{"id":31927,"date":"2023-05-05T05:40:14","date_gmt":"2023-05-04T22:40:14","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=31927"},"modified":"2023-05-05T20:04:13","modified_gmt":"2023-05-05T13:04:13","slug":"ty-le-thanh-cong-implant-sau-ky-thuat-nang-xoang-cua-so-ngoai","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/05\/ty-le-thanh-cong-implant-sau-ky-thuat-nang-xoang-cua-so-ngoai\/","title":{"rendered":"T\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng Implant sau k\u1ef9 thu\u1eadt n\u00e2ng xoang c\u1eeda s\u1ed5 ngo\u00e0i."},"content":{"rendered":"

B\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y \u0111\u1ec1 c\u1eadp \u0111\u1ebfn c\u00e1c y\u1ebfu t\u1ed1 v\u00e0 v\u1ea5n \u0111\u1ec1 li\u00ean quan \u0111\u1ebfn t\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng c\u1ee7a qu\u00e1 tr\u00ecnh c\u1ea5y gh\u00e9p Implant Nha khoa \u0111\u1ed1i v\u1edbi k\u1ef9 thu\u1eadt n\u00e2ng xoang theo ph\u01b0\u01a1ng ph\u00e1p c\u1eeda s\u1ed5 ngo\u00e0i, \u0111\u1ed3ng th\u1eddi \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 c\u1ee7a vi\u1ec7c \u0111\u1eb7t Implant c\u00f9ng l\u00fac v\u1edbi th\u1eddi \u0111i\u1ec3m n\u00e2ng xoang. C\u00f9ng t\u00ecm hi\u1ec3u th\u00eam v\u1ec1 b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y.<\/strong><\/p>\n

1. \u0110\u1eb7t Implant \u0111\u1ed3ng th\u1eddi v\u1edbi n\u00e2ng xoang<\/h2>\n

N\u1ebfu chi\u1ec1u cao x\u01b0\u01a1ng c\u00f2n l\u1ea1i v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng x\u01b0\u01a1ng t\u1ea1o ra \u0111\u1ee7 \u0111\u1ed9 \u1ed5n \u0111\u1ecbnh s\u01a1 kh\u1edfi cho implant, th\u00ec c\u00f3 th\u1ec3 \u0111\u1eb7t implant \u0111\u1ed3ng th\u1eddi v\u1edbi n\u00e2ng xoang. N\u00f3 \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 ph\u01b0\u01a1ng ph\u00e1p m\u1ed9t th\u00ec. Khi kh\u00f4ng \u0111\u1ee7 chi\u1ec1u cao x\u01b0\u01a1ng, c\u00f3 th\u1ec3 r\u1ea5t kh\u00f3 \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c \u1ed5n \u0111\u1ecbnh s\u01a1 kh\u1edfi c\u1ee7a implant, v\u00e0 c\u1ea7n th\u1ef1c hi\u1ec7n ph\u01b0\u01a1ng ph\u00e1p hai th\u00ec. Nh\u01b0 m\u1ed9t quy t\u1eafc chung, c\u1ea7n t\u1ed1i thi\u1ec3u 3-5 mm chi\u1ec1u cao m\u00e0o x\u01b0\u01a1ng \u1ed5 \u0111\u1ec3 t\u1ea1o \u0111\u1ed9 \u1ed5n \u0111\u1ecbnh s\u01a1 kh\u1edfi cho implant, nh\u01b0ng b\u1eb1ng ch\u1ee9ng hi\u1ec7n nay trong y v\u0103n v\u1eabn c\u00f2n m\u1eabu thu\u1eabn. H\u1ed9i ngh\u1ecb \u0110\u1ed3ng thu\u1eadn v\u1ec1 Xoang 1996 \u0111\u00e3 \u0111\u01b0a ra c\u00e1c khuy\u1ebfn ngh\u1ecb sau. N\u1ebfu chi\u1ec1u cao x\u01b0\u01a1ng c\u00f2n l\u1ea1i l\u00e0 7-9 mm, th\u00ec k\u1ef9 thu\u1eadt \u0111\u1ee5c x\u01b0\u01a1ng (osteotome) l\u00e0 an to\u00e0n v\u00e0 c\u00f3 th\u1ec3 \u0111\u1eb7t implant \u0111\u1ed3ng th\u1eddi (H\u00ecnh d\u01b0\u1edbi \u0111\u00e2y).<\/p>\n

\"ty-le-thanh-cong-1\"
\u0110\u1eb7t Implant v\u1edbi k\u1ef9 thu\u1eadt c\u1eeda s\u1ed5 ngo\u00e0i<\/figcaption><\/figure>\n

N\u1ebfu chi\u1ec1u cao x\u01b0\u01a1ng c\u00f2n l\u1ea1i l\u00e0 4-6 mm, th\u00ec k\u1ef9 thu\u1eadt c\u1ee7a s\u1ed5 ngo\u00e0i k\u1ebft h\u1ee3p \u0111\u1eb7t implant tr\u00ec ho\u00e3n ho\u1eb7c \u0111\u1ed3ng th\u1eddi \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb. Cu\u1ed1i c\u00f9ng, n\u1ebfu chi\u1ec1u cao x\u01b0\u01a1ng c\u00f2n l\u1ea1i l\u00e0 1-3 mm, th\u00ec k\u1ef9 thu\u1eadt c\u1eeda s\u1ed5 ngo\u00e0i k\u1ebft h\u1ee3p v\u1eadt li\u1ec7u gh\u00e9p r\u1ed3i \u0111\u1eb7t implant tr\u00ec ho\u00e3n l\u00e0 ph\u01b0\u01a1ng \u00e1n \u0111i\u1ec1u tr\u1ecb t\u1ed1t nh\u1ea5t.<\/p>\n

2. \u0110\u00e1nh gi\u00e1 t\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng c\u1ee7a Implant v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 li\u00ean quan sau k\u1ef9 thu\u1eadt n\u00e2ng xoang c\u1eeda s\u1ed5 ngo\u00e0i<\/h2>\n

Theo c\u00e1c t\u1ed5ng ph\u00e2n t\u00edch hi\u1ec7n c\u00f3 trong y v\u0103n, t\u1ef7 l\u1ec7 t\u1ed3n t\u1ea1i 3 n\u0103m c\u1ee7a implant c\u00f3 th\u1ec3 dao \u0111\u1ed9ng t\u1eeb 90 \u0111\u1ebfn 98%, t\u00f9y theo lo\u1ea1i implant. C\u00f3 nhi\u1ec1u y\u1ebfu t\u1ed1 c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ef1 th\u00e0nh c\u00f4ng c\u1ee7a implant \u0111\u01b0\u1ee3c \u0111\u1eb7t v\u00e0o v\u1ecb tr\u00ed \u0111\u00e3 n\u00e2ng xoang; v\u00ed d\u1ee5, chi\u1ec1u cao x\u01b0\u01a1ng c\u00f2n l\u1ea1i tr\u01b0\u1edbc ph\u1eabu thu\u1eadt, \u0111\u1eb7c \u0111i\u1ec3m b\u1ec1 m\u1eb7t c\u1ee7a implant, v\u00e0 \u0111\u1ed9 \u1ed5n \u0111\u1ecbnh l\u00e2u d\u00e0i c\u1ee7a x\u01b0\u01a1ng gh\u00e9p, \u0111\u1ec1u ph\u1ea3i \u0111\u01b0\u1ee3c xem x\u00e9t. T\u1ef7 l\u1ec7 t\u1ed3n t\u1ea1i 3 n\u0103m c\u1ee7a implant b\u1ec1 m\u1eb7t nh\u00e1m (96.5%) d\u01b0\u1eddng nh\u01b0 cao h\u01a1n implant b\u1ec1 m\u1eb7t nh\u1eb5n v\u1edbi t\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng 3 n\u0103m l\u00e0 81.4%. Chi\u1ec1u cao x\u01b0\u01a1ng c\u00f2n l\u1ea1i d\u01b0\u1eddng nh\u01b0 c\u00f2n c\u00f3 vai tr\u00f2 kh\u00e1c: t\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng c\u1ee7a implant khi chi\u1ec1u cao x\u01b0\u01a1ng c\u00f2n l\u1ea1i < 5 mm l\u00e0 kho\u1ea3ng 85.7%, nh\u01b0ng khi chi\u1ec1u cao x\u01b0\u01a1ng c\u00f2n l\u1ea1i > 5 mm th\u00ec t\u1ef7 l\u1ec7 l\u00e0 96%. Nhi\u1ec1u t\u00e1c gi\u1ea3 \u0111\u00e3 ph\u00e2n t\u00edch s\u1ef1 t\u1ed3n t\u1ea1i c\u1ee7a implant v\u00e0o v\u1ecb tr\u00ed sau n\u00e2ng xoang gh\u00e9p x\u01b0\u01a1ng, v\u00e0 b\u00e1o c\u00e1o t\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng r\u1ea5t cao, dao \u0111\u1ed9ng t\u1eeb 90 \u0111\u1ebfn 93%.<\/p>\n

C\u00f3 m\u1ed9t v\u00e0i y\u1ebfu t\u1ed1 \u0111\u01b0\u1ee3c xem l\u00e0 th\u00e0nh c\u00f4ng c\u1ee7a ph\u1eabu thu\u1eadt, ch\u1eb3ng h\u1ea1n nh\u01b0 \u0111\u1ea1t \u0111\u01b0\u1ee3c chi\u1ec1u cao x\u01b0\u01a1ng c\u1ea7n thi\u1ebft, kh\u00f4ng c\u00f3 bi\u1ebfn ch\u1ee9ng trong qu\u00e1 tr\u00ecnh ph\u1eabu thu\u1eadt, v\u00e0 kh\u00f4ng c\u00f3 bi\u1ebfn ch\u1ee9ng\/t\u00e1c d\u1ee5ng ph\u1ee5 sau ph\u1eabu thu\u1eadt. B\u1edfi v\u00ec m\u1ee5c ti\u00eau c\u1ee7a ph\u1eabu thu\u1eadt l\u00e0 nh\u1eb1m t\u1ea1o ra \u0111\u1ee7 chi\u1ec1u cao \u0111\u1ec3 \u0111\u1eb7t implant, n\u00ean s\u1ef1 t\u00edch h\u1ee3p x\u01b0\u01a1ng c\u1ee7a implant v\u00e0o v\u1ecb tr\u00ed ph\u1eabu thu\u1eadt l\u00e0 k\u1ebft qu\u1ea3 sau c\u00f9ng \u0111\u1ec3 quy\u1ebft \u0111\u1ecbnh ph\u1eabu thu\u1eadt th\u00e0nh c\u00f4ng hay kh\u00f4ng.<\/p>\n

C\u00f3 r\u1ea5t \u00edt th\u00f4ng tin v\u1ec1 nh\u1eefng toa thu\u1ed1c th\u01b0\u1eddng \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb, nh\u01b0ng t\u1ed5ng quan h\u1ec7 th\u1ed1ng Cochrane \u0111\u00e3 \u0111\u1ec1 ngh\u1ecb s\u1eed d\u1ee5ng kh\u00e1ng sinh nh\u01b0 sau \u2013 amoxicillin 2 g 1 gi\u1edd tr\u01b0\u1edbc ph\u1eabu thu\u1eadt ho\u1eb7c 1 g 1 gi\u1edd tr\u01b0\u1edbc ph\u1eabu thu\u1eadt v\u00e0 m\u1ed7i 6 gi\u1edd trong 2 ng\u00e0y sau ph\u1eabu thu\u1eadt. Misch \u0111\u1ec1 ngh\u1ecb s\u1eed d\u1ee5ng amoxicillin 500 mg 1 gi\u1edd tr\u01b0\u1edbc ph\u1eabu thu\u1eadt v\u00e0 500 mg 3 l\u1ea7n\/ng\u00e0y trong 7-10 ng\u00e0y sau ph\u1eabu thu\u1eadt. Kh\u00e1ng sinh c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c tr\u1ed9n v\u1edbi x\u01b0\u01a1ng gh\u00e9p h\u1ea1t \u0111\u1ec3 t\u1ea1o t\u00e1c d\u1ee5ng t\u1ea1i ch\u1ed7. Do nguy c\u01a1 nhi\u1ec5m tr\u00f9ng li\u00ean quan \u0111\u1ebfn n\u00e2ng xoang, n\u00ean t\u1ed1t nh\u1ea5t l\u00e0 s\u1eed d\u1ee5ng Augmentin (amoxicillin v\u1edbi clavulanic acid), b\u1edfi v\u00ec th\u00e0nh ph\u1ea7n clavulanic acid s\u1ebd ph\u00e1 h\u1ee7y c\u00e1c vi khu\u1ea9n beta-lactam v\u00e0 \u0111\u1ea3m b\u1ea3o hi\u1ec7u qu\u1ea3 cao h\u01a1n c\u1ee7a thu\u1ed1c kh\u00e1ng sinh.<\/p>\n

C\u00f3 nhi\u1ec1u lo\u1ea1i v\u1eadt li\u1ec7u x\u01b0\u01a1ng gh\u00e9p c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 n\u00e2ng xoang. X\u01b0\u01a1ng t\u1ef1 th\u00e2n v\u1eabn \u0111\u01b0\u1ee3c xem l\u00e0 chu\u1ea9n v\u00e0ng c\u1ee7a v\u1eadt li\u1ec7u gh\u00e9p nh\u1edd h\u00e0m l\u01b0\u1ee3ng protein t\u1ea1o h\u00ecnh th\u00e1i x\u01b0\u01a1ng (BMPs) cao v\u00e0 kh\u1ea3 n\u0103ng bi\u1ec7t h\u00f3a c\u00e1c t\u1ebf b\u00e0o t\u1eeb m\u00f4 xung quanh th\u00e0nh t\u1ebf b\u00e0o x\u01b0\u01a1ng. Tuy nhi\u00ean, c\u00e1c nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng c\u0169ng \u0111\u00e3 ch\u1ee9ng minh \u0111\u01b0\u1ee3c k\u1ebft qu\u1ea3 th\u00e0nh c\u00f4ng c\u1ee7a gh\u00e9p \u0111\u1ed3ng lo\u1ea1i, gh\u00e9p d\u1ecb lo\u1ea1i, v\u00e0 v\u1eadt li\u1ec7u t\u1ed5ng h\u1ee3p. \u0110i\u1ec3m kh\u00e1c bi\u1ec7t c\u1ee7a nh\u1eefng v\u1eadt li\u1ec7u gh\u00e9p n\u00e0y l\u00e0 ch\u00fang b\u1ecb h\u1ea5p thu ch\u1eadm h\u01a1n so v\u1edbi x\u01b0\u01a1ng t\u1ef1 th\u00e2n. M\u1ed9t nghi\u00ean c\u1ee9u \u0111\u00e3 cho th\u1ea5y khi th\u00eam m\u1ed9t l\u01b0\u1ee3ng nh\u1ecf x\u01b0\u01a1ng t\u1ef1 th\u00e2n v\u00e0o x\u01b0\u01a1ng gh\u00e9p d\u1ecb lo\u1ea1i th\u00ec s\u1ebd t\u0103ng s\u1ef1 t\u1ea1o x\u01b0\u01a1ng s\u1ed1ng.<\/p>\n

B\u1eb1ng ch\u1ee9ng trong y v\u0103n d\u01b0\u1eddng nh\u01b0 cho th\u1ea5y quy tr\u00ecnh gh\u00e9p t\u1ed1t nh\u1ea5t l\u00e0 h\u1ed7n h\u1ee3p x\u01b0\u01a1ng h\u1ea1t t\u1ef1 th\u00e2n v\u1edbi x\u01b0\u01a1ng b\u00f2 kho\u00e1ng kh\u1eed kho\u00e1ng ho\u1eb7c x\u01b0\u01a1ng gh\u00e9p \u0111\u1ed3ng lo\u1ea1i kh\u1eed kho\u00e1ng \u0111\u00f4ng kh\u00f4. T\u1ef7 l\u1ec7 t\u1ed3n t\u1ea1i c\u1ee7a implant b\u1ec1 m\u1eb7t nh\u00e1m s\u1eed d\u1ee5ng quy tr\u00ecnh gh\u00e9p n\u00e0y l\u00e0 kho\u1ea3ng 96.8-99.8%. B\u1eb1ng ch\u1ee9ng hi\u1ec7n n\u00e0y c\u00f2n cho th\u1ea5y gh\u00e9p x\u01b0\u01a1ng h\u1ea1t cho k\u1ebft qu\u1ea3 t\u1ed1t h\u01a1n gh\u00e9p x\u01b0\u01a1ng kh\u1ed1i. Wallace v\u00e0 Froum \u0111\u00e3 b\u00e1o c\u00e1o t\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng 80.40% c\u1ee7a implant b\u1ec1 m\u1eb7t nh\u00e1m \u0111\u01b0\u1ee3c \u0111\u1eb7t v\u00e0o x\u01b0\u01a1ng gh\u00e9p kh\u1ed1i so v\u1edbi 94.83% c\u1ee7a x\u01b0\u01a1ng gh\u00e9p h\u1ea1t. Ngo\u00e0i ra, BMP-2 v\u00e0 -7 t\u00e1i t\u1ed5 h\u1ee3p c\u1ee7a ng\u01b0\u1eddi c\u00f3 th\u1ec3 c\u1ea3i thi\u1ec7n k\u1ebft qu\u1ea3 sau c\u00f9ng b\u1eb1ng c\u00e1ch l\u00e0m t\u0103ng l\u01b0\u1ee3ng x\u01b0\u01a1ng h\u00ecnh th\u00e0nh nh\u1edd t\u00ednh ch\u1ea5t c\u1ea3m \u1ee9ng x\u01b0\u01a1ng c\u1ee7a ch\u00fang (H\u00ecnh d\u01b0\u1edbi \u0111\u00e2y).<\/p>\n

\"ty-le-thanh-cong-2\"
S\u1eed d\u1ee5ng v\u1eadt li\u1ec7u gh\u00e9p ch\u1ee9a BMPs v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 t\u0103ng tr\u01b0\u1edfng<\/figcaption><\/figure>\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 d\u01b0\u1edbi \u0111\u00e2y \u0111\u1ec1 c\u1eadp \u0111\u1ebfn c\u00e1c y\u1ebfu t\u1ed1 v\u00e0 v\u1ea5n \u0111\u1ec1 li\u00ean quan \u0111\u1ebfn t\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng c\u1ee7a qu\u00e1 tr\u00ecnh c\u1ea5y gh\u00e9p Implant Nha khoa \u0111\u1ed1i v\u1edbi k\u1ef9 thu\u1eadt n\u00e2ng xoang theo ph\u01b0\u01a1ng ph\u00e1p c\u1eeda s\u1ed5 ngo\u00e0i, \u0111\u1ed3ng th\u1eddi \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 c\u1ee7a vi\u1ec7c \u0111\u1eb7t Implant c\u00f9ng l\u00fac v\u1edbi th\u1eddi \u0111i\u1ec3m […]<\/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":"\nT\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng Implant sau k\u1ef9 thu\u1eadt n\u00e2ng xoang c\u1eeda s\u1ed5 ngo\u00e0i.<\/title>\n<meta name=\"description\" content=\"B\u00e0i vi\u1ebft \u0111\u1ec1 c\u1eadp c\u00e1c y\u1ebfu t\u1ed1 li\u00ean 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