{"id":31924,"date":"2023-05-05T05:06:13","date_gmt":"2023-05-04T22:06:13","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=31924"},"modified":"2023-05-05T20:05:25","modified_gmt":"2023-05-05T13:05:25","slug":"chong-chi-dinh-danh-gia-ky-thuat-cua-so-ngoai-trong-nang-xoang","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/05\/chong-chi-dinh-danh-gia-ky-thuat-cua-so-ngoai-trong-nang-xoang\/","title":{"rendered":"Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh, \u0111\u00e1nh gi\u00e1 k\u1ef9 thu\u1eadt c\u1eeda s\u1ed5 ngo\u00e0i trong n\u00e2ng xoang."},"content":{"rendered":"<p><strong>B\u00e0i vi\u1ebft n\u00e0y \u0111\u00e1nh gi\u00e1 hai v\u1ea5n \u0111\u1ec1 ch\u00ednh, \u0111\u1ea7u ti\u00ean l\u00e0 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh \u0111\u1ed1i v\u1edbi k\u1ef9 thu\u1eadt c\u1eeda s\u1ed5 ngo\u00e0i trong qu\u00e1 tr\u00ecnh n\u00e2ng xoang Implant, \u0111\u1ed3ng th\u1eddi nh\u00ecn nh\u1eadn t\u1ed5ng quan c\u00e1c b\u01b0\u1edbc ph\u1eabu thu\u1eadt c\u01a1 b\u1ea3n khi th\u1ef1c hi\u1ec7n k\u1ef9 thu\u1eadt c\u1eeda s\u1ed5 ngo\u00e0i tr\u00ean b\u1ec7nh nh\u00e2n c\u00f3 ch\u1ec9 \u0111\u1ecbnh. C\u00f9ng \u0111\u00e1nh gi\u00e1 v\u00e0 t\u00ecm hi\u1ec3u th\u00eam k\u1ef9 thu\u1eadt n\u00e0y trong l\u0129nh v\u1ef1c Implant Nha khoa.\u00a0<\/strong><\/p>\n<h2>1. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh \u0111\u1ed1i v\u1edbi k\u1ef9 thu\u1eadt c\u1eeda s\u1ed5 ngo\u00e0i trong qu\u00e1 tr\u00ecnh n\u00e2ng xoang Implant<\/h2>\n<p>C\u00e1c ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh c\u1ee7a k\u1ef9 thu\u1eadt c\u1eeda s\u1ed5 ngo\u00e0i \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i theo y\u1ebfu t\u1ed1 y khoa v\u00e0 t\u1ea1i ch\u1ed7.<\/p>\n<ul>\n<li>C\u00e1c ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh y khoa:\n<ul>\n<li>Ti\u1ec1n s\u1eed h\u00f3a tr\u1ecb hay x\u1ea1 tr\u1ecb v\u00f9ng \u0111\u1ea7u v\u00e0 c\u1ed5 t\u1ea1i th\u1eddi \u0111i\u1ec3m n\u00e2ng xoang ho\u1eb7c trong 6 th\u00e1ng tr\u01b0\u1edbc \u0111\u00f3.<\/li>\n<li>Ti\u00eam t\u0129nh m\u1ea1ch bisphosphonate. B\u1ec7nh nh\u00e2n suy gi\u1ea3m mi\u1ec5n d\u1ecbch.<\/li>\n<li>C\u00e1c t\u00ecnh tr\u1ea1ng y khoa \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ef1 chuy\u1ec3n h\u00f3a x\u01b0\u01a1ng.<\/li>\n<li>\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng kh\u00f4ng ki\u1ec3m so\u00e1t.<\/li>\n<li>Nghi\u1ec7n ma t\u00fay r\u01b0\u1ee3u.<\/li>\n<li>Kh\u00f4ng h\u1ee3p t\u00e1c ho\u1eb7c t\u00e2m th\u1ea7n.<\/li>\n<\/ul>\n<\/li>\n<li>C\u00e1c ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh t\u1ea1i ch\u1ed7: \u0110ang hi\u1ec7n di\u1ec7n ho\u1eb7c c\u00f3 ti\u1ec1n s\u1eed b\u1ec7nh l\u00fd xoang, bao g\u1ed3m vi\u00eam xoang c\u1ea5p, vi\u00eam m\u0169i d\u1ecb \u1ee9ng, vi\u00eam xoang m\u1ea1n t\u00e1i ph\u00e1t, ni\u00eam m\u1ea1c gi\u1ea3m ch\u1ee9c n\u0103ng v\u00e0 b\u1ecb s\u1eb9o, kh\u1ed1i u l\u00e0nh t\u00ednh x\u00e2m l\u1ea5n t\u1ea1i ch\u1ed7 v\u00e0 kh\u1ed1i u \u00e1c t\u00ednh.<\/li>\n<\/ul>\n<h2>2. C\u00e1c b\u01b0\u1edbc ph\u1eabu thu\u1eadt c\u01a1 b\u1ea3n khi th\u1ef1c hi\u1ec7n k\u1ef9 thu\u1eadt c\u1eeda s\u1ed5 ngo\u00e0i<\/h2>\n<ul>\n<li>\u0110\u1ec3 g\u00e2y t\u00ea t\u1ea1i ch\u1ed7, ng\u01b0\u1eddi ta khuy\u1ebfn c\u00e1o n\u00ean d\u00f9ng thu\u1ed1c t\u00ea ch\u1ee9a epinephrine n\u1ebfu kh\u00f4ng c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh y khoa, b\u1edfi v\u00ec s\u1ebd c\u00f3 ch\u1ea3y m\u00e1u \u0111\u00e1ng k\u1ec3 trong su\u1ed1t qu\u00e1 tr\u00ecnh ph\u1eabu thu\u1eadt, v\u00e0 epinephrine s\u1ebd gi\u00fap quan s\u00e1t thu\u1eadn l\u1ee3i h\u01a1n.<\/li>\n<li>\u0110\u01b0\u1eddng r\u1ea1ch gi\u1eefa m\u00e0o x\u01b0\u01a1ng \u1edf v\u00f9ng m\u1ea5t r\u0103ng v\u00e0 \u0111\u01b0\u1eddng r\u1ea1ch \u0111\u1ee9ng l\u00e0 nh\u1eefng \u0111\u01b0\u1eddng r\u1ea1ch th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng. C\u1ea7n t\u1ed1i thi\u1ec3u 5 mm kho\u1ea3ng c\u00e1ch t\u1eeb c\u1eeda s\u1ed5 x\u01b0\u01a1ng \u0111\u1ebfn c\u00e1c \u0111\u01b0\u1eddng r\u1ea1ch. Sau \u0111\u00f3, l\u1eadt v\u1ea1t to\u00e0n b\u1ed9 b\u1eb1ng c\u00e2y b\u00f3c t\u00e1ch m\u00e0ng x\u01b0\u01a1ng.<\/li>\n<li>Thi\u1ebft k\u1ebf c\u1eeda s\u1ed5 x\u01b0\u01a1ng \u0111i theo \u0111\u01b0\u1eddng vi\u1ec1n c\u1ee7a xoang h\u00e0m v\u00e0 c\u00e1c c\u1ea5u tr\u00fac gi\u1ea3i ph\u1eabu l\u00e2n c\u1eadn. Th\u00f4ng th\u01b0\u1eddng, c\u00f3 hai k\u1ef9 thu\u1eadt \u0111\u1ec3 t\u1ea1o c\u1eeda s\u1ed5: &#8220;k\u1ef9 thu\u1eadt c\u1ee7a s\u1eadp&#8221; v\u00e0 &#8220;k\u1ef9 thu\u1eadt c\u1eeda m\u1edf&#8221;. Trong k\u1ef9 thu\u1eadt c\u1ee7a s\u1eadp, c\u1eeda s\u1ed5 x\u01b0\u01a1ng \u0111\u01b0\u1ee3c n\u00e2ng v\u00e0o b\u00ean trong kho\u1ea3ng tr\u1ed1ng sau n\u00e2ng xoang. D\u1ee5ng c\u1ee5 quay nh\u01b0 m\u0169i khoan carbide ho\u1eb7c kim c\u01b0\u01a1ng tr\u00f2n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng d\u01b0\u1edbi n\u01b0\u1edbc b\u01a1m r\u1eeda (H\u00ecnh d\u01b0\u1edbi \u0111\u00e2y), v\u00e0 c\u1eeda s\u1ed5 x\u01b0\u01a1ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c n\u00e2ng v\u00e0 \u0111\u1ec3 l\u1ea1i b\u00ean trong kho\u1ea3ng tr\u1ed1ng sau n\u00e2ng xoang. Ng\u01b0\u1ee3c l\u1ea1i, trong k\u1ef9 thu\u1eadt c\u1eeda m\u1edf, c\u1eeda s\u1ed5 x\u01b0\u01a1ng s\u1ebd \u0111\u01b0\u1ee3c l\u1ea5y \u0111i b\u1eb1ng c\u00e1ch m\u00e0i m\u1ecfng x\u01b0\u01a1ng. Trong qu\u00e1 tr\u00ecnh ph\u1eabu thu\u1eadt, c\u00f3 th\u1ec3 quan s\u00e1t th\u1ea5y m\u00e0ng Schneiderian m\u00e0u xanh.<\/li>\n<\/ul>\n<figure id=\"attachment_31925\" aria-describedby=\"caption-attachment-31925\" style=\"width: 586px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-31925 size-full\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/Untitled-33.png\" alt=\"chong-chi-dinh-1\" width=\"586\" height=\"392\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/Untitled-33.png 586w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/Untitled-33-300x201.png 300w\" sizes=\"(max-width: 586px) 100vw, 586px\" \/><figcaption id=\"caption-attachment-31925\" class=\"wp-caption-text\">S\u1eed d\u1ee5ng m\u0169i khoan kim c\u01b0\u01a1ng tr\u00f2n \u0111\u1ec3 thi\u1ebft k\u1ebf c\u1eeda s\u1ed5<\/figcaption><\/figure>\n<ul>\n<li>N\u1ebfu c\u00f3, thi\u1ebft b\u1ecb \u0111i\u1ec7n \u00e1p c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng m\u1ed9t m\u00ecnh ho\u1eb7c c\u00f9ng v\u1edbi d\u1ee5ng c\u1ee5 quay \u0111\u1ec3 ho\u00e0n thi\u1ec7n \u0111\u01b0\u1eddng vi\u1ec1n c\u1ee7a c\u1eeda s\u1ed5 v\u00e0 nh\u1eb9 nh\u00e0ng n\u00e2ng c\u1eeda s\u1ed5 x\u01b0\u01a1ng. Ti\u1ebfp theo, n\u00e2ng m\u00e0ng Schneiderian b\u1eb1ng \u0111\u1ea7u \u00e1p (piezo) v\u00e0 d\u1ee5ng c\u1ee5 tay.<\/li>\n<li>Sau khi ho\u00e0n t\u1ea5t n\u00e2ng m\u00e0ng Schneiderian, \u0111i\u1ec1u quan tr\u1ecdng l\u00e0 ph\u1ea3i x\u00e1c nh\u1eadn m\u00e0ng kh\u00f4ng b\u1ecb th\u1ee7ng b\u1eb1ng nghi\u1ec7m ph\u00e1p th\u1ed5i m\u0169i (nghi\u1ec7m ph\u00e1p Valsalva). Trong tr\u01b0\u1eddng h\u1ee3p th\u1ee7ng m\u00e0ng, \u00e1p d\u1ee5ng k\u1ef9 thu\u1eadt s\u1eeda ch\u1eefa t\u00f9y theo k\u00edch th\u01b0\u1edbc l\u1ed7 th\u1ee7ng. V\u1eadt li\u1ec7u x\u01b0\u01a1ng gh\u00e9p s\u1ebd \u0111\u01b0\u1ee3c nh\u1ed3i nh\u1eb9 nh\u00e0ng v\u00e0o trong khoang sau n\u00e2ng xoang, v\u00e0 m\u00e0ng ti\u00eau sinh h\u1ecdc collagen s\u1ebd \u0111\u01b0\u1ee3c \u0111\u1eb7t l\u00ean c\u1eeda s\u1ed5 x\u01b0\u01a1ng.<\/li>\n<li>Tr\u01b0\u1edbc khi kh\u00e2u \u0111\u1ec3 t\u00e1i \u0111\u1ecbnh v\u1ecb v\u1ea1t, th\u01b0\u1eddng t\u1ea1o \u0111\u01b0\u1eddng r\u1ea1ch m\u00e0ng x\u01b0\u01a1ng \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o \u0111\u00f3ng k\u00edn ban \u0111\u1ea7u m\u00e0 kh\u00f4ng g\u00e2y c\u0103ng.<\/li>\n<\/ul>\n<p><strong>M\u1ed9t s\u1ed1 c\u1ea5u tr\u00fac gi\u1ea3i ph\u1eabu c\u1ea7n l\u01b0u \u00fd<\/strong><\/p>\n<p>M\u1eb7c d\u00f9 c\u00f3 th\u1ec3 \u0111\u00e1nh gi\u00e1 X-quang b\u1eb1ng phim to\u00e0n c\u1ea3nh, nh\u01b0ng n\u00f3 c\u00f3 \u0111\u1ed9 bi\u1ebfn d\u1ea1ng h\u00ecnh \u1ea3nh cao v\u00e0 kh\u00f4ng th\u1ec3 quan s\u00e1t r\u00f5 c\u00e1c c\u1ea5u tr\u00fac gi\u1ea3i ph\u1eabu. S\u1eed d\u1ee5ng CBCT \u0111\u01b0\u1ee3c khuy\u1ebfn kh\u00edch \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 gi\u1ea3i ph\u1eabu xoang h\u00e0m v\u00e0 c\u00e1c c\u1ea5u tr\u00fac quan tr\u1ecdng l\u00e2n c\u1eadn (v\u00e1ch ng\u0103n x\u01b0\u01a1ng, k\u00edch th\u01b0\u1edbc v\u00e0 b\u1ec7nh l\u00fd c\u1ee7a xoang, c\u00e1c h\u1ed1c xoang, chi\u1ec1u cao x\u01b0\u01a1ng t\u1eeb s\u00e0n xoang \u0111\u1ebfn \u0111\u1ec9nh s\u1ed1ng h\u00e0m) tr\u01b0\u1edbc khi ph\u1eabu thu\u1eadt. CBCT cung c\u1ea5p th\u00f4ng tin gi\u00fap b\u00e1c s\u0129 l\u00e2m s\u00e0ng x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed c\u1ee7a nh\u00e1nh x\u01b0\u01a1ng \u1ed5 tr\u00ean sau c\u1ee7a \u0111\u1ed9ng m\u1ea1ch h\u00e0m tr\u00ean m\u00e0 c\u00f3 th\u1ec3 n\u1ed1i v\u1edbi \u0111\u1ed9ng m\u1ea1ch d\u01b0\u1edbi \u1ed5 m\u1eaft n\u1eb1m trong th\u00e0nh x\u01b0\u01a1ng b\u00ean, \u0111\u1ed9 d\u00e0y c\u1ee7a m\u00e0ng Schneiderian, gi\u1ea3i ph\u1eabu c\u1ee7a th\u00e0nh b\u00ean v\u00e0 th\u00e0nh tr\u01b0\u1edbc, s\u1ef1 hi\u1ec7n di\u1ec7n v\u00e0 v\u1ecb tr\u00ed c\u1ee7a v\u00e1ch ng\u0103n, l\u1ed7 v\u00e0o, v\u00e0 v\u1ecb tr\u00ed c\u1ee7a th\u1ea7n kinh d\u01b0\u1edbi \u1ed5 m\u1eaft. T\u1ea5t c\u1ea3 nh\u1eefng y\u1ebfu t\u1ed1 n\u00e0y \u0111\u1ec1u \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn thi\u1ebft k\u1ebf c\u1ee7a c\u1eeda s\u1ed5 x\u01b0\u01a1ng. V\u00ed d\u1ee5, v\u00e1ch ng\u0103n ph\u1ea3i \u0111\u01b0\u1ee3c l\u01b0u \u00fd khi thi\u1ebft k\u1ebf c\u1eaft x\u01b0\u01a1ng v\u00e0 c\u00f3 th\u1ec3 l\u00e0m ph\u1ee9c t\u1ea1p vi\u1ec7c t\u00e1ch m\u00e0ng. Khi nghi ng\u1edd c\u00f3 b\u1ec7nh l\u00fd xoang (vi\u00eam m\u0169i nhi\u1ec5m tr\u00f9ng, vi\u00eam xoang do d\u1ecb v\u1eadt\/ do r\u0103ng, nang ni\u00eam d\u1ecbch, nang v\u00e0 b\u01b0\u1edbu) qua c\u00e1c k\u1ef9 thu\u1eadt h\u00ecnh \u1ea3nh n\u00e0y, b\u1ec7nh nh\u00e2n n\u00ean \u0111\u01b0\u1ee3c chuy\u1ec3n cho b\u00e1c s\u0129 tai-m\u0169i-h\u1ecdng (ENT). Nh\u1eefng t\u00ecnh tr\u1ea1ng n\u00e0y ph\u1ea3i \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb tr\u01b0\u1edbc khi ph\u1eabu thu\u1eadt.<\/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<p><em>1. Tatum Jr H. Maxillary and sinus implant reconstructions. Dent Clin North Am 1986;30(2):207-229.<\/em><br \/>\n<em>2. Stern A, Green J. Sinus lift procedures: an overview of current techniques. Dent Clin North Am 2012;56(1):219-233.<\/em><br \/>\n<em>3. Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg 1980;38(8):613-616.<\/em><br \/>\n<em>4. Summers RB. A new concept in maxillary implant surgery: the osteotome technique. Compendium 1994;15(2):152, 154-156, 158.<\/em><br \/>\n<em>5. Davarpanah M, Martinez H, Tecucianu JF, et al. The modified osteotome technique. Int J Periodontics Restorative Dent 2001;21(6):599\u2013607.<\/em><br \/>\n<em>6. Garg AK. Augmentation grafting of the maxillary sinus for placement of dental implants: anatomy, physiology, and procedures. Implant Dent 1999;8(1):36-46.<\/em><br \/>\n<em>7. Toscano NJ, Holtzclaw D, Rosen PS. The effect of piezoelectric use on open sinus lift perforation: a retrospective evaluation of 56 consecutively treated cases from private practices. J Periodontol 2010;81(1):167-171.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>B\u00e0i vi\u1ebft n\u00e0y \u0111\u00e1nh gi\u00e1 hai v\u1ea5n \u0111\u1ec1 ch\u00ednh, \u0111\u1ea7u ti\u00ean l\u00e0 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh \u0111\u1ed1i v\u1edbi k\u1ef9 thu\u1eadt c\u1eeda s\u1ed5 ngo\u00e0i trong qu\u00e1 tr\u00ecnh n\u00e2ng xoang Implant, \u0111\u1ed3ng th\u1eddi nh\u00ecn nh\u1eadn t\u1ed5ng quan c\u00e1c b\u01b0\u1edbc ph\u1eabu thu\u1eadt c\u01a1 b\u1ea3n khi th\u1ef1c hi\u1ec7n k\u1ef9 thu\u1eadt c\u1eeda s\u1ed5 ngo\u00e0i tr\u00ean b\u1ec7nh nh\u00e2n c\u00f3 ch\u1ec9 \u0111\u1ecbnh. C\u00f9ng [&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>Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh, \u0111\u00e1nh gi\u00e1 k\u1ef9 thu\u1eadt c\u1eeda s\u1ed5 ngo\u00e0i trong n\u00e2ng xoang.<\/title>\n<meta name=\"description\" content=\"B\u00e0i vi\u1ebft n\u00e0y n\u00f3i v\u1ec1 v\u1ea5n \u0111\u1ec1 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u00e0 \u0111\u1ed3ng th\u1eddi ti\u1ebfn h\u00e0nh \u0111\u00e1nh gi\u00e1 k\u1ef9 thu\u1eadt c\u1eeda s\u1ed5 ngo\u00e0i trong n\u00e2ng xoang Implant. 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