{"id":31934,"date":"2023-05-05T06:13:16","date_gmt":"2023-05-04T23:13:16","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=31934"},"modified":"2023-05-05T20:02:29","modified_gmt":"2023-05-05T13:02:29","slug":"phuong-phap-nang-xoang-kin-trong-implant-nha-khoa","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/05\/phuong-phap-nang-xoang-kin-trong-implant-nha-khoa\/","title":{"rendered":"Ph\u01b0\u01a1ng ph\u00e1p n\u00e2ng xoang k\u00edn trong Implant Nha khoa – G\u00f3c nh\u00ecn."},"content":{"rendered":"

B\u00e0i vi\u1ebft n\u00e0y cung c\u1ea5p cho nha s\u0129 c\u00e1i nh\u00ecn t\u1ed5ng quan v\u1ec1 ph\u01b0\u01a1ng ph\u00e1p n\u00e2ng xoang k\u00edn \u0111\u1ed1i v\u1edbi ph\u1eabu thu\u1eadt Implant nha khoa, \u0111\u1ed3ng th\u1eddi ti\u1ebfn h\u00e0nh \u0111\u00e1nh gi\u00e1 nh\u1eefng l\u01b0u \u00fd trong su\u1ed1t qu\u00e1 tr\u00ecnh th\u1ee7 thu\u1eadt, \u0111\u01b0a ra nh\u1eefng gi\u1ea3i ph\u00e1p thay th\u1ebf v\u00e0 h\u1ea1n ch\u1ebf c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p n\u00e0y trong v\u1ea5n \u0111\u1ec1 n\u00e2ng xoang Implant Nha khoa. C\u00f9ng t\u00ecm hi\u1ec3u.<\/p>\n

1. \u0110\u00e1nh gi\u00e1 ph\u01b0\u01a1ng ph\u00e1p n\u00e2ng xoang k\u00edn \u0111\u1ed1i v\u1edbi ph\u1eabu thu\u1eadt Implant nha khoa<\/h2>\n

Ph\u1ea7n l\u1edbn c\u00e1c ph\u01b0\u01a1ng ph\u00e1p m\u00e0o x\u01b0\u01a1ng, bao g\u1ed3m c\u1ea3 k\u1ef9 thu\u1eadt n\u00e0y, \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 “k\u1ef9 thu\u1eadt m\u00f9\u201d. Do \u0111\u00f3, kh\u00f4ng th\u1ec3 nh\u00ecn th\u1ea5y m\u00e0ng Schneiderian b\u1eb1ng nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p m\u00e0o x\u01b0\u01a1ng n\u00e0y [1-3]. Ng\u01b0\u1ee3c l\u1ea1i, c\u00f3 m\u1ed9t k\u1ef9 thu\u1eadt kh\u00e1c g\u1ecdi l\u00e0 \u201ck\u1ef9 thu\u1eadt c\u1eeda s\u1ed5 m\u00e0o x\u01b0\u01a1ng”[4] \u2013 trong \u0111\u00f3 ch\u00fang ta c\u00f3 th\u1ec3 t\u1ea1o c\u1eeda s\u1ed1 m\u00e0o x\u01b0\u01a1ng v\u00e0 nh\u00ecn th\u1ea5y m\u00e0ng (H\u00ecnh d\u01b0\u1edbi \u0111\u00e2y), t\u1eeb \u0111\u00f3 cho ph\u00e9p n\u00e2ng m\u00e0ng xoang b\u1eb1ng tay m\u1ed9t c\u00e1ch ki\u1ec3m so\u00e1t h\u01a1n.<\/p>\n

\"phuong-phap-nang-xoang-1\"
C\u00f3 th\u1ec3 nh\u00ecn th\u1ea5y m\u00e0ng Schneiderian b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng k\u1ef9 thu\u1eadt c\u1eeda s\u1ed5 m\u00e0o x\u01b0\u01a1ng cho n\u00e2ng xoang gh\u00e9p x\u01b0\u01a1ng, t\u1eeb \u0111\u00f3 cho ph\u00e9p n\u00e2ng m\u00e0ng xoang b\u1eb1ng tay m\u1ed9t c\u00e1ch ki\u1ec3m so\u00e1t h\u01a1n<\/figcaption><\/figure>\n

Trong m\u1ed9t s\u1ed1 ca l\u00e2m s\u00e0ng, k\u1ef9 thu\u1eadt \u0111\u1ee5c x\u01b0\u01a1ng c\u1ee7a Summer \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 n\u00e2ng xoang gh\u00e9p x\u01b0\u01a1ng. Tuy nhi\u00ean, vi\u1ec7c s\u1eed d\u1ee5ng l\u1ef1c c\u1ee7a b\u00faa kh\u00f4ng \u0111\u00fang m\u1ee9c c\u00f3 th\u1ec3 g\u00e2y \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn b\u1ec7nh nh\u00e2n, ch\u00f3ng m\u1eb7t t\u01b0 th\u1ebf l\u00e0nh t\u00ednh, v\u00e0 c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn ki\u1ec7n t\u1ee5ng [1-3, 5].<\/p>\n

\"phuong-phap-nang-xoang-2\"
S\u1eed d\u1ee5ng c\u00e2y \u0111\u1ee5c x\u01b0\u01a1ng \u0111\u1ec3 n\u00e2ng xoang, tuy nhi\u00ean vi\u1ec7c s\u1eed d\u1ee5ng l\u1ef1c c\u1ee7a b\u00faa kh\u00f4ng \u0111\u00fang m\u1ee9c c\u00f3 th\u1ec3 g\u00e2y \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn b\u1ec7nh nh\u00e2n, n\u00ean c\u1ea7n thi\u1ebft ph\u1ea3i l\u01b0u \u00fd.<\/figcaption><\/figure>\n

2. L\u01b0u \u00fd trong qu\u00e1 tr\u00ecnh th\u1ef1c hi\u1ec7n th\u1ee7 thu\u1eadt<\/h2>\n

Do s\u1ef1 kh\u00f3 ch\u1ecbu t\u1eeb vi\u1ec7c s\u1eed d\u1ee5ng b\u00faa, t\u00e1c gi\u1ea3 \u0111\u1eb7c bi\u1ec7t \u0111\u1ec1 ngh\u1ecb n\u00ean g\u00e2y m\u00ea t\u0129nh m\u1ea1ch cho th\u1ee7 thu\u1eadt n\u00e0y \u0111\u1ec3 cho ph\u00e9p ki\u1ec3m so\u00e1t \u0111au v\u00e0 c\u0103ng th\u1eb3ng t\u1ed1t h\u01a1n. Thu\u1ed1c th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 an th\u1ea7n l\u00e0 midazolam. Th\u00f4ng th\u01b0\u1eddng, 1-10 mg Versed l\u00e0 \u0111\u00e3 \u0111\u1ee7 \u0111\u1ec3 \u0111\u1ea1t hi\u1ec7u qu\u1ea3 an th\u1ea7n v\u00e0 khi\u1ebfn b\u1ec7nh nh\u00e2n l\u01a1 m\u01a1; n\u00f3 n\u00ean \u0111\u01b0\u1ee3c ti\u00eam tr\u01b0\u1edbc khi g\u00e2y t\u00ea. Ch\u00fang ta ph\u1ea3i xem x\u00e9t c\u00e1c ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh: qu\u00e1 m\u1eabn c\u1ea3m v\u1edbi benzodiazepines, v\u00e0 suy h\u00f4 h\u1ea5p n\u1eb7ng ho\u1eb7c suy h\u00f4 h\u1ea5p c\u1ea5p t\u00ednh. Li\u1ec1u ban \u0111\u1ea7u \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o l\u00e0 1 mg, v\u00e0 kh\u00f4ng qu\u00e1 10 mg \u1edf ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh kh\u1ecfe m\u1ea1nh. Tuy nhi\u00ean, li\u1ec1u th\u1ea5p h\u01a1n ph\u1ea3i \u0111\u01b0\u1ee3c xem x\u00e9t cho b\u1ec7nh nh\u00e2n > 60 tu\u1ed5i v\u00e0 b\u1ec7nh nh\u00e2n suy nh\u01b0\u1ee3c.<\/p>\n

Ngo\u00e0i ra, b\u00e1c s\u0129 l\u00e2m s\u00e0ng ph\u1ea3i c\u1ea3nh b\u00e1o cho b\u1ec7nh nh\u00e2n tr\u01b0\u1edbc khi s\u1eed d\u1ee5ng midazolam l\u00e0 kh\u00f4ng \u0111\u01b0\u1ee3c l\u00e1i xe ho\u1eb7c v\u1eadn h\u00e0nh m\u00e1y m\u00f3c cho \u0111\u1ebfn khi h\u1ecd b\u00ecnh ph\u1ee5c ho\u00e0n to\u00e0n. B\u1ec7nh nh\u00e2n n\u00ean \u0111i c\u00f9ng v\u1edbi m\u1ed9t th\u00e0nh vi\u00ean trong gia \u0111\u00ecnh b\u1edfi v\u00ec s\u1ebd c\u00f3 t\u00ecnh tr\u1ea1ng l\u01a1 m\u01a1, \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u1ec7 th\u1ea7n kinh, g\u00e2y nguy hi\u1ec3m cho ch\u00ednh h\u1ecd n\u1ebfu l\u00e1i xe ho\u1eb7c v\u1eadn h\u00e0nh m\u00e1y m\u00f3c, c\u00e1c c\u00f4ng vi\u1ec7c \u0111\u00f2i h\u1ecfi t\u1eadp trung cao<\/p>\n

Do t\u00ednh ch\u1ea5t g\u00e2y \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u1ec7 th\u1ea7n kinh c\u1ee7a Versed, b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 s\u1ebd kh\u00f4ng nh\u1edb b\u1ea5t k\u1ef3 tr\u1ea3i nghi\u1ec7m ti\u00eau c\u1ef1c n\u00e0o khi ti\u1ebfn h\u00e0nh ph\u1ecfng v\u1ea5n v\u00e0o m\u1ed9t tu\u1ea7n sau \u0111\u00f3. N\u1ebfu kh\u00f4ng th\u1ec3 g\u00e2y m\u00ea t\u0129nh m\u1ea1ch, t\u00e1c gi\u1ea3 \u0111\u1ec1 ngh\u1ecb n\u00ean s\u1eed d\u1ee5ng k\u1ef9 thu\u1eadt
\nc\u1eeda s\u1ed5 m\u00e0o x\u01b0\u01a1ng v\u1edbi m\u0169i khoan, b\u1edfi v\u00ec k\u1ef9 thu\u1eadt n\u00e0y kh\u00f4ng \u0111\u00f2i h\u1ecfi s\u1eed d\u1ee5ng b\u00faa. N\u00f3 s\u1ebd l\u00e0m t\u0103ng s\u1ef1 tho\u1ea3i m\u00e1i cho b\u1ec7nh nh\u00e2n v\u00e0 s\u1ef1 t\u1ef1 tin cho b\u00e1c s\u0129 [5-7].<\/p>\n

M\u1ed9t trong nh\u1eefng h\u1ea1n ch\u1ebf ch\u00ednh c\u1ee7a c\u00e1c ph\u01b0\u01a1ng ph\u00e1p m\u00e0o x\u01b0\u01a1ng th\u00f4ng th\u01b0\u1eddng (\u0111\u1ee5c x\u01b0\u01a1ng) l\u00e0 ch\u00fang c\u1ea7n t\u1ed1i thi\u1ec3u 5 mm chi\u1ec1u cao x\u01b0\u01a1ng. Ng\u01b0\u1ee3c l\u1ea1i, k\u1ef9 thu\u1eadt c\u1ee7a s\u1ed5 m\u00e0o x\u01b0\u01a1ng l\u1ea1i d\u1ec5 d\u00e0ng h\u01a1n n\u1ebfu chi\u1ec1u cao x\u01b0\u01a1ng ban \u0111\u1ea7u < 5 mm [1-3, 6]. L\u00fd do t\u1ea1i sao chi\u1ec1u cao x\u01b0\u01a1ng \u00edt h\u01a1n l\u1ea1i d\u1ec5 d\u00e0ng h\u01a1n l\u00e0 v\u00ec n\u00f3 l\u00e0m t\u0103ng kh\u1ea3 n\u0103ng quan s\u00e1t v\u00e0 ti\u1ebfp c\u1eadn v\u00e0o b\u00ean trong xoang. \u0110\u00e2y l\u00e0 l\u00fd do t\u1ea1i sao t\u00e1c gi\u1ea3 l\u1ea1i \u0111\u1ec1 ngh\u1ecb s\u1eed d\u1ee5ng k\u1ef9 thu\u1eadt c\u1eeda s\u1ed5 m\u00e0o x\u01b0\u01a1ng trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p nh\u01b0 v\u1eady, \u0111\u00f3 l\u00e0 do nguy c\u01a1 g\u00e2y b\u1ec7nh v\u00e0 b\u1ea3n ch\u1ea5t “m\u00f9” li\u00ean quan \u0111\u1ebfn k\u1ef9 thu\u1eadt \u0111\u1ee5c x\u01b0\u01a1ng.<\/p>\n

M\u1ed9t y\u1ebfu t\u1ed1 quan tr\u1ecdng kh\u00e1c khi th\u1ef1c hi\u1ec7n ph\u1eabu thu\u1eadt c\u1ea5y gh\u00e9p l\u00e0 c\u1ea7n \u0111\u1ec3 l\u1ea1i \u0111\u1ee7 n\u01b0\u1edbu d\u00ednh quanh implant [1-3]. C\u1ea7n t\u1ed1i thi\u1ec3u 2 mm [8]. Nha s\u0129 c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng tr\u1ee5 l\u00e0nh th\u01b0\u01a1ng (ph\u01b0\u01a1ng ph\u00e1p m\u1ed9t th\u00ec) \u0111\u1ec3 h\u1ed7 tr\u1ee3 \u0111\u1ea1t \u0111\u01b0\u1ee3c m\u00f4 s\u1eebng ho\u00e1. Tuy nhi\u00ean, n\u1ebfu kh\u00f4ng \u0111\u1ea1t \u0111\u01b0\u1ee3c \u0111\u1ed9 \u1ed5n \u0111\u1ecbnh ban \u0111\u1ea7u t\u1ed1t (< 20 Ncm), th\u00ec n\u00ean l\u1ef1a ch\u1ecdn ph\u1eabu thu\u1eadt hai th\u00ec \u0111\u1ec3 ng\u0103n ng\u1eeba s\u1ef1 di chuy\u1ec3n c\u1ee7a implant trong giai \u0111o\u1ea1n l\u00e0nh th\u01b0\u01a1ng (4-6 th\u00e1ng). \u0110\u1ed3ng th\u1eddi, torque qu\u00e1 l\u1edbn tr\u00ean m\u1ed9t implant kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn kh\u00edch. Torque qu\u00e1 l\u1edbn c\u00f3 th\u1ec3 g\u00e2y ho\u1ea1i t\u1eed do \u00e1p l\u1ef1c, b\u1edfi v\u00ec n\u00f3 c\u00f3 th\u1ec3 h\u1ea1n ch\u1ebf s\u1ef1 c\u1ea5p m\u00e1u \u0111\u1ebfn x\u01b0\u01a1ng v\u1ecf.<\/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

1. Misch C. Maxillary sinus augmentation for endosteal implants: organized treatment plans. Int J.Oral Implantol 1987;4:49-58.<\/p>\n

2. Summers R. The osteotome technique part 3 – less invasive methods of the elevation of the sinus floor. Compendium 1994;15:698-704.<\/p>\n

3. Lee S, Lee GK, Park K, Han T. Redefining perioplastic surgery. J Implant Adv Clin Dent 2009;1(1):76-88.<\/p>\n

4. Lee SS, Karimbux N. Sinus grafting: crestal. In: KarimbuxN (ed.), Clinical Cases in Periodontics. Chchester: Wiley Blackwell; 2012, pp 255-262.<\/p>\n

5. Summers R. A new concept in maxillary implant surgery: the osteotome technique. Compendium 1994;15:152-158.<\/p>\n

6. Tatum Jr H. Maxillary and sinus implant reconstruction. Dent Clin North Am 1986;30(2):207-229.<\/p>\n

7. Boyne P, James R. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg 1980;38:613-616.<\/p>\n

8. Schrott AR, Jimenez M, Hwang JW, et al. Five-year evaluation of the influence of keratinized mucosa on peri- implant soft-tissue health and stability around implants supporting full-arch mandibular fixed prostheses. Clin Oral Implants Res 2009;20:1170-1177.<\/p>\n","protected":false},"excerpt":{"rendered":"

B\u00e0i vi\u1ebft n\u00e0y cung c\u1ea5p cho nha s\u0129 c\u00e1i nh\u00ecn t\u1ed5ng quan v\u1ec1 ph\u01b0\u01a1ng ph\u00e1p n\u00e2ng xoang k\u00edn \u0111\u1ed1i v\u1edbi ph\u1eabu thu\u1eadt Implant nha khoa, \u0111\u1ed3ng th\u1eddi ti\u1ebfn h\u00e0nh \u0111\u00e1nh gi\u00e1 nh\u1eefng l\u01b0u \u00fd trong su\u1ed1t qu\u00e1 tr\u00ecnh th\u1ee7 thu\u1eadt, \u0111\u01b0a ra nh\u1eefng gi\u1ea3i ph\u00e1p thay th\u1ebf v\u00e0 h\u1ea1n ch\u1ebf c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p n\u00e0y 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":"\nPh\u01b0\u01a1ng ph\u00e1p n\u00e2ng xoang k\u00edn trong Implant Nha khoa - G\u00f3c nh\u00ecn.<\/title>\n<meta name=\"description\" content=\"B\u00e0i vi\u1ebft n\u00e0y cung c\u1ea5p cho nha s\u0129 c\u00e1i nh\u00ecn t\u1ed5ng quan v\u1ec1 ph\u01b0\u01a1ng ph\u00e1p n\u00e2ng xoang k\u00edn \u0111\u1ed1i v\u1edbi ph\u1eabu thu\u1eadt Implant nha khoa. 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