{"id":28960,"date":"2023-04-27T22:55:54","date_gmt":"2023-04-27T15:55:54","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=28960"},"modified":"2023-05-01T23:37:58","modified_gmt":"2023-05-01T16:37:58","slug":"benh-ly-y-khoa-nguy-co-cao-den-su-thanh-cong-cua-implant","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/27\/benh-ly-y-khoa-nguy-co-cao-den-su-thanh-cong-cua-implant\/","title":{"rendered":"B\u1ec7nh l\u00fd Y khoa nguy c\u01a1 cao \u0111\u1ebfn s\u1ef1 th\u00e0nh c\u00f4ng c\u1ee7a Implant."},"content":{"rendered":"

B\u00e0i vi\u1ebft n\u00f3i v\u1ec1 c\u00e1c b\u1ec7nh l\u00fd to\u00e0n th\u00e2n\/Y khoa c\u00f3 nguy c\u01a1 cao \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ef1 th\u00e0nh c\u00f4ng c\u1ee7a qu\u00e1 tr\u00ecnh ph\u1eabu thu\u1eadt v\u00e0 duy tr\u00ec Implant tr\u00ean b\u1ec7nh nh\u00e2n. N\u1eafm \u0111\u01b0\u1ee3c c\u00e1c l\u01b0u \u00fd v\u00e0 \u1ea3nh h\u01b0\u1edfng c\u1ee7a nguy c\u01a1 s\u1ee9c kho\u1ebb n\u00e0y, Nha s\u0129 c\u00f3 th\u1ec3 gi\u1ea3m thi\u1ec3u th\u1ea5t b\u1ea1i trong m\u1ed7i ca l\u00e2m s\u00e0ng Implant nha khoa c\u1ee7a m\u00ecnh. C\u00f9ng t\u00ecm hi\u1ec3u.<\/strong><\/p>\n

\"khoa-nguy-co-cao\"<\/p>\n

1. B\u1ec7nh l\u00fd to\u00e0n th\u00e2n\/Y khoa nguy c\u01a1 cao \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ef1 th\u00e0nh c\u00f4ng c\u1ee7a Implant<\/h2>\n

Vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p<\/strong><\/p>\n

M\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u h\u1ed3i c\u1ee9u v\u1ec1 k\u1ebft qu\u1ea3 c\u1ea5y gh\u00e9p nha khoa \u1edf b\u1ec7nh nh\u00e2n n\u1eef b\u1ecb vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p t\u1ef1 mi\u1ec5n c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 k\u00e8m theo b\u1ec7nh l\u00fd m\u00f4 li\u00ean k\u1ebft \u0111\u00e3 k\u1ebft lu\u1eadn r\u1eb1ng nh\u1eefng b\u1ec7nh nh\u00e2n vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p \u0111\u01b0\u1ee3c d\u1ef1 \u0111o\u00e1n l\u00e0 c\u00f3 t\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng c\u1ee7a implant v\u00e0 ph\u1ee5c h\u00ecnh cao, nh\u01b0ng n\u1ebfu c\u00f3 k\u00e8m theo b\u1ec7nh l\u00fd m\u00f4 li\u00ean k\u1ebft th\u00ec s\u1ebd b\u1ecb ti\u00eau x\u01b0\u01a1ng quanh implant v\u00e0 ch\u1ea3y m\u00e1u nhi\u1ec1u h\u01a1n so v\u1edbi kh\u00f4ng c\u00f3.<\/p>\n

Nhuy\u1ec5n x\u01b0\u01a1ng<\/strong><\/p>\n

\u0110\u00e2y l\u00e0 t\u00ecnh tr\u1ea1ng khi\u1ebfm khuy\u1ebft s\u1ef1 kho\u00e1ng h\u00f3a khu\u00f4n x\u01b0\u01a1ng h\u1eefu c\u01a1 (t\u1ee9c l\u00e0 collagen). R\u1ed1i lo\u1ea1n n\u00e0y th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn t\u00ecnh tr\u1ea1ng thi\u1ebfu vitamin D v\u00e0 thi\u1ebfu dinh d\u01b0\u1ee1ng. Thi\u1ebfu vitamin D l\u00e0m gi\u1ea3m h\u1ea5p thu \u0111\u01b0\u1eddng ru\u1ed9t v\u00e0 huy \u0111\u1ed9ng ion calcium ra kh\u1ecfi x\u01b0\u01a1ng, k\u1ebft qu\u1ea3 l\u00e0 g\u00e2y h\u1ea1 calci huy\u1ebft. \u0110i\u1ec1u n\u00e0y d\u1eabn \u0111\u1ebfn vi\u1ec7c t\u0103ng ti\u1ebft hormone c\u1eadn gi\u00e1p, t\u1eeb \u0111\u00f3 l\u00e0m t\u0103ng b\u00e0i ti\u1ebft phospho qua th\u1eadn. S\u1ef1 gi\u1ea3m n\u1ed3ng \u0111\u1ed9 phospho trong d\u1ecbch x\u01b0\u01a1ng \u0111\u00e3 c\u1ea3n tr\u1edf qu\u00e1 tr\u00ecnh kho\u00e1ng h\u00f3a b\u00ecnh th\u01b0\u1eddng. Nh\u1eefng \u0111\u1eb7c tr\u01b0ng c\u1ee7a x\u01b0\u01a1ng trong ch\u1ee9ng chuy\u1ec5n x\u01b0\u01a1ng tr\u00ean phim X-quang l\u00e0 x\u01b0\u01a1ng v\u1ecf m\u1ecfng v\u00e0 gi\u1ea3m m\u1eadt \u0111\u1ed9 b\u00e8 x\u01b0\u01a1ng. Kh\u00f4ng t\u00ecm \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o n\u00e0o v\u1ec1 s\u1ef1 li\u00ean quan l\u00e2m s\u00e0ng gi\u1eefa ch\u1ee9ng nhuy\u1ec5n x\u01b0\u01a1ng v\u1edbi k\u1ebft qu\u1ea3 c\u1ea5y gh\u00e9p nha khoa. C\u00f3 th\u1ec3 m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n nhuy\u1ec5n x\u01b0\u01a1ng \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i l\u00e0 b\u1ec7nh nh\u00e2n c\u00f3 “ch\u1ea5t l\u01b0\u1ee3ng x\u01b0\u01a1ng k\u00e9m\u201d, x\u01b0\u01a1ng lo\u1ea1i IV, do \u0111\u00f3 nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y r\u00f5 r\u00e0ng c\u00f3 t\u1ef7 l\u1ec7 th\u1ea5t b\u1ea1i cao h\u01a1n.<\/p>\n

Nh\u1eefng b\u1ec7nh nh\u00e2n suy gi\u1ea3m mi\u1ec5n d\u1ecbch (HIV, s\u1eed d\u1ee5ng thu\u1ed1c \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch)<\/strong><\/p>\n

M\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u (\u0111a s\u1ed1 l\u00e0 tr\u00ean \u0111\u1ed9ng v\u1eadt) cho th\u1ea5y cyclosporin l\u00e0m gi\u1ea3m s\u1ef1 l\u00e0nh th\u01b0\u01a1ng x\u01b0\u01a1ng quanh implant v\u00e0 s\u1ef1 t\u00edch h\u1ee3p x\u01b0\u01a1ng . Tuy nhi\u00ean, nhi\u1ec1u b\u1ec7nh nh\u00e2n gh\u00e9p t\u1ea1ng (ch\u1ee7 y\u1ebfu l\u00e0 gan v\u00e0 th\u1eadn) s\u1eed d\u1ee5ng cyclosporin trong th\u1eddi gian d\u00e0i v\u1eabn \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb c\u1ea5y gh\u00e9p nha khoa th\u00e0nh c\u00f4ng. T\u01b0\u01a1ng t\u1ef1, kh\u00f4ng c\u00f3 v\u1ea5n \u0111\u1ec1 \u0111\u00e1ng k\u1ec3 n\u00e0o sau ph\u1eabu thu\u1eadt r\u0103ng-x\u01b0\u01a1ng \u1ed5 r\u0103ng \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n HIV (+). Trong m\u1ed9t nghi\u00ean c\u1ee9u b\u1ec7nh-ch\u1ee9ng g\u1ea7n \u0111\u00e2y \u1edf c\u00e1c b\u1ec7nh nh\u00e2n HIV (+) \u0111ang s\u1eed d\u1ee5ng nh\u1eefng ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb kh\u00e1ng retrovirus hi\u1ec7u qu\u1ea3 cao kh\u00e1c nhau, sau khi \u0111\u00e1nh gi\u00e1 s\u1ee9c kh\u1ecfe quanh implant, c\u00e1c t\u00e1c gi\u1ea3 k\u1ebft lu\u1eadn r\u1eb1ng c\u1ea5y gh\u00e9p nha khoa c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t ph\u01b0\u01a1ng \u00e1n \u0111i\u1ec1u tr\u1ecb h\u1ee3p l\u00fd cho b\u1ec7nh nh\u00e2n HIV (+), b\u1ea5t k\u1ec3 s\u1ed1 l\u01b0\u1ee3ng t\u1ebf b\u00e0o CD4, m\u1ee9c \u0111\u1ed9 nhi\u1ec5m virus, v\u00e0 ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb kh\u00e1ng retrovirus. D\u01b0\u1eddng nh\u01b0 implant nha khoa \u0111\u01b0\u1ee3c dung n\u1ea1p t\u1ed1t v\u00e0 c\u00f3 k\u1ebft qu\u1ea3 ng\u1eafn h\u1ea1n t\u1ed1t \u1edf nh\u1eefng \u0111\u1ed1i t\u01b0\u1ee3ng nhi\u1ec5m HIV, nh\u01b0ng b\u1eb1ng ch\u1ee9ng n\u00e0y v\u1eabn c\u00f2n h\u1ea1n ch\u1ebf v\u00e0 ti\u00ean l\u01b0\u1ee3ng v\u1ec1 s\u1ef1 th\u00e0nh c\u00f4ng l\u00e2u d\u00e0i v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh. Ti\u1ebfn h\u00e0nh \u0111i\u1ec1u tr\u1ecb c\u1ea5y gh\u00e9p khi t\u1ef7 l\u1ec7 CD4 cao v\u00e0 b\u1ec7nh nh\u00e2n \u0111ang \u0111i\u1ec1u tr\u1ecb kh\u00e1ng retrovirus l\u00e0 m\u1ed9t quy\u1ebft \u0111\u1ecbnh kh\u00f4n ngoan. N\u00f3i chung, kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng cho th\u1ea5y suy gi\u1ea3m mi\u1ec5n d\u1ecbch l\u00e0 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh c\u1ee7a c\u1ea5y gh\u00e9p nha khoa, nh\u01b0ng c\u1ea7n ph\u1ea3i tham v\u1ea5n y khoa tr\u01b0\u1edbc khi \u0111i\u1ec1u tr\u1ecb c\u1ea5y gh\u00e9p, v\u00e0 ph\u1ea3i tu\u00e2n th\u1ee7 c\u00e1c bi\u1ec7n ph\u00e1p ch\u1ed1ng nhi\u1ec5m khu\u1ea9n nghi\u00eam ng\u1eb7t khi \u0111i\u1ec1u tr\u1ecb nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y.<\/p>\n

Ng\u01b0\u1eddi nghi\u1ec7n ma t\u00fay ho\u1eb7c nghi\u1ec7n r\u01b0\u1ee3u. Kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng \u0111\u00e1ng tin c\u1eady v\u1ec1 vi\u1ec7c nghi\u1ec7n r\u01b0\u1ee3u l\u00e0 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh c\u1ee7a implant, nh\u01b0ng nh\u1eefng b\u1ec7nh nh\u00e2n u\u1ed1ng r\u01b0\u1ee3u c\u00f3 th\u1ec3 t\u0103ng nguy c\u01a1 bi\u1ebfn ch\u1ee9ng. \u1ea2nh h\u01b0\u1edfng c\u1ee7a vi\u1ec7c u\u1ed1ng r\u01b0\u1ee3u l\u00ean m\u1eadt \u0111\u1ed9 x\u01b0\u01a1ng v\u00e0 s\u1ef1 t\u00edch h\u1ee3p x\u01b0\u01a1ng \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh trong m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u tr\u00ean \u0111\u1ed9ng v\u1eadt. \u1ede ng\u01b0\u1eddi, \u0111\u00e3 c\u00f3 b\u1eb1ng ch\u1ee9ng cho th\u1ea5y b\u1ec7nh nh\u00e2n u\u1ed1ng r\u01b0\u1ee3u nhi\u1ec1u s\u1ebd t\u0103ng nguy c\u01a1 ti\u00eau x\u01b0\u01a1ng quanh implant v\u00e0 th\u1ea5t b\u1ea1i. N\u00f3i chung, c\u1ea7n \u0111\u00e1nh gi\u00e1 ng\u01b0\u1eddi c\u00f3 th\u00f3i quen u\u1ed1ng r\u01b0\u1ee3u tr\u01b0\u1edbc khi \u0111\u1eb7t implant b\u1edfi v\u00ec nghi\u1ec7n r\u01b0\u1ee3u (a) th\u01b0\u1eddng k\u00e8m theo th\u00f3i quen h\u00fat thu\u1ed1c l\u00e1 (\u0111\u00e2y \u0111\u01b0\u1ee3c xem l\u00e0 m\u1ed9t ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh c\u1ee7a c\u1ea5y gh\u00e9p), (b) g\u00e2y suy gi\u1ea3m ch\u1ee9c n\u0103ng gan v\u00e0 c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c v\u1ea5n \u0111\u1ec1 ch\u1ea3y m\u00e1u, (c) c\u00f3 th\u1ec3 g\u00e2y lo\u00e3ng x\u01b0\u01a1ng (m\u1ed9t ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh t\u01b0\u01a1ng \u0111\u1ed1i kh\u00e1c c\u1ee7a c\u1ea5y gh\u00e9p), (d) c\u00f3 th\u1ec3 l\u00e0m suy gi\u1ea3m \u0111\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch, v\u00e0 (e) c\u00f3 th\u1ec3 g\u00e2y thi\u1ebfu dinh d\u01b0\u1ee1ng, \u0111\u1eb7c bi\u1ec7t l\u00e0 folate (vitamin B9) v\u00e0 vitamin B n\u00f3i chung.<\/p>\n

2. \u1ea2nh h\u01b0\u1edfng c\u1ee7a c\u00e1c nguy c\u01a1 s\u1ee9c kho\u1ebb l\u00ean k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb c\u1ea5y gh\u00e9p<\/h2>\n

\u1ea2nh h\u01b0\u1edfng c\u1ee7a c\u00e1c nguy c\u01a1 s\u1ee9c kh\u1ecfe l\u00ean k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb c\u1ea5y gh\u00e9p v\u1eabn ch\u01b0a r\u00f5 r\u00e0ng b\u1edfi v\u00ec ch\u1ec9 c\u00f3 m\u1ed9t v\u00e0i th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng c\u00f3 nh\u00f3m ch\u1ee9ng \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe nh\u01b0 m\u1ed9t y\u1ebfu t\u1ed1 nguy c\u01a1. V\u1ec1 nguy\u00ean t\u1eafc, ch\u1ec9 nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 t\u00ecnh tr\u1ea1ng th\u1ec3 ch\u1ea5t \u0111\u1ed9 I (P1: b\u1ec7nh nh\u00e2n kh\u1ecfe m\u1ea1nh b\u00ecnh th\u01b0\u1eddng) ho\u1eb7c \u0111\u1ed9 II (P2: b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh l\u00fd to\u00e0n th\u00e2n nh\u1eb9) theo Hi\u1ec7p h\u1ed9i G\u00e2y m\u00ea Hoa K\u1ef3 (ASA) m\u1edbi \u0111\u1ee7 \u0111i\u1ec1u ki\u1ec7n th\u1ef1c hi\u1ec7n ph\u1eabu thu\u1eadt, ch\u1eb3ng h\u1ea1n nh\u01b0 c\u1ea5y gh\u00e9p nha khoa, v\u00e0 nguy c\u01a1 ph\u1eabu thu\u1eadt c\u1ee7a b\u1ec7nh nh\u00e2n ph\u1ea3i \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc so v\u1edbi l\u1ee3i \u00edch m\u00e0 c\u1ea5y gh\u00e9p nha khoa c\u00f3 th\u1ec3 \u0111em l\u1ea1i cho h\u1ecd. \u0110\u1ed1i v\u1edbi c\u00e1c v\u1ea5n \u0111\u1ec1 y khoa c\u1ea5p t\u00ednh v\u00e0 nghi\u00eam tr\u1ecdng (t\u00ecnh tr\u1ea1ng th\u1ec3 ch\u1ea5t ASA x\u1ebfp lo\u1ea1i P3 \u0111\u1ebfn P6), vi\u1ec7c t\u00ednh to\u00e1n nguy c\u01a1 th\u1ea5t b\u1ea1i d\u01b0\u1eddng nh\u01b0 l\u00e0 b\u1ea5t kh\u1ea3 thi b\u1edfi v\u00ec nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 t\u00ecnh tr\u1ea1ng nh\u01b0 v\u1eady h\u1ea7u nh\u01b0 kh\u00f4ng bao gi\u1edd \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb c\u1ea5y gh\u00e9p. M\u1ed9t \u1ea5n ph\u1ea9m g\u1ea7n \u0111\u00e2y n\u00f3i r\u1eb1ng \u0111i\u1ec1u tr\u1ecb nha khoa cho nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c x\u1ebfp lo\u1ea1i P4 ho\u1eb7c cao h\u01a1n n\u00ean \u0111\u01b0\u1ee3c tr\u00ec ho\u00e3n cho \u0111\u1ebfn khi t\u00ecnh tr\u1ea1ng y khoa c\u1ee7a b\u1ec7nh nh\u00e2n \u1ed5n \u0111\u1ecbnh v\u00e0 c\u1ea3i thi\u1ec7n t\u1ed1i thi\u1ec3u \u0111\u1ebfn P3. C\u00e1c b\u1ec7nh l\u00fd to\u00e0n th\u00e2n c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn m\u00f4 trong mi\u1ec7ng b\u1eb1ng c\u00e1ch t\u0103ng t\u00ednh nh\u1ea1y c\u1ea3m v\u1edbi nh\u1eefng b\u1ec7nh l\u00fd kh\u00e1c ho\u1eb7c c\u1ea3n tr\u1edf s\u1ef1 l\u00e0nh th\u01b0\u01a1ng.<\/p>\n

Ngu\u1ed3n t\u00e0i li\u1ec7u: Clinical Cases in Implant Dentistry, First Edition – Published 2017 by John Wiley & Sons, Inc.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

B\u00e0i vi\u1ebft n\u00f3i v\u1ec1 c\u00e1c b\u1ec7nh l\u00fd to\u00e0n th\u00e2n\/Y khoa c\u00f3 nguy c\u01a1 cao \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ef1 th\u00e0nh c\u00f4ng c\u1ee7a qu\u00e1 tr\u00ecnh ph\u1eabu thu\u1eadt v\u00e0 duy tr\u00ec Implant tr\u00ean b\u1ec7nh nh\u00e2n. N\u1eafm \u0111\u01b0\u1ee3c c\u00e1c l\u01b0u \u00fd v\u00e0 \u1ea3nh h\u01b0\u1edfng c\u1ee7a nguy c\u01a1 s\u1ee9c kho\u1ebb n\u00e0y, Nha s\u0129 c\u00f3 th\u1ec3 gi\u1ea3m thi\u1ec3u th\u1ea5t b\u1ea1i trong […]<\/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":"\nB\u1ec7nh l\u00fd Y khoa nguy c\u01a1 cao \u0111\u1ebfn s\u1ef1 th\u00e0nh c\u00f4ng c\u1ee7a Implant.<\/title>\n<meta name=\"description\" content=\"Ph\u1ea7n n\u00e0y \u0111\u1ec1 c\u1eadp \u0111\u1ebfn v\u1ea5n \u0111\u1ec1 c\u00e1c b\u1ec7nh l\u00fd Y khoa c\u00f3 nguy c\u01a1 cao \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ef1 th\u00e0nh c\u00f4ng c\u1ee7a th\u1ee7 thu\u1eadt Implant. 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