{"id":31814,"date":"2023-05-04T19:39:41","date_gmt":"2023-05-04T12:39:41","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=31814"},"modified":"2023-05-04T21:10:02","modified_gmt":"2023-05-04T14:10:02","slug":"nhung-tien-bo-trong-ky-thuat-tai-tao-xuong-va-bao-ton-o-rang","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/nhung-tien-bo-trong-ky-thuat-tai-tao-xuong-va-bao-ton-o-rang\/","title":{"rendered":"Nh\u1eefng ti\u1ebfn b\u1ed9 trong k\u1ef9 thu\u1eadt t\u00e1i t\u1ea1o x\u01b0\u01a1ng v\u00e0 b\u1ea3o t\u1ed3n \u1ed5 r\u0103ng."},"content":{"rendered":"<p><strong>G\u1ea7n \u0111\u00e2y, h\u00e0ng lo\u1ea1t ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u00e3 th\u00fac \u0111\u1ea9y l\u0129nh v\u1ef1c t\u00e1i t\u1ea1o m\u00f4. V\u00ed d\u1ee5, c\u00e1c li\u1ec7u ph\u00e1p t\u1ebf b\u00e0o v\u00e0 gen \u0111ang \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng v\u00e0 kh\u00f4ng ng\u1eebng \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u. C\u00f9ng t\u00ecm hi\u1ec3u nh\u1eefng ti\u1ebfn b\u1ed9 trong k\u1ef9 thu\u1eadt t\u00e1i t\u1ea1o x\u01b0\u01a1ng v\u00e0 b\u1ea3o t\u1ed3n \u1ed5 r\u0103ng \u1edf b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y.<\/strong><\/p>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"alignnone size-full wp-image-31818\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/phau-thuat-ghep-xuong-rang-trong-implant-1.jpg\" alt=\"nhung-tien-bo-1\" width=\"700\" height=\"434\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/phau-thuat-ghep-xuong-rang-trong-implant-1.jpg 700w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/phau-thuat-ghep-xuong-rang-trong-implant-1-300x186.jpg 300w\" sizes=\"(max-width: 700px) 100vw, 700px\" \/><\/p>\n<h2>1. T\u1ed5ng quan v\u1ec1 ch\u1ec9 \u0111\u1ecbnh c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p t\u00e1i t\u1ea1o x\u01b0\u01a1ng v\u00e0 b\u1ea3o t\u1ed3n \u1ed5 r\u0103ng<\/h2>\n<p>V\u00e0o n\u0103m 2012, B\u00e1o c\u00e1o \u0110\u1ed3ng thu\u1eadn tr\u00ean m\u1ed9t h\u1ed9i th\u1ea3o \u0111\u00e3 \u0111\u1ecbnh ngh\u0129a nh\u1eefng thu\u1eadt ng\u1eef b\u1ea3o t\u1ed3n s\u1ed1ng h\u00e0m v\u00e0 t\u0103ng s\u1ed1ng h\u00e0m nh\u01b0 sau:<\/p>\n<p>&#8220;B\u1ea3o t\u1ed3n s\u1ed1ng h\u00e0m = b\u1ea3o t\u1ed3n th\u1ec3 t\u00edch s\u1ed1ng h\u00e0m b\u00ean trong h\u00ecnh bao s\u1eb5n c\u00f3 t\u1ea1i th\u1eddi \u0111i\u1ec3m nh\u1ed5 r\u0103ng.<br \/>\nT\u0103ng s\u1ed1ng h\u00e0m = t\u0103ng th\u1ec3 t\u00edch s\u1ed1ng h\u00e0m v\u01b0\u1ee3t qua h\u00ecnh bao x\u01b0\u01a1ng s\u1eb5n c\u00f3 t\u1ea1i th\u1eddi \u0111i\u1ec3m nh\u1ed5 r\u0103ng.&#8221;<\/p>\n<p>Theo Vi\u1ec7n Nha chu Hoa K\u1ef3, &#8220;T\u00e1i t\u1ea1o m\u00f4 (x\u01b0\u01a1ng) c\u00f3 h\u01b0\u1edbng d\u1eabn l\u00e0 nh\u1eefng quy tr\u00ecnh t\u00e1i t\u1ea1o c\u00e1c c\u1ea5u tr\u00fac nha chu b\u1ecb m\u1ea5t nh\u1edd ph\u1ea3n \u1ee9ng bi\u1ec7t h\u00f3a m\u00f4. T\u00e1i t\u1ea1o x\u01b0\u01a1ng c\u00f3 h\u01b0\u1edbng d\u1eabn th\u01b0\u1eddng \u0111\u1ec1 c\u1eadp \u0111\u1ebfn ph\u1eabu thu\u1eadt t\u0103ng s\u1ed1ng h\u00e0m ho\u1eb7c t\u00e1i t\u1ea1o x\u01b0\u01a1ng; t\u00e1i t\u1ea1o m\u00f4 c\u00f3 h\u01b0\u1edbng d\u1eabn th\u01b0\u1eddng \u0111\u1ec1 c\u1eadp \u0111\u1ebfn t\u00e1i t\u1ea1o b\u00e1m d\u00ednh nha chu. Nh\u1eefng k\u1ef9 thu\u1eadt m\u00e0ng ng\u0103n, s\u1eed d\u1ee5ng c\u00e1c v\u1eadt li\u1ec7u nh\u01b0 polytetrafluoroethylene m\u1edf r\u1ed9ng, polyglactin, polylactic acid, calcium sulfate v\u00e0 collagen, \u0111\u00e3 \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng v\u1edbi hy v\u1ecdng lo\u1ea1i tr\u1eeb bi\u1ec3u m\u00f4 v\u00e0 l\u1edbp m\u00f4 \u0111\u1ec7m n\u01b0\u1edbu kh\u1ecfi ch\u00e2n r\u0103ng ho\u1eb7c b\u1ec1 m\u1eb7t x\u01b0\u01a1ng c\u00f2n l\u1ea1i, v\u00ec ng\u01b0\u1eddi ta fin r\u1eb1ng ch\u00fang s\u1ebd c\u1ea3n tr\u1ee3 s\u1ef1 t\u00e1i t\u1ea1o&#8221;.<\/p>\n<p>Trong khi b\u1ea3o t\u1ed3n \u1ed5 r\u0103ng ho\u1eb7c b\u1ea3o t\u1ed3n s\u1ed1ng h\u00e0m l\u00e0 quy tr\u00ecnh nh\u1eb1m l\u00e0m gi\u1ea3m s\u1ef1 ti\u00eau x\u01b0\u01a1ng \u1ed5 sau nh\u1ed5 r\u0103ng, th\u00ec t\u00e1i t\u1ea1o x\u01b0\u01a1ng c\u00f3 h\u01b0\u1edbng d\u1eabn GBR sau nh\u1ed5 r\u0103ng l\u1ea1i nh\u1eb1m m\u1ee5c \u0111\u00edch \u0111\u1ecbnh h\u01b0\u1edbng cho s\u1ef1 t\u0103ng tr\u01b0\u1edfng c\u1ee7a x\u01b0\u01a1ng m\u1edbi t\u1ea1i nh\u1eefng v\u1ecb tr\u00ed thi\u1ebfu th\u1ec3 t\u00edch ho\u1eb7c k\u00edch th\u01b0\u1edbc x\u01b0\u01a1ng h\u01a1n l\u00e0 b\u1ea3o t\u1ed3n x\u01b0\u01a1ng. Do \u0111\u00f3, thu\u1eadt ng\u1eef n\u00e0y th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng khi c\u00f3 thi\u1ebfu h\u1ed3ng m\u1eb7t ngo\u00e0i. Tuy nhi\u00ean, v\u1eadt li\u1ec7u x\u01b0\u01a1ng gh\u00e9p, ho\u1eb7c gi\u00e1 th\u1ec3 c\u00f3 hay kh\u00f4ng c\u00f3 m\u00e0ng, v\u1eabn s\u1ebd \u0111\u01b0\u1ee3c \u0111\u1eb7t v\u00e0o \u1ed5 r\u0103ng t\u1ea1i th\u1eddi \u0111i\u1ec3m nh\u1ed5 r\u0103ng.<\/p>\n<p>Gi\u1ea3m k\u00edch th\u01b0\u1edbc s\u1ed1ng h\u00e0m \u0111\u00e1ng k\u1ec3 l\u00e0 \u0111i\u1ec1u kh\u00f4ng th\u1ec3 tr\u00e1nh kh\u1ecfi trong nhi\u1ec1u tr\u01b0\u1eddng h\u1ee3p sau nh\u1ed5 r\u0103ng do s\u1ef1 t\u00e1i c\u1ea5u tr\u00fac b\u00ecnh th\u01b0\u1eddng c\u1ee7a x\u01b0\u01a1ng \u1ed5 r\u0103ng. Ti\u00eau x\u01b0\u01a1ng sau nh\u1ed5 r\u0103ng \u1edf m\u1eb7t ngo\u00e0i s\u1ed1ng h\u00e0m th\u00ec r\u00f5 r\u00e0ng h\u01a1n. Nh\u1eefng thay \u0111\u1ed5i ch\u00ednh c\u1ee7a v\u1ecb tr\u00ed nh\u1ed5 r\u0103ng s\u1ebd x\u1ea3y ra trong 1 n\u0103m, ch\u1ee7 y\u1ebfu l\u00e0 trong 3 th\u00e1ng \u0111\u1ea7u ti\u00ean. Trong B\u00e1o c\u00e1o \u0110\u1ed3ng thu\u1eadn n\u0103m 2012, d\u1ef1a tr\u00ean t\u1ed5ng quan h\u1ec7 th\u1ed1ng c\u1ee7a Lang v\u00e0 c\u1ed9ng s\u1ef1, s\u1ed1ng h\u00e0m \u0111\u01b0\u1ee3c \u01b0\u1edbc t\u00ednh gi\u1ea3m chi\u1ec1u ngang trung b\u00ecnh l\u00e0 3.8 mm v\u00e0 gi\u1ea3m chi\u1ec1u d\u1ecdc trung b\u00ecnh l\u00e0 1.24 mm trong v\u00f2ng 6 th\u00e1ng sau nh\u1ed5 r\u0103ng. C\u00e1c nghi\u00ean c\u1ee9u \u0111\u00e3 cho th\u1ea5y v\u1edbi ph\u1eabu thu\u1eadt t\u0103ng x\u01b0\u01a1ng, c\u00f3 th\u1ec3 l\u00e0 b\u1ea3o t\u1ed3n \u1ed5 r\u0103ng ho\u1eb7c t\u00e1i t\u1ea1o x\u01b0\u01a1ng c\u00f3 h\u01b0\u1edbng d\u1eabn GBR, th\u00ec s\u1ef1 m\u1ea5t th\u1ec3 t\u00edch x\u01b0\u01a1ng l\u00e0 t\u1ed1i thi\u1ec3u. \u0110i\u1ec1u n\u00e0y s\u1ebd t\u1ea1o thu\u1eadn l\u1ee3i cho vi\u1ec7c \u0111\u1eb7t implant trong t\u01b0\u01a1ng lai.<\/p>\n<ul>\n<li>D\u1ef1 ki\u1ebfn \u0111\u1eb7t implant v\u00e0o m\u1ed9t th\u1eddi \u0111i\u1ec3m n\u00e0o \u0111\u00f3 sau nh\u1ed5 r\u0103ng; c\u1ee5 th\u1ec3 l\u00e0:\n<ul>\n<li>i. khi c\u1ea5y gh\u00e9p t\u1ee9c th\u00ec ho\u1eb7c s\u1edbm kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn kh\u00edch;<\/li>\n<li>ii. khi b\u1ec7nh nh\u00e2n ch\u01b0a s\u1eb5n s\u00e0ng \u0111\u1ec3 \u0111\u1eb7t implant t\u1ee9c th\u00ec ho\u1eb7c s\u1edbm (ch\u1eb3ng h\u1ea1n nh\u01b0 mang thai, ngh\u1ec9 l\u1ec5);<\/li>\n<li>ii. khi implant kh\u00f4ng th\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c \u0111\u1ed9 \u1ed5n \u0111\u1ecbnh s\u01a1 kh\u1edfi;<\/li>\n<li>iv. b\u1ec7nh nh\u00e2n v\u1ecb th\u00e0nh ni\u00ean.<\/li>\n<\/ul>\n<\/li>\n<li>T\u1ea1o \u0111\u01b0\u1eddng vi\u1ec1n s\u1ed1ng h\u00e0m cho \u0111i\u1ec1u tr\u1ecb ph\u1ee5c h\u00ecnh th\u00f4ng th\u01b0\u1eddng.<\/li>\n<li>T\u1ef7 s\u1ed1 chi ph\u00ed\/l\u1ee3i \u00edch (+).<\/li>\n<li>Gi\u1ea3m ch\u1ec9 \u0111\u1ecbnh n\u00e2ng xoang.<\/li>\n<\/ul>\n<p>Gi\u1ed1ng nh\u01b0 c\u00e1c ph\u1eabu thu\u1eadt kh\u00e1c, nh\u1eefng bi\u1ebfn ch\u1ee9ng h\u1eadu ph\u1eabu th\u01b0\u1eddng x\u1ea3y ra g\u1ed3m c\u00f3 ch\u1ea3y m\u00e1u, s\u01b0ng, b\u1ea7m t\u00edm, v\u00e0 nhi\u1ec5m tr\u00f9ng. C\u00e1c bi\u1ebfn ch\u1ee9ng \u00edt g\u1eb7p h\u01a1n c\u00f3 th\u1ec3 l\u00e0 t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh ho\u1eb7c m\u1ea1ch m\u00e1u.<\/p>\n<p>Vi\u1ec7c s\u1eed d\u1ee5ng m\u00e0ng collagen \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 l\u00e0m gi\u1ea3m t\u1ef7 l\u1ec7 l\u1ed9 m\u00e0ng trong c\u00e1c ph\u1eabu thu\u1eadt t\u00e1i t\u1ea1o. Tuy nhi\u00ean, l\u1ed9 m\u00e0ng v\u1eabn c\u00f3 th\u1ec3 x\u1ea3y ra trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p. Theo ph\u00e2n t\u00edch c\u1ee7a Machfei, l\u1ed9 m\u00e0ng xung quanh r\u0103ng \u0111\u01b0\u1ee3c can thi\u1ec7p t\u00e1i t\u1ea1o ch\u1ec9 c\u00f3 t\u00e1c \u0111\u1ed9ng b\u1ea5t l\u1ee3i t\u1ed1i thi\u1ec3u so v\u1edbi nh\u1eefng b\u1ecb tr\u00ed kh\u00f4ng l\u1ed9.<\/p>\n<h2>2. Nh\u1eefng ti\u1ebfn b\u1ed9 v\u1ec1 sinh h\u1ecdc hi\u1ec7n nay<\/h2>\n<p>G\u1ea7n \u0111\u00e2y, h\u00e0ng lo\u1ea1t ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u00e3 th\u00fac \u0111\u1ea9y l\u0129nh v\u1ef1c t\u00e1i t\u1ea1o m\u00f4. V\u00ed d\u1ee5, c\u00e1c li\u1ec7u ph\u00e1p t\u1ebf b\u00e0o v\u00e0 gen \u0111ang \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng v\u00e0 kh\u00f4ng ng\u1eebng \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u.<\/p>\n<ul>\n<li>Y\u1ebfu t\u1ed1 t\u0103ng tr\u01b0\u1edfng c\u00f3 ngu\u1ed3n g\u1ed1c ti\u1ec3u c\u1ea7u (PDGF) l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 t\u0103ng tr\u01b0\u1edfng \u0111\u01b0\u1ee3c ti\u1ebft ra b\u1edfi ti\u1ec3u c\u1ea7u. N\u00f3 c\u00f3 t\u00ednh ch\u1ea5t h\u00f3a h\u01b0\u1edbng v\u00e0 nguy\u00ean ph\u00e2n l\u00ean nguy\u00ean b\u00e0o x\u01b0\u01a1ng, v\u00e0 c\u00f3 th\u1ec3 k\u00edch th\u00edch t\u1ed5ng h\u1ee3p collagen lo\u1ea1i I. Trong c\u00e1c nghi\u00ean c\u1ee9u tr\u00ean \u0111\u1ed9ng v\u1eadt, PDGF th\u00fac \u0111\u1ea9y s\u1ef1 l\u00e0nh th\u01b0\u01a1ng, k\u00edch th\u00edch d\u00e2y ch\u1eb1ng nha chu v\u00e0 t\u1ebf b\u00e0o x\u01b0\u01a1ng, v\u00e0 k\u1ebft qu\u1ea3 l\u00e0 t\u00e1i t\u1ea1o m\u00f4 nha chu. G\u1ea7n \u0111\u00e2y, PDGF \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 k\u00edch th\u00edch t\u00e1i t\u1ea1o m\u00f4 nha chu \u1edf ng\u01b0\u1eddi.<\/li>\n<li>Huy\u1ebft t\u01b0\u01a1ng gi\u00e0u ti\u1ec3u c\u1ea7u (PRP) v\u00e0 calcium sulfate \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh b\u1edfi Infini v\u00e0 c\u1ed9ng s\u1ef1 l\u00e0 c\u00f3 kh\u1ea3 n\u0103ng k\u00edch th\u00edch t\u00e1i t\u1ea1o x\u01b0\u01a1ng. PRP \u0111\u01b0\u1ee3c thu t\u1eeb m\u00e1u t\u1ef1 th\u00e2n, v\u00e0 \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 huy\u1ebft t\u01b0\u01a1ng ch\u1ee9a n\u1ed3ng \u0111\u1ed9 ti\u1ec3u c\u1ea7u cao g\u1ea5p nhi\u1ec1u l\u1ea7n so v\u1edbi n\u1ed3ng \u0111\u1ed9 sinh l\u00fd. Calcium sulfate, l\u00e0 m\u1ed9t h\u1ec7 th\u1ed1ng v\u1eadn chuy\u1ec3n, c\u00f3 kh\u1ea3 n\u0103ng k\u00edch ho\u1ea1t ti\u1ec3u c\u1ea7u, t\u1eeb \u0111\u00f3 ph\u00f3ng th\u00edch c\u00e1c y\u1ebfu t\u1ed1 ho\u1ea1t t\u00ednh sinh h\u1ecdc t\u1eeb ti\u1ec3u c\u1ea7u \u0111\u00e3 k\u00edch ho\u1ea1t \u0111\u1ec3 th\u00fac \u0111\u1ea9y s\u1ef1 t\u00e1i t\u1ea1o m\u00f4. Do \u0111\u00f3, calcium sulfate- ti\u1ec3u c\u1ea7u \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u1ec1 ngh\u1ecb s\u1eed d\u1ee5ng trong l\u00e2m s\u00e0ng \u0111\u1ec3 t\u00e1i t\u1ea1o x\u01b0\u01a1ng.<\/li>\n<li>Protein t\u1ea1o h\u00ecnh th\u00e1i x\u01b0\u01a1ng (BMP)-2, m\u1ed9t y\u1ebfu t\u1ed1 bi\u1ec7t h\u00f3a, c\u0169ng \u0111\u00e3 \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u. Trong m\u1ed9t th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng g\u1ea7n \u0111\u00e2y, vi\u1ec7c s\u1eed d\u1ee5ng BMP-2 t\u00e1i t\u1ed5 h\u1ee3p c\u1ee7a ng\u01b0\u1eddi c\u00f9ng v\u1edbi v\u1eadt li\u1ec7u x\u01b0\u01a1ng kh\u1eed kho\u00e1ng kh\u00f4ng cho th\u1ea5y s\u1ef1 kh\u00e1c bi\u1ec7t c\u00f3 \u00fd ngh\u0129a v\u1ec1 chi\u1ec1u r\u1ed9ng v\u00e0 chi\u1ec1u cao x\u01b0\u01a1ng \u1ed5 so v\u1edbi ch\u1ec9 s\u1eed d\u1ee5ng x\u01b0\u01a1ng kh\u1eed kho\u1ea3ng. Kh\u00f4ng ghi nh\u1eadn \u0111\u01b0\u1ee3c t\u00e1c d\u1ee5ng ph\u1ee5 t\u1ea1i ch\u1ed7 v\u00e0 to\u00e0n th\u00e2n.<\/li>\n<li>Emdogain v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 t\u0103ng tr\u01b0\u1edfng kh\u00e1c. D\u1eabn xu\u1ea5t khu\u00f4n men (EMD) l\u00e0 chi\u1ebft xu\u1ea5t c\u1ee7a khu\u00f4n men, ch\u1ee9a c\u00e1c amelogenin v\u1edbi tr\u1ecdng l\u01b0\u1ee3ng ph\u00e2n t\u1eed kh\u00e1c nhau. Amelogenin tham gia v\u00e0o s\u1ef1 h\u00ecnh th\u00e0nh men r\u0103ng v\u00e0 b\u00e1m d\u00ednh nha chu trong su\u1ed1t qu\u00e1 tr\u00ecnh ph\u00e1t tri\u1ec3n c\u1ee7a r\u0103ng b\u1eb1ng c\u00e1ch th\u00fac \u0111\u1ea9y t\u1ebf b\u00e0o trung m\u00f4 di c\u01b0 l\u00ean b\u1ec1 m\u1eb7t ch\u00e2n r\u0103ng b\u1ecb l\u1ed9, \u0111\u00e2y l\u00e0 b\u01b0\u1edbc thi\u1ebft y\u1ebfu tr\u01b0\u1edbc khi h\u00ecnh th\u00e0nh x\u00ea m\u0103ng. L\u1ee3i \u00edch l\u00e2m s\u00e0ng c\u1ee7a EMD trong ph\u1eabu thu\u1eadt t\u00e1i t\u1ea1o th\u00f4ng th\u01b0\u1eddng v\u1eabn c\u00f2n g\u00e2y tranh c\u00e3i<\/li>\n<\/ul>\n<p>Nhi\u1ec1u nghi\u00ean c\u1ee9u \u0111\u00e3 cho th\u1ea5y l\u1ee3i \u00edch c\u1ee7a b\u1ea3o t\u1ed3n \u1ed5 r\u0103ng v\u00e0 s\u1ed1ng h\u00e0m. K\u1ebft qu\u1ea3 si\u00eau ph\u00e2n t\u00edch cho th\u1ea5y b\u1ea3o t\u1ed3n s\u1ed1ng h\u00e0m l\u00e0m gi\u1ea3m \u0111\u00e1ng k\u1ec3 s\u1ef1 ti\u00eau x\u01b0\u01a1ng \u1ed5 r\u0103ng, c\u1ea3 chi\u1ec1u cao v\u00e0 chi\u1ec1u ngang, so v\u1edbi s\u1ef1 l\u00e0nh th\u01b0\u01a1ng c\u1ee7a \u1ed5 r\u0103ng kh\u00f4ng can thi\u1ec7p (nh\u00f3m ch\u1ee9ng).<\/p>\n<ul>\n<li>Ti\u00eau x\u01b0\u01a1ng theo chi\u1ec1u ngang: dao \u0111\u1ed9ng t\u1eeb +3.25 \u0111\u1ebfn -2.50 mm \u1edf nh\u00f3m can thi\u1ec7p so v\u1edbi -0.16 \u0111\u1ebfn -4.50 mm \u1edf nh\u00f3m ch\u1ee9ng.<\/li>\n<li>Ti\u00eau x\u01b0\u01a1ng theo chi\u1ec1u \u0111\u1ee9ng: dao \u0111\u1ed9ng t\u1eeb -2.48 \u0111\u1ebfn +1.3 mm \u1edf nh\u00f3m can thi\u1ec7p so v\u1edbi -0.3 \u0111\u1ebfn -3.75 mm \u1edf nh\u00f3m ch\u1ee9ng.<\/li>\n<\/ul>\n<p>K\u1ebft qu\u1ea3 n\u00e0y cho th\u1ea5y b\u1ea3o t\u1ed3n s\u1ed1ng h\u00e0m gi\u00fap h\u1ea1n ch\u1ebf s\u1ef1 thay \u0111\u1ed5i k\u00edch th\u01b0\u1edbc (chi\u1ec1u ngang v\u00e0 chi\u1ec1u d\u1ecdc) c\u1ee7a s\u1ed1ng h\u00e0m sau nh\u1ed5 r\u0103ng. Tuy nhi\u00ean, s\u1ef1 ti\u00eau x\u01b0\u01a1ng \u1ed5 r\u0103ng theo chi\u1ec1u ngang v\u00e0 chi\u1ec1u d\u1ecdc v\u1eabn c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf m\u1ed9t m\u1ee9c \u0111\u1ed9 n\u00e0o \u0111\u00f3. S\u1ef1 bi\u1ebfn thi\u00ean trong k\u1ebft qu\u1ea3 gh\u00e9p x\u01b0\u01a1ng \u0111\u00e3 \u0111\u01b0\u1ee3c ghi nh\u1eadn gi\u1eefa c\u00e1c nghi\u00ean c\u1ee9u. Tuy nhi\u00ean, nguy\u00ean nh\u00e2n gi\u1ea3i th\u00edch cho \u0111i\u1ec1u n\u00e0y v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c l\u00e0m r\u00f5.<\/p>\n<p>Do \u0111\u00f3, trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, c\u00f3 th\u1ec3 c\u1ea7n ph\u1ea3i gh\u00e9p th\u00eam. V\u00ec v\u1eady, b\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c th\u00f4ng b\u00e1o v\u00e0 nh\u1eadn th\u1ee9c v\u1ec1 \u0111i\u1ec1u n\u00e0y.<\/p>\n<p>Nhi\u1ec1u lo\u1ea1i x\u01b0\u01a1ng v\u00e0 v\u1eadt li\u1ec7u gh\u00e9p, bao g\u1ed3m x\u01b0\u01a1ng gh\u00e9p t\u1ef1 th\u00e2n, x\u01b0\u01a1ng gh\u00e9p \u0111\u1ed3ng lo\u1ea1i, v\u1eadt li\u1ec7u t\u1ed5ng h\u1ee3p, x\u01b0\u01a1ng gh\u00e9p d\u1ecb lo\u1ea1i, v\u00e0 m\u00e0ng ng\u0103n, \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u1ec1 ngh\u1ecb s\u1eed d\u1ee5ng \u0111\u1ec3 gh\u00e9p v\u00e0o v\u1ecb tr\u00ed sau nh\u1ed5 r\u0103ng. Ch\u00fang c\u00f3 \u0111\u1ed9 nh\u1ea1y k\u1ef9 thu\u1eadt v\u00e0 chi ph\u00ed kh\u00e1c nhau. D\u01b0\u1edbi \u0111\u00e2y l\u00e0 m\u1ed9t s\u1ed1 \u0111i\u1ec1u \u0111\u00e3 bi\u1ebft v\u1ec1 x\u01b0\u01a1ng gh\u00e9p d\u1ecb lo\u1ea1i v\u00e0 v\u1eadt li\u1ec7u t\u1ed5ng h\u1ee3p.<\/p>\n<ul>\n<li>X\u01b0\u01a1ng gh\u00e9p d\u1ecb lo\u1ea1i. V\u1ecb tr\u00ed nh\u1ed5 r\u0103ng \u0111\u01b0\u1ee3c gh\u00e9p b\u1eb1ng x\u01b0\u01a1ng b\u00f2 kho\u00e1ng h\u00f3a v\u00e0 m\u00e0ng ti\u00eau cho k\u1ebft qu\u1ea3 th\u1ec3 t\u00edch x\u01b0\u01a1ng t\u1ed1t h\u01a1n so v\u1edbi v\u1ecb tr\u00ed ch\u1ec9 \u0111\u01b0\u1ee3c gh\u00e9p b\u1eb1ng x\u01b0\u01a1ng b\u00f2 kho\u00e1ng h\u00f3a ho\u1eb7c kh\u00f4ng \u0111\u01b0\u1ee3c gh\u00e9p. Ngo\u00e0i m\u00e0ng ti\u00eau, mi\u1ebfng x\u1ed1p collagen v\u00e0 x\u01b0\u01a1ng gh\u00e9p d\u1ecb lo\u1ea1i c\u0169ng l\u00e0m gi\u1ea3m \u0111\u00e1ng k\u1ec3 s\u1ef1 ti\u00eau x\u01b0\u01a1ng \u1ed5 r\u0103ng so v\u1edbi ch\u1ec9 gh\u00e9p x\u01b0\u01a1ng d\u1ecb lo\u1ea1i. \u0110i\u1ec1u n\u00e0y cho th\u1ea5y trong khi x\u01b0\u01a1ng gh\u00e9p d\u1ecb lo\u1ea1i ng\u0103n ng\u1eeba s\u1ef1 ti\u00eau s\u1ed1ng h\u00e0m, th\u00ec mi\u1ebfng x\u1ed1p collagen l\u1ea1i ng\u0103n ch\u1eb7n s\u1ef1 x\u00e2m nh\u1eadp c\u1ee7a m\u00f4 m\u1ec1m v\u00e0o \u1ed5 r\u0103ng, t\u1eeb \u0111\u00f3 t\u1ea1o thu\u1eadn l\u1ee3i cho s\u1ef1 l\u00e0m \u0111\u1ea7y x\u01b0\u01a1ng. V\u1ec1 m\u1eb7t l\u00fd thuy\u1ebft, vi\u1ec7c s\u1eed d\u1ee5ng m\u00e0ng ng\u0103n c\u00f3 th\u1ec3 t\u0103ng c\u01b0\u1eddng qu\u00e1 tr\u00ecnh l\u00e0nh th\u01b0\u01a1ng x\u01b0\u01a1ng, v\u00e0 gi\u1ea3m thi\u1ec3u s\u1ef1 ti\u00eau x\u01b0\u01a1ng. Tuy nhi\u00ean, m\u1ed9t si\u00eau ph\u00e2n t\u00edch \u0111\u00e3 cho th\u1ea5y s\u1eed d\u1ee5ng m\u00e0ng \u0111\u01a1n thu\u1ea7n \u0111\u00e3 \u0111em l\u1ea1i k\u1ebft qu\u1ea3 l\u00e2m s\u00e0ng t\u1ed1t h\u01a1n so v\u1edbi s\u1eed d\u1ee5ng m\u00e0ng k\u1ebft h\u1ee3p v\u1edbi x\u01b0\u01a1ng gh\u00e9p ho\u1eb7c so v\u1edbi x\u01b0\u01a1ng gh\u00e9p \u0111\u01a1n thu\u1ea7n. Do \u0111\u00f3, vi\u1ec7c s\u1eed d\u1ee5ng m\u00e0ng ph\u1ea3i \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc t\u00f9y t\u1eebng tr\u01b0\u1eddng h\u1ee3p.<\/li>\n<li>V\u1eadt li\u1ec7u t\u1ed5ng h\u1ee3p. M\u1ed9t trong nh\u1eefng v\u1eadt li\u1ec7u t\u1ed5ng h\u1ee3p \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong nha khoa l\u00e0 calcium sulfate, \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 c\u00f3 t\u00ednh k\u00edch d\u1eabn x\u01b0\u01a1ng. M\u1eb7c d\u00f9 th\u1ef1c t\u1ebf l\u00e0 n\u00f3 kh\u00f4ng c\u00f3 t\u00ednh c\u1ea3m \u1ee9ng x\u01b0\u01a1ng, nh\u01b0ng nghi\u00ean c\u1ee9u \u0111\u00e3 cho th\u1ea5y calcium sulfate c\u00f3 hi\u1ec7u qu\u1ea3 gi\u1ed1ng nh\u01b0 x\u01b0\u01a1ng gh\u00e9p \u0111\u1ed3ng lo\u1ea1i \u0111\u00f4ng kh\u00f4 trong vi\u1ec7c b\u1ea3o t\u1ed3n \u1ed5 nh\u1ed5 r\u0103ng\/s\u1ed1ng h\u00e0m. Nh\u1eefng th\u1eed nghi\u1ec7m c\u00f3 nh\u00f3m ch\u1ee9ng g\u1ea7n \u0111\u00e2y \u1edf ng\u01b0\u1eddi \u0111\u00e3 so s\u00e1nh ti\u1ec1m n\u0103ng c\u1ee7a v\u1eadt li\u1ec7u x\u01b0\u01a1ng s\u1ee9 hai pha (g\u1ed3m hydroxyapatite v\u00e0 B-TCP) v\u1edbi x\u01b0\u01a1ng gh\u00e9p d\u1ecb lo\u1ea1i c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb b\u00f2, c\u1ea3 hai \u0111\u1ec1u k\u1ebft h\u1ee3p v\u1edbi m\u00e0ng collagen. K\u1ebft qu\u1ea3 l\u00e0 l\u01b0\u1ee3ng x\u01b0\u01a1ng m\u1edbi h\u00ecnh th\u00e0nh l\u00e0 t\u01b0\u01a1ng t\u1ef1 nhau.<\/li>\n<\/ul>\n<p>Tuy nhi\u00ean, c\u00e1c b\u1eb1ng ch\u1ee9ng khoa h\u1ecdc v\u1eabn ch\u01b0a \u0111\u01b0a ra h\u01b0\u1edbng d\u1eabn r\u00f5 r\u00e0ng v\u1ec1 vi\u1ec7c s\u1eed d\u1ee5ng c\u00e1c lo\u1ea1i v\u1eadt li\u1ec7u sinh h\u1ecdc.<\/p>\n<p><em>Ngu\u1ed3n t\u00e0i li\u1ec7u: Clinical Cases in Implant Dentistry, First Edition &#8211; Published 2017 by John Wiley &amp; Sons, Inc.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>G\u1ea7n \u0111\u00e2y, h\u00e0ng lo\u1ea1t ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u00e3 th\u00fac \u0111\u1ea9y l\u0129nh v\u1ef1c t\u00e1i t\u1ea1o m\u00f4. V\u00ed d\u1ee5, c\u00e1c li\u1ec7u ph\u00e1p t\u1ebf b\u00e0o v\u00e0 gen \u0111ang \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng v\u00e0 kh\u00f4ng ng\u1eebng \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u. C\u00f9ng t\u00ecm hi\u1ec3u nh\u1eefng ti\u1ebfn b\u1ed9 trong k\u1ef9 thu\u1eadt t\u00e1i t\u1ea1o x\u01b0\u01a1ng v\u00e0 b\u1ea3o t\u1ed3n \u1ed5 r\u0103ng \u1edf b\u00e0i vi\u1ebft [&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>Nh\u1eefng ti\u1ebfn b\u1ed9 trong k\u1ef9 thu\u1eadt t\u00e1i t\u1ea1o x\u01b0\u01a1ng v\u00e0 b\u1ea3o t\u1ed3n \u1ed5 r\u0103ng.<\/title>\n<meta name=\"description\" content=\"G\u1ea7n \u0111\u00e2y, h\u00e0ng lo\u1ea1t ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u00e3 th\u00fac \u0111\u1ea9y l\u0129nh v\u1ef1c t\u00e1i t\u1ea1o m\u00f4. 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