\u1ef1 b\u1ea3o t\u1ed3n \u0111\u1ec3 ch\u1ed1ng l\u1ea1i c\u00e1c l\u1ef1c ph\u00e1 h\u1ee7y theo chi\u1ec1u \u0111\u1ee9ng. N\u1ebfu ti\u00eau chu\u1ea9n n\u00e0y kh\u00f4ng \u0111\u01b0\u1ee3c t\u00f4n tr\u1ecdng c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn k\u1ebft qu\u1ea3 kh\u00f4ng thu\u1eadn l\u1ee3i. Nh\u1eefng l\u1ef1a ch\u1ecdn thay th\u1ebf cho vi\u1ec7c s\u1eeda so\u1ea1n m\u00e3o r\u0103ng nh\u01b0 ph\u1ee5c h\u1ed3i tr\u1ef1c ti\u1ebfp b\u1eb1ng composite, t\u1ea9y tr\u1eafng b\u00ean trong v\u00e0 l\u00e0m veneer s\u1ee9 th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u01b0a th\u00edch h\u01a1n.<\/p>\n

Ph\u1ee5c h\u1ed3i c\u00e1c r\u0103ng ETT ph\u00eda sau v\u1edbi composite \u0111\u01b0\u1ee3c \u0111\u1ec1 xu\u1ea5t nh\u01b0 m\u1ed9t gi\u1ea3i ph\u00e1p thay th\u1ebf cho m\u00e3o to\u00e0n ph\u1ea7n. M\u1ed9t v\u00e0i t\u00e1c gi\u1ea3 nghi\u00ean c\u1ee9u \u0111\u00e3 khuy\u00ean s\u1eed d\u1ee5ng composite \u0111\u1ec3 t\u00e1i t\u1ea1o n\u1ebfu m\u1ed9t ho\u1eb7c c\u1ea3 2 th\u00e0nh b\u00ean ho\u1eb7c nhi\u1ec1u h\u01a1n 1 hay 2 th\u00e0nh th\u00e2n r\u0103ng c\u00f2n nguy\u00ean v\u1eb9n. M\u1ed9t nghi\u00ean c\u1ee9u s\u1eed d\u1ee5ng m\u1eabu k\u00edch th\u01b0\u1edbc nh\u1ecf \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 s\u1ef1 n\u1ee9t g\u00e3y m\u00fai r\u0103ng \u1edf nh\u1eefng r\u0103ng c\u1ed1i nh\u1ecf \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha v\u1edbi ph\u1ee5c h\u1ed3i b\u1eb1ng amalgam m\u1eb7t g\u1ea7n-nhai-xa (Mesial-Occlusal-Distal – MOD) ho\u1eb7c composite MOD v\u00e0 k\u1ebft lu\u1eadn r\u1eb1ng nh\u1ef1a composite \u0111\u01b0\u1ee3c \u01b0a th\u00edch h\u01a1n amalgam. Ng\u01b0\u1ee3c l\u1ea1i, sau khi ph\u00e2n t\u00edch l\u1ea7n th\u1ee9 2 th\u00ec nh\u00f3m nghi\u00ean c\u1ee9u \u0111\u00f3 c\u0169ng c\u00f4ng nh\u1eadn r\u1eb1ng c\u00e1c xoang MOD l\u00e0 kh\u00f4ng th\u1ec3 th\u1ef1c hi\u1ec7n khi ph\u1ee5c h\u1ed3i nh\u1eefng r\u0103ng ETT ph\u00eda sau n\u1ebfu m\u00e3o r\u0103ng kh\u00f4ng c\u00f3 trong k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb.<\/p>\n

2. K\u1ebft qu\u1ea3 c\u1ee5 th\u1ec3<\/h2>\n

M\u1ed9t nghi\u00ean c\u1ee9u thu\u1ea7n t\u1eadp h\u1ed3i c\u1ee9u kh\u00e1c \u0111\u00e1nh gi\u00e1 t\u1ec9 l\u1ec7 t\u1ed3n t\u1ea1i l\u00e2u d\u00e0i c\u1ee7a c\u00e1c r\u0103ng ETT kh\u00f4ng \u0111\u01b0\u1ee3c b\u1ecdc m\u00e3o v\u00e0 kh\u1eb3ng \u0111\u1ecbnh r\u1eb1ng r\u0103ng ETT c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u1ee5c h\u1ed3i th\u00e0nh c\u00f4ng v\u1edbi composite khi r\u0103ng c\u00f2n nguy\u00ean v\u1eb9n ngo\u1ea1i tr\u1eeb l\u1ed7 m\u1edf t\u1ee7y b\u1ea3o t\u1ed3n. Ng\u01b0\u1eddi ta kh\u1eb3ng \u0111\u1ecbnh r\u1eb1ng t\u1ec9 l\u1ec7 t\u1ed3n t\u1ea1i l\u00e2u d\u00e0i c\u1ee7a r\u0103ng t\u0103ng l\u00ean nh\u1edd v\u00e0o s\u1ef1 gia t\u0103ng c\u1ea5u tr\u00fac m\u00f4 r\u0103ng \u0111\u01b0\u1ee3c b\u1ea3o t\u1ed3n. \u0110\u1ed3ng th\u1eddi \u0111i \u0111\u1ebfn k\u1ebft lu\u1eadn t\u1ec9 l\u1ec7 l\u00e2u d\u00e0i chung c\u1ee7a c\u00e1c r\u0103ng ETT \u0111\u01b0\u1ee3c ph\u1ee5c h\u1ed3i b\u1eb1ng composite gi\u1ea3m xu\u1ed1ng sau 5 n\u0103m v\u00e0 l\u00fac \u0111\u00f3 th\u01b0\u1eddng \u0111\u00f2i h\u1ecfi thay th\u1ebf b\u1eb1ng m\u00e3o b\u00e1n ph\u1ea7n \u0111\u1ed1i v\u1edbi nh\u1eefng r\u0103ng c\u1ed1i l\u1edbn. Trong m\u1ed9t nghi\u00ean c\u1ee9u t\u01b0\u01a1ng t\u1ef1, c\u00e1c r\u0103ng c\u1ed1i nh\u1ecf ETT \u0111\u01b0\u1ee3c ph\u1ee5c h\u1ed3i b\u1eb1ng ch\u1ed1t v\u00e0 t\u00e1i t\u1ea1o composite c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 b\u1ecdc m\u00e3o to\u00e0n ph\u1ea7n cho th\u1ea5y t\u1ec9 l\u1ec7 th\u00e0nh c\u00f4ng t\u01b0\u01a1ng t\u1ef1 sau 3 n\u0103m. Nh\u00ecn chung, khi so s\u00e1nh v\u1edbi amalgam, ph\u1ee5c h\u1ed3i tr\u1ef1c ti\u1ebfp cho c\u00e1c l\u1ed7 m\u1edf t\u1ee7y r\u0103ng ph\u00eda sau b\u1eb1ng composite d\u01b0\u1eddng nh\u01b0 li\u00ean quan \u0111\u1ebfn t\u1ec9 l\u1ec7 n\u1ee9t g\u00e3y m\u00fai r\u0103ng th\u1ea5p h\u01a1n v\u00e0 t\u1ec9 l\u1ec7 t\u1ed3n t\u1ea1i l\u00e2u d\u00e0i cao h\u01a1n.<\/p>\n

C\u00f3 2 b\u00e0i t\u1ed5ng quan h\u1ec7 th\u1ed1ng \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb c\u00e1c r\u0103ng ETT \u0111\u01b0\u1ee3c ph\u1ee5c h\u1ed3i tr\u1ef1c ti\u1ebfp so v\u1edbi ph\u1ee5c h\u1ed3i b\u1eb1ng m\u00e3o r\u0103ng. M\u1ed9t b\u00e0i k\u1ebft lu\u1eadn r\u1eb1ng r\u0103ng ETT kh\u00f4ng b\u1ecdc m\u00e3o to\u00e0n ph\u1ea7n c\u00f3 t\u1ec9 l\u1ec7 t\u1ed3n t\u1ea1i l\u00e2u d\u00e0i th\u1ea5p h\u01a1n r\u0103ng \u0111\u01b0\u1ee3c b\u1ecdc m\u00e3o. B\u00e0i vi\u1ebft c\u0169ng cho bi\u1ebft t\u1ec9 l\u1ec7 t\u1ed3n t\u1ea1i c\u1ee7a c\u00e1c r\u0103ng ETT \u0111\u01b0\u1ee3c t\u00e1i t\u1ea1o c\u00f9i ch\u1ee9 kh\u00f4ng b\u1ecdc m\u00e3o to\u00e0n ph\u1ea7n l\u00e0 84% trong 3 n\u0103m \u0111\u1ea7u. Tuy nhi\u00ean, t\u1ec9 l\u1ec7 t\u1ed3n t\u1ea1i n\u00e0y \u0111\u01b0\u1ee3c ghi nh\u1eadn l\u00e0 gi\u1ea3m \u0111\u00e1ng k\u1ec3 sau kho\u1ea3ng th\u1eddi gian n\u00e0y. B\u00e0i vi\u1ebft c\u00f2n l\u1ea1i th\u00ec k\u1ebft lu\u1eadn hi\u1ec7n nay v\u1eabn c\u00f2n thi\u1ebfu nhi\u1ec1u b\u1eb1ng ch\u1ee9ng h\u1ee3p l\u00ed \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh l\u00e0 li\u1ec7u ph\u1ee5c h\u1ed3i r\u0103ng c\u1ed1i nh\u1ecf v\u1edbi c\u1ea5u tr\u00fac r\u0103ng \u0111\u01b0\u1ee3c b\u1ea3o t\u1ed3n b\u1eb1ng c\u00e1ch t\u00e1i t\u1ea1o composite tr\u1ef1c ti\u1ebfp c\u00f3 hi\u1ec7u qu\u1ea3 h\u01a1n m\u1ed9t m\u00e3o r\u0103ng hay kh\u00f4ng.<\/p>\n

Khi t\u00e1i t\u1ea1o c\u00f9i cho r\u0103ng ETT b\u1eb1ng nh\u1ef1a composite, v\u1ea5n \u0111\u1ec1 c\u1ef1c k\u00ec quan tr\u1ecdng l\u00e0 nh\u1ef1a composite quang tr\u00f9ng h\u1ee3p ph\u1ea3i \u0111\u01b0\u1ee3c tr\u00f9ng h\u1ee3p ho\u00e0n to\u00e0n b\u1eb1ng c\u00e1ch \u0111\u1eafp v\u00e0 tr\u00f9ng h\u1ee3p t\u1eebng l\u1edbp 2 mm, ngo\u1ea1i tr\u1eeb l\u1edbp l\u00f5i trong m\u1edd. R\u0103ng \u0111\u01b0\u1ee3c t\u00e1i t\u1ea1o b\u1eb1ng composite t\u1ef1 tr\u00f9ng h\u1ee3p c\u00f3 t\u1ec9 l\u1ec7 t\u1ed3n t\u1ea1i cao h\u01a1n composite quang tr\u00f9ng h\u1ee3p, c\u00f3 th\u1ec3 l\u00e0 do s\u1ef1 tr\u00f9ng h\u1ee3p \u0111\u01b0\u1ee3c t\u1ef1 gia t\u0103ng. M\u1ed9t nghi\u00ean c\u1ee9u in vitro hi\u1ec7n t\u1ea1i \u0111\u00e1nh gi\u00e1 l\u1ef1c d\u00e1n c\u1ee7a composite tr\u00f9ng h\u1ee3p k\u00e9p l\u00ean ng\u00e0 r\u0103ng b\u1eb1ng h\u1ec7 th\u1ed1ng composite quang tr\u00f9ng h\u1ee3p, h\u00f3a tr\u00f9ng h\u1ee3p v\u00e0 tr\u00f9ng h\u1ee3p k\u00e9p, v\u00e0 x\u00e1c \u0111\u1ecbnh r\u1eb1ng h\u1ec7 th\u1ed1ng d\u00e1n tr\u00f9ng h\u1ee3p k\u00e9p c\u00f3 th\u1ec3 kh\u00f4ng cung c\u1ea5p l\u1ef1c d\u00e1n v\u1edbi ng\u00e0 r\u0103ng \u1edf m\u1ee9c ch\u1ea5p nh\u1eadn \u0111\u01b0\u1ee3c. D\u01b0\u1eddng nh\u01b0 li\u00ean k\u1ebft quang tr\u00f9ng h\u1ee3p m\u00e0 kh\u00f4ng c\u00f3 c\u00e1c k\u00edch ho\u1ea1t h\u00f3a h\u1ecdc th\u00ec cho l\u1ef1c d\u00e1n v\u1edbi ng\u00e0 r\u0103ng cao h\u01a1n. Glass ionomer r\u00f5 r\u00e0ng kh\u00f4ng ph\u1ea3i l\u00e0 m\u1ed9t l\u1ef1a ch\u1ecdn t\u1ed1t khi t\u00e1i t\u1ea1o c\u00e1c r\u0103ng ETT, ch\u00fang ch\u1ec9 n\u00ean \u0111\u01b0\u1ee3c \u0111\u01b0\u1ee3c l\u00e0m l\u1edbp n\u1ec1n ch\u1ee9 kh\u00f4ng n\u00ean d\u00f9ng t\u00e1i t\u1ea1o tr\u1ef1c ti\u1ebfp c\u00f9i r\u0103ng hay th\u00e2n r\u0103ng.<\/p>\n

Nhi\u1ec1u b\u1eb1ng ch\u1ee9ng r\u00f5 r\u00e0ng cho th\u1ea5y r\u0103ng \u0111\u01b0\u1ee3c ph\u1ee5c h\u1ed3i v\u1edbi ch\u1ed1t th\u01b0\u1eddng b\u1ecb m\u1ea5t nhi\u1ec1u h\u01a1n r\u0103ng kh\u00f4ng c\u00f3 ch\u1ed1t. Ch\u1ed1t v\u1eb7n kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u00ean d\u00f9ng. C\u00e1c nghi\u00ean c\u1ee9u trong ph\u00f2ng th\u00ed nghi\u1ec7m cho th\u1ea5y t\u1ea5t c\u1ea3 c\u00e1c h\u00ecnh th\u1ee9c c\u1ee7a ch\u1ed1t v\u1eb7n \u0111\u1ec1u l\u00e0m t\u0103ng nguy c\u01a1 n\u1ee9t g\u00e3y ch\u00e2n r\u0103ng do t\u1ea1o ra l\u1ef1c c\u0103ng b\u1ea5t l\u1ee3i trong \u1ed1ng t\u1ee7y. Ch\u1ed1t v\u1eb7n thu\u00f4n c\u00f3 th\u1ec3 l\u00e0m t\u0103ng t\u1ec9 l\u1ec7 n\u1ee9t g\u00e3y ch\u00e2n r\u0103ng g\u1ea5p 20 l\u1ea7n so v\u1edbi ch\u1ed1t v\u1eb7n song song. \u0110\u00e1nh gi\u00e1 c\u00e1c d\u1eef li\u1ec7u r\u00fat ra t\u1eeb nhi\u1ec1u nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng cho th\u1ea5y, ch\u1ed1t v\u1eb7n th\u01b0\u1eddng g\u00e2y ra t\u1ec9 l\u1ec7 g\u00e3y ch\u00e2n r\u0103ng cao nh\u1ea5t (7%) so v\u1edbi ch\u1ed1t thu\u00f4n (2%) v\u00e0 ch\u1ed1t song song (1%).<\/p>\n

Th\u1ee7ng, c\u00f3 th\u1ec3 g\u00e2y ra b\u1edfi ch\u1ed1t ho\u1eb7c c\u00e1c d\u1ee5ng c\u1ee5 khi n\u1ed9i nha th\u01b0\u1eddng \u00edt g\u1eb7p. Ch\u00fang g\u00e2y \u1ea3nh h\u01b0\u1edfng x\u1ea5u \u0111\u1ebfn k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb ETT v\u00e0 g\u00e2y ra nhi\u1ec1u tranh c\u00e3i trong ; v\u1ea5n \u0111\u1ec1 tr\u00e1nh s\u1eed d\u1ee5ng ch\u1ed1t. R\u0103ng \u0111\u01b0\u1ee3c t\u00e1i t\u1ea1o v\u1edbi ch\u1ed1t d\u01b0\u1eddng nh\u01b0 c\u00f3 nguy c\u01a1 cao g\u00e2y th\u1ea5t b\u1ea1i khi n\u00f3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng l\u00e0m tr\u1ee5 cho c\u1ea7u r\u0103ng c\u1ed1 \u0111\u1ecbnh ho\u1eb7c h\u00e0m gi\u1ea3 th\u00e1o l\u1eafp b\u00e1n ph\u1ea7n. M\u1eb7c d\u00f9 implant v\u00e0 c\u00e1c lo\u1ea1i ph\u1ee5c h\u1ed3i \u0111\u01b0\u1ee3c n\u00e2ng \u0111\u1ee1 b\u1edfi implant l\u00e0 m\u1ed9t l\u1ef1a ch\u1ecdn t\u1ed1i \u01b0u \u0111\u1ec3 ph\u1ee5c h\u1ed3i v\u00f9ng r\u0103ng m\u1ea5t nh\u01b0ng v\u1eabn c\u1ea7n c\u00e2n nh\u1eafc k\u0129 c\u00e1c ph\u01b0\u01a1ng \u00e1n \u0111i\u1ec1u tr\u1ecb kh\u00e1c tr\u01b0\u1edbc.<\/p>\n

Ph\u01b0\u01a1ng th\u1ee9c \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 ph\u1ee5c h\u1ed3i v\u00e0 gi\u1eef l\u1ea1i c\u00e1c r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha l\u00e0 m\u1ed9t l\u1ef1a ch\u1ecdn kh\u1ea3 thi, v\u00e0 \u0111\u00f4i khi n\u00f3 l\u00e0 l\u1ef1a ch\u1ecdn duy nh\u1ea5t cho nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh l\u00fd y khoa to\u00e0n th\u00e2n m\u00e0 nh\u1ed5 r\u0103ng b\u1ecb ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh ho\u1eb7c nh\u1eefng ng\u01b0\u1eddi kh\u00f4ng \u0111\u1ee7 \u0111i\u1ec1u ki\u1ec7n kinh t\u1ebf \u0111\u1ec3 th\u1ef1c hi\u1ec7n implant ho\u1eb7c ph\u1ee5c h\u1ed3i n\u00e2ng \u0111\u1ee1 b\u1eb1ng implant. \u0110i\u1ec1u quan tr\u1ecdng l\u00e0 vi\u1ec7c \u00e1p d\u1ee5ng ph\u01b0\u01a1ng th\u1ee9c \u0111i\u1ec1u tr\u1ecb n\u00e0y c\u00f3 th\u1ec3 \u0111em l\u1ea1i l\u1ee3i \u00edch v\u00ec gi\u00fap b\u1ea3o t\u1ed3n chi\u1ec1u cao x\u01b0\u01a1ng \u1ed5 r\u0103ng \u1edf t\u1ea5t c\u1ea3 c\u00e1c nh\u00f3m tu\u1ed5i, k\u1ec3 c\u1ea3 b\u1ec7nh nh\u00e2n tr\u1ebb em c\u00f3 t\u1ed5n th\u01b0\u01a1ng th\u00e2n\/ch\u00e2n r\u0103ng kh\u00f4ng h\u1ed3i ph\u1ee5c do ch\u1ea5n th\u01b0\u01a1ng v\u00e0 nh\u1eefng ng\u01b0\u1eddi kh\u00f4ng \u0111\u1ee7 tu\u1ed5i \u0111\u1ec3 th\u1ef1c hi\u1ec7n implant.<\/p>\n

Trong nh\u1eefng n\u0103m g\u1ea7n \u0111\u00e2y, ch\u1ed1t l\u00e0m s\u1eb5n tr\u1edf n\u00ean r\u1ea5t ph\u1ed5 bi\u1ebfn. Ch\u1ed1t b\u1eb1ng nh\u1ef1a epoxy \u0111\u01b0\u1ee3c gia c\u1ed1 s\u1ee3i th\u1ee7y tinh (glass fiber-reinforced epoxy resin post \u2013 GFR) th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nhi\u1ec1u nh\u1ea5t. Khi so s\u00e1nh v\u1edbi ch\u1ed1t kim lo\u1ea1i, ch\u1ed1t b\u1eb1ng nh\u1ef1a epoxy \u0111\u01b0\u1ee3c gia c\u1ed1 s\u1ee3i th\u1ee7y tinh th\u1ec3 hi\u1ec7n nh\u1eefng \u0111\u1eb7c t\u00ednh c\u01a1 h\u1ecdc v\u00e0 l\u00fd h\u1ecdc v\u01b0\u1ee3t tr\u1ed9i. Tuy nhi\u00ean, ch\u00fang m\u1ec1m d\u1ebbo h\u01a1n ch\u1ed1t kim lo\u1ea1i v\u00e0 c\u00f3 m\u00f4-\u0111un \u0111\u00e0n h\u1ed3i th\u1ea5p. Khi ch\u1ed1t b\u1eb1ng nh\u1ef1a epoxy \u0111\u01b0\u1ee3c gia c\u1ed1 s\u1ee3i th\u1ee7y tinh \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho r\u0103ng ETT v\u1edbi v\u00e0nh \u0111ai ng\u00e0 (ferrule) r\u1ea5t \u00edt ho\u1eb7c kh\u00f4ng c\u00f3 th\u00ec kh\u1ea3 n\u0103ng u\u1ed1n cong c\u1ee7a ch\u00fang c\u00f3 th\u1ec3 t\u1ea1o ra nhi\u1ec1u l\u1ef1c c\u0103ng \u1edf v\u00f9ng c\u1ed5, g\u00e2y nguy c\u01a1 g\u00e3y ch\u1ed1t cao, d\u00e1n l\u1ea1i ch\u1ed1t v\u00e0\/ho\u1eb7c c\u00f9i, m\u1ea5t \u0111i s\u1ef1 l\u01b0u gi\u1eef c\u1ee7a ch\u1ed1t sau \u0111\u00f3 l\u00e0 g\u00e2y r\u00f2 r\u1ec9 v\u00e0 s\u00e2u r\u0103ng. C\u00e1c cu\u1ed9c \u0111i\u1ec1u tra s\u1eed d\u1ee5ng nhi\u1ec7t v\u00e0 chu k\u00ec t\u1ea3i \u0111\u00e3 ch\u1ec9 ra r\u1eb1ng b\u1ea3n th\u00e2n c\u00e1c ch\u1ed1t b\u1eb1ng nh\u1ef1a epoxy \u0111\u01b0\u1ee3c gia c\u1ed1 s\u1ee3i th\u1ee7y tinh t\u1ef1 gi\u1ea3m 40% s\u1ee9c b\u1ec1n v\u00e0 gi\u1ea3m 10% m\u00f4-\u0111un u\u1ed1n. Do \u0111\u00f3, ti\u1ebfp x\u00fac tr\u1ef1c ti\u1ebfp v\u1edbi d\u1ecbch xoang mi\u1ec7ng l\u00e0m gi\u1ea3m \u0111\u1ed9 b\u1ec1n u\u1ed1n c\u1ee7a ch\u00fang, l\u00e0m t\u0103ng t\u1ec9 l\u1ec7 l\u1ecfng ch\u1ed1t, g\u00e3y ch\u1ed1t, s\u00fat m\u00e3o v\u00e0 g\u00e3y ch\u00e2n r\u0103ng. C\u00e1c ch\u1ed1t b\u1eb1ng nh\u1ef1a epoxy \u0111\u01b0\u1ee3c gia c\u1ed1 s\u1ee3i th\u1ee7y tinh cho t\u1ec9 l\u1ec7 th\u1ea5t b\u1ea1i cao h\u01a1n ch\u1ed1t kim lo\u1ea1i, nh\u01b0ng t\u1ec9 l\u1ec7 g\u00e3y ch\u00e2n r\u0103ng th\u1ea5p h\u01a1n. T\u01b0\u01a1ng t\u1ef1 nh\u01b0 ch\u1ed1t kim lo\u1ea1i l\u00e0m s\u1eb5n, vi\u1ec7c \u0111\u1eb7t ch\u1ed1t b\u1eb1ng nh\u1ef1a epoxy \u0111\u01b0\u1ee3c gia c\u1ed1 s\u1ee3i th\u1ee7y tinh kh\u00f4ng l\u00e0m c\u1ea3i thi\u1ec7n \u0111\u1ed9 t\u1ed3n t\u1ea1i l\u00e2u d\u00e0i c\u1ee7a r\u0103ng ETT \u0111\u01b0\u1ee3c t\u00e1i t\u1ea1o tr\u1ef1c ti\u1ebfp b\u1eb1ng composite, cho th\u1ea5y c\u1ea5u tr\u00fac r\u0103ng \u0111\u01b0\u1ee3c b\u1ea3o t\u1ed3n m\u1edbi l\u00e0 t\u1ed1i quan tr\u1ecdng v\u00e0 ch\u1ee9c n\u0103ng ch\u00ednh c\u1ee7a ch\u00fang l\u00e0 gi\u00fap l\u01b0u gi\u1eef c\u00f9i.<\/p>\n

Nh\u00ecn chung, ph\u1ee5c h\u00ecnh c\u1ed1 \u0111\u1ecbnh, c\u1ea7u r\u0103ng, thay th\u1ebf r\u0103ng m\u1ea5t c\u00f3 t\u1ef7 l\u1ec7 t\u1ed3n t\u1ea1i l\u00e2u d\u00e0i th\u1ea5p h\u01a1n \u0111\u00e1ng k\u1ec3 so v\u1edbi r\u0103ng \u0111\u01b0\u1ee3c gi\u1eef l\u1ea1i nh\u1edd \u0111i\u1ec1u tr\u1ecb tu\u1ef7 v\u00e0 \u0111\u01b0\u1ee3c ph\u1ee5c h\u1ed3i ho\u1eb7c \u0111\u01b0\u1ee3c thay th\u1ebf b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng m\u00e3o tr\u00ean implant \u0111\u01a1n l\u1ebb. C\u00e1c r\u0103ng ETT c\u00f3 t\u1ef7 l\u1ec7 t\u1ed3n t\u1ea1i l\u00e2u d\u00e0i r\u1ea5t cao v\u00e0 t\u1ef7 l\u1ec7 bi\u1ebfn ch\u1ee9ng th\u1ea5p h\u01a1n c\u00e1c l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb kh\u00e1c, \u0111\u1eb7c bi\u1ec7t khi v\u1eabn c\u00f2n r\u0103ng ph\u00eda g\u1ea7n. Kho\u1ea3ng tr\u1ed1ng trong c\u00f9i r\u0103ng ho\u1eb7c gi\u1eefa ch\u1ed1t v\u00e0 v\u1eadt li\u1ec7u tr\u00e1m b\u00edt c\u00f3 th\u1ec3 cung c\u1ea5p nh\u1eefng h\u1ed1c cho s\u1ef1 ph\u00e1t tri\u1ec3n vi khu\u1ea9n v\u00e0 t\u00e1i nhi\u1ec5m c\u1ee7a h\u1ec7 th\u1ed1ng \u1ed1ng t\u1ee7y ch\u00e2n r\u0103ng.<\/p>\n

\"yeu-to-tien-luong\"
X quang ch\u1ee5p l\u00fac t\u00e1i kh\u00e1m c\u1ee7a r\u0103ng c\u1eeda gi\u1eefa h\u00e0m d\u01b0\u1edbi b\u00ean tr\u00e1i cho th\u1ea5y m\u1ed9t ch\u1ed1t \u0111\u00fac ng\u1eafn v\u00e0 s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a m\u1ed9t kho\u1ea3ng tr\u1ed1ng l\u1edbn gi\u1eefa ch\u1ed1t v\u00e0 v\u1eadt li\u1ec7u tr\u00e1m b\u00edt.<\/figcaption><\/figure>\n

Kho\u1ea3ng tr\u1ed1ng gi\u1eefa ph\u1ee5c h\u1ed3i v\u00e0 b\u1ec1 m\u1eb7t v\u1eadt li\u1ec7u tr\u00e1m b\u00edt c\u0169ng \u1ea3nh h\u01b0\u1edfng x\u1ea5u t\u01b0\u01a1ng t\u1ef1 nh\u01b0 kho\u1ea3ng tr\u1ed1ng trong v\u1eadt li\u1ec7u tr\u00e1m b\u00edt, c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u0103ng nguy c\u01a1 b\u1ec7nh l\u00fd quanh ch\u00f3p. C\u00e1c nh\u00e0 l\u00e2m s\u00e0ng \u0111\u01b0\u1ee3c khuy\u00ean ph\u1ea3i x\u00e1c nh\u1eadn chi\u1ec1u d\u00e0i\/kho\u1ea3ng c\u00e1ch \u0111\u1eb7t ch\u1ed1t tr\u01b0\u1edbc khi g\u1eafn ch\u1ed1t b\u1eb1ng cement v\u0129nh vi\u1ec5n. H\u01a1n n\u1eefa, c\u1ea7n c\u1ea9n th\u1eadn \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o \u0111\u1ec3 l\u1ea1i m\u1ed9t l\u01b0\u1ee3ng th\u00edch h\u1ee3p gutta- percha ho\u1eb7c v\u1eadt li\u1ec7u tr\u00e1m b\u00edt kh\u00e1c sau khi s\u1eeda so\u1ea1n \u1ed1ng mang ch\u1ed1t \u0111\u1ec3 tr\u00e1nh nguy c\u01a1 b\u1ec7nh l\u00fd v\u1ec1 sau.<\/p>\n

L\u01b0\u1ee3ng c\u1ea5u tr\u00fac r\u0103ng c\u00f2n l\u1ea1i quan tr\u1ecdng h\u01a1n b\u1ea5t k\u00ec k\u1ebf ho\u1ea1ch ph\u1ee5c h\u1ed3i n\u00e0o v\u00e0 nh\u1eefng nguy c\u01a1 ro do s\u00e2u r\u0103ng, b\u1ec7nh l\u00fd nha chu ph\u1ea3i lu\u00f4n \u0111\u01b0\u1ee3c l\u01b0\u1eddng tr\u01b0\u1edbc.<\/p>\n

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

L\u00fd do ch\u00ednh cho vi\u1ec7c nh\u1ed5 b\u1ecf r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng ph\u1ea3i l\u00e0 th\u1ea5t b\u1ea1i c\u1ee7a \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha m\u00e0 l\u00e0 s\u00e2u r\u0103ng, b\u1ec7nh l\u00fd nha chu, y\u1ebfu t\u1ed1 ph\u1ee5c h\u1ed3i v\u00e0 g\u00e3y ch\u00e2n r\u0103ng. V\u00ec th\u1ebf, trong m\u1ed7i tr\u01b0\u1eddng h\u1ee3p l\u00e2m s\u00e0ng, Nha s\u0129 n\u00ean \u0111\u1eb7t y\u1ebfu t\u1ed1 ti\u00ean l\u01b0\u1ee3ng […]<\/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":"\nY\u1ebfu t\u1ed1 ti\u00ean l\u01b0\u1ee3ng v\u00e0 k\u1ebft qu\u1ea3 tr\u00ean r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb N\u1ed9i nha. - Vinmec<\/title>\n<meta name=\"description\" content=\"Nha s\u0129 n\u00ean \u0111\u1eb7t y\u1ebfu t\u1ed1 ti\u00ean l\u01b0\u1ee3ng gi\u00fap \u0111\u00e1nh gi\u00e1 t\u1ed1t k\u1ebft qu\u1ea3, \u0111\u1eb7c bi\u1ec7t \u0111\u1ed1i v\u1edbi tr\u01b0\u1eddng h\u1ee3p nh\u1eefng r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb N\u1ed9i nha. 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