{"id":31157,"date":"2023-05-03T16:52:24","date_gmt":"2023-05-03T09:52:24","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=31157"},"modified":"2023-05-03T21:56:31","modified_gmt":"2023-05-03T14:56:31","slug":"ghep-mo-lien-ket-duoi-bieu-mo-sectg-duy-tri-tham-my-sinh-ly","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/03\/ghep-mo-lien-ket-duoi-bieu-mo-sectg-duy-tri-tham-my-sinh-ly\/","title":{"rendered":"Gh\u00e9p m\u00f4 li\u00ean k\u1ebft d\u01b0\u1edbi bi\u1ec3u m\u00f4 (SeCTG) – Duy tr\u00ec th\u1ea9m m\u1ef9, sinh l\u00fd."},"content":{"rendered":"

B\u00e0i vi\u1ebft n\u00e0y \u0111\u1ec1 c\u1eadp \u0111\u1ebfn c\u00e1c v\u1ea5n \u0111\u1ec1 th\u1ea9m m\u1ef9 v\u00e0 sinh l\u00fd \u0111\u1ed1i v\u1edbi qu\u00e1 tr\u00ecnh gh\u00e9p m\u00f4 li\u00ean k\u1ebft d\u01b0\u1edbi bi\u1ec3u m\u00f4 (SeCTG), \u0111\u1ed3ng th\u1eddi ti\u1ebfn h\u00e0nh \u0111\u00e1nh gi\u00e1 c\u00e1c y\u1ebfu t\u1ed1 ch\u00ednh \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn qu\u00e1 tr\u00ecnh n\u00e0y. C\u00f9ng t\u00ecm hi\u1ec3u r\u00f5 h\u01a1n trong n\u1ed9i dung b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y.<\/strong><\/p>\n

\"duoi-bieu-mo-sectg\"<\/p>\n

1. Gh\u00e9p m\u00f4 li\u00ean k\u1ebft d\u01b0\u1edbi bi\u1ec3u m\u00f4 (SeCTG) c\u00f3 g\u00e2y s\u1eebng ho\u00e1 kh\u00f4ng?<\/h2>\n

V\u00e0o n\u0103m 1975, Karrring v\u00e0 c\u1ed9ng s\u1ef1 \u0111\u00e3 c\u00f4ng b\u1ed1 m\u1ed9t nghi\u00ean c\u1ee9u th\u1ef1c nghi\u1ec7m tr\u00ean kh\u1ec9, trong \u0111\u00f3 \u0111\u00e1nh gi\u00e1 kh\u1ea3 n\u0103ng c\u1ee7a m\u00f4 li\u00ean k\u1ebft n\u01b0\u1edbu trong vi\u1ec7c quy\u1ebft \u0111\u1ecbnh s\u1ef1 bi\u1ec7t h\u00f3a bi\u1ec3u m\u00f4. K\u1ebft qu\u1ea3 cho th\u1ea5y m\u00f4 li\u00ean k\u1ebft n\u01b0\u1edbc c\u00f3 kh\u1ea3 n\u0103ng k\u00edch t\u1ea1o bi\u1ec3u m\u00f4 n\u01b0\u1edbu s\u1eebng h\u00f3a. D\u1ef1a tr\u00ean nh\u1eefng ph\u00e1t hi\u1ec7n trong nghi\u00ean c\u1ee9u n\u00e0y, c\u00f3 th\u1ec3 suy ra r\u1eb1ng bi\u1ec3u m\u00f4 c\u1ee7a mi\u1ebfng gh\u00e9p \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n nh\u1edd s\u1ef1 di c\u01b0 c\u1ee7a c\u00e1c t\u1ebf b\u00e0o bi\u1ec3u m\u00f4 kh\u00f4ng s\u1eebng h\u00f3a thu\u1ed9c ni\u00eam m\u1ea1c x\u01b0\u01a1ng \u1ed5 xung quanh, v\u00e0 sau khi ch\u00fang \u0111i qua ch\u1ed7 n\u1ed1i gi\u1eefa hai lo\u1ea1i m\u00f4 li\u00ean k\u1ebft th\u00ec m\u00f4 li\u00ean k\u1ebft n\u01b0\u1edbu s\u1ebd g\u00e2y ra s\u1ef1 bi\u1ec7t h\u00f3a ch\u00fang th\u00e0nh c\u00e1c t\u1ebf b\u00e0o c\u00f3 \u0111\u1eb7c \u0111i\u1ec3m gi\u1ed1ng nh\u01b0 bi\u1ec3u m\u00f4 n\u01b0\u1edbu s\u1eebng h\u00f3a.<\/p>\n

2. \u0110\u1ed9 d\u00e0y ni\u00eam m\u1ea1c s\u1eebng ho\u00e1 t\u1ed1i thi\u1ec3u \u0111\u1ec3 duy tr\u00ec l\u00e0nh m\u1ea1nh quanh Implant<\/h2>\n

Vi\u1ec7c kh\u00f4ng c\u00f3 d\u00e2y ch\u1eb1ng nha chu v\u00e0 b\u00e1m d\u00ednh m\u00f4 li\u00ean k\u1ebft quanh implant c\u00f3 th\u1ec3 khi\u1ebfn m\u00f4 quanh implant d\u1ec5 ph\u00e1t tri\u1ec3n ph\u1ea3n \u1ee9ng vi\u00eam n\u1eb7ng n\u1ec1 khi c\u00f3 s\u1ef1 t\u00edch t\u1ee5 m\u1ea3ng b\u00e1m v\u00e0 s\u1ef1 x\u00e2m nh\u1eadp vi khu\u1ea9n. V\u00ec nh\u1eefng l\u00fd do n\u00e0y n\u00ean kh\u00e1 h\u1ee3p l\u00fd khi ngh\u0129 r\u1eb1ng s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a h\u00e0ng r\u00e0o ni\u00eam m\u1ea1c, t\u1ea1o ra t\u1eeb d\u1ea3i ni\u00eam m\u1ea1c s\u1eebng h\u00f3a quanh implant, l\u00e0 m\u1ed9t \u0111i\u1ec1u ki\u1ec7n ti\u00ean quy\u1ebft \u0111\u1ea3m b\u1ea3o cho s\u1ef1 duy tr\u00ec th\u00e0nh c\u00f4ng l\u00e2u d\u00e0i c\u1ee7a m\u00f4 quanh implant theo c\u1ea3 quan \u0111i\u1ec3m sinh h\u1ecdc v\u00e0 th\u1ea9m m\u1ef9. Tuy nhi\u00ean, v\u1eabn ch\u01b0a c\u00f3 b\u1eb1ng ch\u1ee9ng m\u1ea1nh m\u1ebd v\u1ec1 nguy c\u01a1\/l\u1ee3i \u00edch c\u1ee7a vi\u1ec7c kh\u00f4ng c\u00f3\/c\u00f3 ni\u00eam m\u1ea1c s\u1eebng h\u00f3a quanh implant. Cho \u0111\u1ebfn nay, m\u1edbi c\u00f3 ba t\u1ed5ng quan h\u1ec7 th\u1ed1ng cho th\u1ea5y ni\u00eam m\u1ea1c s\u1eebng h\u00f3a gi\u1edbi h\u1ea1n quanh implant (< 2 mm) c\u00f3 li\u00ean quan \u0111\u1ebfn nh\u1eefng th\u00f4ng s\u1ed1 l\u00e2m s\u00e0ng c\u1ee7a t\u00ecnh tr\u1ea1ng vi\u00eam. Trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p l\u00e2m s\u00e0ng c\u00f3 s\u1ef1 ki\u1ec3m so\u00e1t m\u1ea3ng b\u00e1m ph\u00f9 h\u1ee3p, d\u1eef li\u1ec7u l\u1ea1i cho th\u1ea5y s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a ni\u00eam m\u1ea1c s\u1eebng h\u00f3a quanh implant c\u00f3 th\u1ec3 kh\u00f4ng quan tr\u1ecdng. Tuy nhi\u00ean, d\u1ef1a tr\u00ean nh\u1eefng b\u1eb1ng ch\u1ee9ng ch\u1ecdn l\u1ecdc, th\u00ec gi\u00e1 tr\u1ecb ti\u00ean l\u01b0\u1ee3ng c\u1ee7a ni\u00eam m\u1ea1c s\u1eebng h\u00f3a v\u1eabn c\u00f2n h\u1ea1n ch\u1ebf. Do \u0111\u00f3 c\u1ea7n c\u00f3 nh\u1eefng th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng ti\u1ebfn c\u1ee9u theo chi\u1ec1u d\u1ecdc, \u0111\u1ee7 \u0111\u1ed9 m\u1ea1nh, \u0111\u1ec3 c\u00f3 th\u1ec3 l\u00e0m s\u00e1ng t\u1ecf t\u1ea7m quan tr\u1ecdng c\u1ee7a ni\u00eam m\u1ea1c s\u1eebng h\u00f3a trong vi\u1ec7c duy tr\u00ec s\u1ee9c kh\u1ecfe quanh implant.<\/p>\n

3. Y\u1ebfu t\u1ed1 ch\u00ednh \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn k\u1ebft qu\u1ea3 th\u1ea9m m\u1ef9<\/h2>\n

Th\u1ea9m m\u1ef9 kh\u00f4ng ph\u1ea3i ch\u1ec9 l\u00e0 vi\u1ec7c ph\u1ee5c h\u00ecnh tr\u00ean implant m\u00f4 ph\u1ecfng r\u0103ng t\u1ef1 nhi\u00ean, m\u00e0 c\u00f2n bao g\u1ed3m m\u00f4 quanh implant l\u00e0nh m\u1ea1nh v\u1edbi k\u1ebft c\u1ea5u ph\u00f9 h\u1ee3p. S\u1ef1 m\u1ea5t gai n\u01b0\u1edbu v\u00e0 t\u1ee5t n\u01b0\u1edbu m\u1eb7t ngo\u00e0i l\u00e0 nh\u1eefng t\u00ecnh hu\u1ed1ng th\u1ea9m m\u1ef9 \u0111\u1ea7y th\u00e1ch th\u1ee9c. C\u00e1c nghi\u00ean c\u1ee9u \u0111\u00e3 \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh nguy\u00ean nh\u00e2n g\u00e2y m\u1ea5t m\u00f4, v\u00e0 c\u00e1c k\u1ef9 thu\u1eadt \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n \u0111\u1ec3 ng\u0103n ng\u1eeba ho\u1eb7c gi\u1ea3m thi\u1ec3u \u0111i\u1ec1u n\u00e0y. S\u1ef1 b\u1ea3o t\u1ed3n ho\u1eb7c t\u00e1i l\u1eadp k\u1ebft c\u1ea5u ni\u00eam m\u1ea1c- n\u01b0\u1edbu t\u1ef1 nhi\u00ean quanh implant \u1edf v\u00f9ng r\u0103ng tr\u01b0\u1edbc h\u00e0m tr\u00ean l\u00e0 th\u00e1ch th\u1ee9c \u0111\u1ed1i v\u1edbi b\u00e1c s\u0129 ph\u1ee5c h\u00ecnh, \u0111\u1eb7c bi\u1ec7t l\u00e0 khi b\u1ec7nh nh\u00e2n c\u00f3 \u0111\u01b0\u1eddng m\u00f4i cao l\u00fac c\u01b0\u1eddi. Nh\u1eefng th\u00e1ch th\u1ee9c n\u00e0y xu\u1ea5t ph\u00e1t t\u1eeb vi\u1ec7c m\u1ea5t m\u00f4 ni\u00eam m\u1ea1c-n\u01b0\u1edbu do t\u00e1i c\u1ea5u tr\u00fac x\u01b0\u01a1ng sau nh\u1ed5 r\u0103ng\/m\u1ea5t r\u0103ng. Vi\u1ec7c l\u1ef1a ch\u1ecdn h\u1ec7 th\u1ed1ng implant cho ph\u00e9p t\u1ea1o ra \u0111\u00e1p \u1ee9ng sinh h\u1ecdc ph\u00f9 h\u1ee3p cho m\u00f4 c\u1ee9ng v\u00e0 m\u00f4 m\u1ec1m trong t\u1eebng t\u00ecnh hu\u1ed1ng l\u00e2m s\u00e0ng l\u00e0 b\u01b0\u1edbc \u0111\u1ea7u ti\u00ean \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c k\u1ebft qu\u1ea3 th\u1ea9m m\u1ef9 h\u00e0i l\u00f2ng. Ngo\u00e0i ra, k\u1ef9 thu\u1eadt ph\u1eabu thu\u1eadt ph\u00f9 h\u1ee3p, v\u1ecb tr\u00ed 3 chi\u1ec1u l\u00fd t\u01b0\u1edfng c\u1ee7a implant, v\u00e0 ki\u1ec3m so\u00e1t m\u00f4 m\u1ec1m, c\u0169ng c\u1ea7n thi\u1ebft \u0111\u1ec3 \u0111em l\u1ea1i k\u1ebft qu\u1ea3 t\u1ef1 nhi\u00ean. Cu\u1ed1i c\u00f9ng, m\u1ed9t \u0111i\u1ec1u quan tr\u1ecdng kh\u00f4ng k\u00e9m nh\u01b0ng th\u01b0\u1eddng b\u1ecb b\u1ecf qua, l\u00e0 vi\u1ec7c l\u1ef1a ch\u1ecdn ph\u01b0\u01a1ng \u00e1n ph\u1ee5c h\u00ecnh th\u00edch h\u1ee3p, bao g\u1ed3m v\u1eadt li\u1ec7u v\u00e0 \u0111\u01b0\u1eddng vi\u1ec1n, c\u0169ng g\u00f3p ph\u1ea7n \u0111\u00e1ng k\u1ec3 v\u00e0o vi\u1ec7c \u0111\u1ea1t \u0111\u01b0\u1ee3c m\u00e0u s\u1eafc v\u00e0 h\u00ecnh d\u1ea1ng ni\u00eam m\u1ea1c quanh implant ph\u00f9 h\u1ee3p. Vi\u1ec7c s\u1eed d\u1ee5ng abutment t\u00f9y ch\u1ec9nh \u0111\u1ec3 t\u1ea1o ra bi\u00ean d\u1ea1ng ph\u1ea7n tho\u00e1t l\u00fd t\u01b0\u1edfng l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c k\u1ebft qu\u1ea3 th\u1ea9m m\u1ef9 h\u00e0i l\u00f2ng, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf nh\u1eefng v\u1ecb tr\u00ed c\u00f3 d\u1ea1ng sinh h\u1ecdc m\u1ecfng.<\/p>\n

H\u00ecnh d\u1ea1ng t\u1ef1 nhi\u00ean c\u1ee7a ph\u1ee5c h\u00ecnh tr\u00ean implant v\u00e0 s\u1ef1 \u1ed5n \u0111\u1ecbnh c\u1ee7a k\u1ebft c\u1ea5u ni\u00eam m\u1ea1c xung quanh l\u00e0 n\u1ec1n t\u1ea3ng cho k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb th\u00e0nh c\u00f4ng, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf v\u00f9ng th\u1ea9m m\u1ef9. Trong m\u1ed9t s\u1ed1 t\u00ecnh hu\u1ed1ng, nguy\u00ean nh\u00e2n ch\u00ednh g\u00e2y \u0111\u1ed5i m\u00e0u ni\u00eam m\u1ea1c \u1edf m\u1eb7t ngo\u00e0i implant #11 ch\u1ee7 y\u1ebfu l\u00e0 do kh\u00f4ng \u0111\u1ee7 \u0111\u1ed9 d\u00e0y m\u00f4 m\u1ec1m. N\u1ebfu implant \u0111\u01b0\u1ee3c \u0111\u1eb7t v\u00e0o v\u1ecb tr\u00ed 3 chi\u1ec1u ch\u00ednh x\u00e1c v\u00e0 ho\u00e0n to\u00e0n \u0111\u01b0\u1ee3c bao quanh b\u1edfi x\u01b0\u01a1ng cho \u0111\u1ebfn ch\u1ed7 n\u1ed1i implant-abutment, th\u00ec s\u1ef1 \u0111\u1ed5i m\u00e0u m\u00f4 m\u1ec1m v\u00e0 \u1ea3nh h\u01b0\u1edfng c\u1ee7a t\u00ecnh tr\u1ea1ng n\u00e0y l\u00ean b\u1edd m\u00f4 m\u1ec1m quanh implant l\u00e0 do thi\u1ebfu \u0111\u1ed9 d\u00e0y ni\u00eam m\u1ea1c. Jung v\u00e0 c\u1ed9ng s\u1ef1 \u0111\u00e3 ch\u1ee9ng minh \u0111\u01b0\u1ee3c r\u1eb1ng v\u1eadt li\u1ec7u ph\u1ee5c h\u00ecnh c\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u00e1ng k\u1ec3 l\u00ean m\u00e0u s\u1eafc m\u00f4 m\u1ec1m. M\u00e0u s\u1eafc m\u1ea5t th\u1ea9m m\u1ef9 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c kh\u1eafc ph\u1ee5c b\u1eb1ng c\u00e1ch t\u0103ng \u0111\u1ed9 d\u00e0y ni\u00eam m\u1ea1c. Trong m\u1ed9t nghi\u00ean c\u1ee9u kh\u00e1c, Bressan v\u00e0 c\u1ed9ng s\u1ef1 \u0111\u00e3 b\u00e1o c\u00e1o r\u1eb1ng abutment n\u1eb1m g\u1ea7n m\u00f4 m\u1ec1m c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn th\u1ea9m m\u1ef9 c\u1ee7a m\u00f4 m\u1ec1m quanh implant v\u00e0 l\u00e0m thay \u0111\u1ed5i m\u00e0u s\u1eafc c\u0169ng nh\u01b0 h\u00ecnh d\u1ea1ng c\u1ee7a n\u00f3. Do \u0111\u00f3, m\u00e0u s\u1eafc ni\u00eam m\u1ea1c quanh implant tr\u1edf n\u00ean kh\u00e1c so v\u1edbi m\u00e0u s\u1eafc n\u01b0\u1edbu quanh r\u0103ng th\u1eadt, b\u1ea5t k\u1ec3 l\u00e0 lo\u1ea1i v\u1eadt li\u1ec7u ph\u1ee5c h\u00ecnh n\u00e0o. \u0110\u1ed9 d\u00e0y c\u1ee7a m\u00f4 m\u1ec1m quanh implant d\u01b0\u1eddng nh\u01b0 l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 quan tr\u1ecdng t\u00e1c \u0111\u1ed9ng l\u00ean s\u1ef1 thay \u0111\u1ed5i m\u00e0u s\u1eafc \u1edf ni\u00eam m\u1ea1c quanh implant.<\/p>\n

V\u00ec v\u1eady, ng\u01b0\u1ee1ng \u0111\u1ed9 d\u00e0y m\u00f4 m\u1ec1m \u1edf v\u00f9ng th\u1ea9m m\u1ef9 c\u1ea7n \u0111\u01b0\u1ee3c xem x\u00e9t c\u1ea9n th\u1eadn. \u0110i\u1ec1u th\u00fa v\u1ecb l\u00e0 ng\u01b0\u1eddi ta nh\u1eadn th\u1ea5y r\u1eb1ng s\u1ef1 thay \u0111\u1ed5i m\u00e0u s\u1eafc do titanium v\u1eabn c\u00f3 th\u1ec3 g\u00e2y ra s\u1ef1 kh\u00e1c bi\u1ec7t c\u00f3 th\u1ec3 nh\u00ecn th\u1ea5y ngay c\u1ea3 v\u1edbi \u0111\u1ed9 d\u00e0y ni\u00eam m\u1ea1c l\u00ean \u0111\u1ebfn 2 mm. Ng\u01b0\u1ee3c l\u1ea1i, v\u1edbi \u0111\u1ed9 d\u00e0y t\u1ed1i thi\u1ec3u 3 mm, s\u1ef1 kh\u00e1c bi\u1ec7t c\u00f3 th\u1ec3 nh\u00ecn th\u1ea5y \u0111\u00e3 \u0111\u01b0\u1ee3c ghi nh\u1eadn l\u00e0 kh\u00f4ng li\u00ean quan v\u1edbi v\u1eadt li\u1ec7u abutment. Do \u0111\u00f3, d\u1ea1ng sinh h\u1ecdc d\u00e0y quanh implant lu\u00f4n lu\u00f4n \u0111\u01b0\u1ee3c khuy\u1ebfn kh\u00edch \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c k\u1ebft qu\u1ea3 th\u1ea9m m\u1ef9 l\u00fd t\u01b0\u1edfng, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf ph\u00e2n \u0111o\u1ea1n r\u0103ng tr\u01b0\u1edbc.<\/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\u00e0y \u0111\u1ec1 c\u1eadp \u0111\u1ebfn c\u00e1c v\u1ea5n \u0111\u1ec1 th\u1ea9m m\u1ef9 v\u00e0 sinh l\u00fd \u0111\u1ed1i v\u1edbi qu\u00e1 tr\u00ecnh gh\u00e9p m\u00f4 li\u00ean k\u1ebft d\u01b0\u1edbi bi\u1ec3u m\u00f4 (SeCTG), \u0111\u1ed3ng th\u1eddi ti\u1ebfn h\u00e0nh \u0111\u00e1nh gi\u00e1 c\u00e1c y\u1ebfu t\u1ed1 ch\u00ednh \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn qu\u00e1 tr\u00ecnh n\u00e0y. C\u00f9ng t\u00ecm hi\u1ec3u r\u00f5 h\u01a1n trong n\u1ed9i dung b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y. 1. 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