{"id":32462,"date":"2023-05-07T11:39:42","date_gmt":"2023-05-07T04:39:42","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=32462"},"modified":"2023-05-07T12:49:09","modified_gmt":"2023-05-07T05:49:09","slug":"thieu-rang-bam-sinh-chi-dinh-implant-ket-hop-chinh-nha","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/07\/thieu-rang-bam-sinh-chi-dinh-implant-ket-hop-chinh-nha\/","title":{"rendered":"Thi\u1ebfu r\u0103ng b\u1ea9m sinh – Ch\u1ec9 \u0111\u1ecbnh Implant k\u1ebft h\u1ee3p ch\u1ec9nh nha."},"content":{"rendered":"

Thi\u1ebfu b\u1ea9m sinh c\u00e1c r\u0103ng c\u1eeda b\u00ean l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng thi\u1ebfu r\u0103ng v\u0129nh vi\u1ec5n th\u01b0\u1eddng g\u1eb7p. T\u1ef7 l\u1ec7 thay \u0111\u1ed5i gi\u1eefa c\u00e1c d\u00e2n t\u1ed9c kh\u00e1c nhau nh\u01b0ng \u0111\u01b0\u1ee3c \u01b0\u1edbc t\u00ednh l\u00e0 kho\u1ea3ng 1-2%. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb bao g\u1ed3m h\u00e0m gi\u1ea3 th\u00e1o l\u1eafp b\u00e1n ph\u1ea7n, c\u1ea7u r\u0103ng th\u00f4ng th\u01b0\u1eddng, c\u1ea7u r\u0103ng d\u00e1n, c\u1ea5y chuy\u1ec3n r\u0103ng, thay th\u1ebf b\u1eb1ng r\u0103ng nanh, v\u00e0 m\u00e3o \u0111\u01a1n l\u1ebb tr\u00ean implant. C\u00f9ng t\u00ecm hi\u1ec3u ch\u1ec9 \u0111\u1ecbnh c\u1ee7a v\u1ea5n \u0111\u1ec1 n\u00e0y trong tr\u01b0\u1eddng h\u1ee3p k\u1ebft h\u1ee3p v\u1edbi chuy\u00ean ng\u00e0nh Implant v\u00e0 ch\u1ec9nh nha.<\/strong><\/p>\n

1. Kh\u00e1i qu\u00e1t v\u1ec1 v\u1ea5n \u0111\u1ec1 thi\u1ebfu r\u0103ng b\u1ea9m sinh v\u00e0 ch\u1ec9 \u0111\u1ecbnh<\/h2>\n

Thi\u1ebfu b\u1ea9m sinh c\u00e1c r\u0103ng c\u1eeda b\u00ean l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng thi\u1ebfu r\u0103ng v\u0129nh vi\u1ec5n th\u01b0\u1eddng g\u1eb7p. T\u1ef7 l\u1ec7 thay \u0111\u1ed5i gi\u1eefa c\u00e1c d\u00e2n t\u1ed9c kh\u00e1c nhau nh\u01b0ng \u0111\u01b0\u1ee3c \u01b0\u1edbc t\u00ednh l\u00e0 kho\u1ea3ng 1-2% [1]. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb bao g\u1ed3m h\u00e0m gi\u1ea3 th\u00e1o l\u1eafp b\u00e1n ph\u1ea7n, c\u1ea7u r\u0103ng th\u00f4ng th\u01b0\u1eddng, c\u1ea7u r\u0103ng d\u00e1n, c\u1ea5y chuy\u1ec3n r\u0103ng, thay th\u1ebf b\u1eb1ng r\u0103ng nanh, v\u00e0 m\u00e3o \u0111\u01a1n l\u1ebb tr\u00ean implant. Nh\u1eefng \u01b0u \u0111i\u1ec3m v\u00e0 nh\u01b0\u1ee3c \u0111i\u1ec3m c\u1ee7a c\u00e1c ph\u01b0\u01a1ng ph\u00e1p n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e0n lu\u1eadn r\u1ed9ng r\u00e3i trong y v\u0103n [2-4]. C\u00f3 m\u1ed9t cu\u1ed9c tranh lu\u1eadn trong c\u00e1c t\u00e0i li\u1ec7u ch\u1ec9nh nha v\u1ec1 vi\u1ec7c n\u00ean \u0111\u00f3ng kho\u1ea3ng b\u1eb1ng r\u0103ng nanh hay t\u1ea1o kho\u1ea3ng k\u1ebft h\u1ee3p v\u1edbi ph\u1ee5c h\u00ecnh c\u1ed1 \u0111\u1ecbnh \u0111\u1ec3 \u0111em l\u1ea1i k\u1ebft qu\u1ea3 l\u00e2m s\u00e0ng t\u1ed1t nh\u1ea5t [5, 6]. V\u1edbi s\u1ef1 t\u00edch h\u1ee3p \u0111i\u1ec1u tr\u1ecb c\u1ea5y gh\u00e9p v\u00e0o k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb, ph\u1ee5c h\u00ecnh tr\u00ean implant c\u00f9ng v\u1edbi ph\u01b0\u01a1ng ph\u00e1p li\u00ean chuy\u00ean khoa c\u00f3 th\u1ec3 \u0111em l\u1ea1i k\u1ebft qu\u1ea3 th\u1ea9m m\u1ef9 ti\u00ean l\u01b0\u1ee3ng v\u00e0 l\u00fd t\u01b0\u1edfng [7-9]. Tr\u01b0\u1eddng h\u1ee3p n\u00e0y tr\u00ecnh b\u00e0y \u0111i\u1ec1u tr\u1ecb li\u00ean chuy\u00ean khoa v\u00e0 ki\u1ec3m so\u00e1t c\u00e1c bi\u1ebfn ch\u1ee9ng \u1edf b\u1ec7nh nh\u00e2n b\u1ecb thi\u1ebfu c\u00e1c r\u0103ng c\u1eeda b\u00ean b\u1ea9m sinh.<\/p>\n

Ba v\u1ea5n \u0111\u1ec1 ch\u00ednh trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb tr\u01b0\u1eddng h\u1ee3p thi\u1ebfu r\u0103ng b\u1ea9m sinh r\u0103ng c\u1eeda b\u00ean:<\/p>\n

    \n
  1. Th\u1eddi \u0111i\u1ec3m \u0111\u1eb7t implant;<\/li>\n
  2. Kh\u00f4ng \u0111\u1ee7 kho\u1ea3ng v\u00e0 m\u00f4 c\u1ee9ng cho v\u1ecb tr\u00ed c\u1ea5y gh\u00e9p;<\/li>\n
  3. Ki\u1ec3m so\u00e1t c\u00e1c bi\u1ebfn ch\u1ee9ng c\u1ee7a \u0111i\u1ec1u tr\u1ecb ch\u1ec9nh nha.<\/li>\n<\/ol>\n

    N\u00ean tr\u00ec ho\u00e3n vi\u1ec7c \u0111\u1eb7t implant \u1edf tr\u1ebb v\u1ecb th\u00e0nh ni\u00ean cho \u0111\u1ebfn khi ch\u1ea5m d\u1ee9t t\u0103ng tr\u01b0\u1edfng x\u01b0\u01a1ng. M\u1ed9t trong nh\u1eefng h\u1eadu qu\u1ea3 kh\u00f4ng ho\u00e0n nguy\u00ean c\u1ee7a vi\u1ec7c \u0111\u1eb7t implant s\u1edbm l\u00e0 m\u00e3o tr\u00ean implant b\u1ecb s\u1ee5p kh\u1edbp c\u1eafn v\u00e0 kh\u00f4ng th\u1ef1c ch\u1ee9c n\u0103ng, t\u1eeb \u0111\u00f3 g\u00e2y ra c\u00e1c bi\u1ebfn ch\u1ee9ng ch\u1ee9c n\u0103ng v\u00e0 th\u1ea9m m\u1ef9. K\u1ebft qu\u1ea3 quan s\u00e1t cho th\u1ea5y b\u1ec7nh nh\u00e2n n\u00e0y \u0111\u00e3 ho\u00e0n to\u00e0n k\u1ebft th\u00fac t\u0103ng tr\u01b0\u1edfng t\u1ea1i th\u1eddi \u0111i\u1ec3m \u0111\u1eb7t implant.<\/p>\n

    2. Nguy c\u01a1 thi\u1ebfu x\u01b0\u01a1ng \u1ed5 r\u0103ng<\/h2>\n

    M\u1ed9t v\u1ea5n \u0111\u1ec1 n\u1eefa khi \u0111\u1eb7t implant \u0111\u1ec3 thay th\u1ebf c\u00e1c r\u0103ng c\u1ee7a b\u00ean b\u1ecb thi\u1ebfu l\u00e0 nguy c\u01a1 thi\u1ebfu x\u01b0\u01a1ng \u1ed5 r\u0103ng. Ng\u01b0\u1eddi ta nh\u1eadn th\u1ea5y sau khi di xa r\u0103ng nanh \u0111\u1ec3 t\u1ea1o kho\u1ea3ng, chi\u1ec1u r\u1ed9ng x\u01b0\u01a1ng \u1ed5 r\u0103ng gi\u1ea3m trung b\u00ecnh t\u1eeb 17% \u0111\u1ebfn 25% c\u00f9ng v\u1edbi chi\u1ec1u cao s\u1ed1ng h\u00e0m, khi\u1ebfn l\u00f5m m\u1eb7t ngo\u00e0i l\u1edbn h\u01a1n [10]. Quan s\u00e1t t\u01b0\u01a1ng t\u1ef1 c\u0169ng \u0111\u01b0\u1ee3c ghi nh\u1eadn trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y, trong \u0111\u00f3 v\u00f9ng m\u1ea5t r\u0103ng c\u00f3 chi\u1ec1u r\u1ed9ng x\u01b0\u01a1ng \u1ed5 r\u0103ng gi\u1edbi h\u1ea1n v\u00e0 l\u00f5m m\u1eb7t ngo\u00e0i l\u1edbn sau \u0111i\u1ec1u tr\u1ecb ch\u1ec9nh nha. Do \u0111\u00f3, ph\u1eabu thu\u1eadt t\u0103ng s\u1ed1ng h\u00e0m \u0111\u00e3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ed3ng th\u1eddi v\u1edbi \u0111\u1eb7t implant \u0111\u1ec3 t\u0103ng s\u1ed1ng h\u00e0m b\u1ecb thi\u1ebfu h\u1ee5t. Nghi\u00ean c\u1ee9u CBCT cho th\u1ea5y khi\u1ebfm khuy\u1ebft c\u1eeda s\u1ed5 l\u00e0 kh\u00e1 ph\u1ed5 bi\u1ebfn (kho\u1ea3ng 20%) n\u1ebfu \u0111\u1eb7t implant theo v\u1ecb tr\u00ed cingulum c\u1ee7a ph\u1ee5c h\u00ecnh \u1edf c\u00e1c r\u0103ng c\u1ee7a h\u00e0m tr\u00ean [11].<\/p>\n

    \"thieu-rang-bam-sinh-1\"
    \u0110\u1ea1t \u0111\u01b0\u1ee3c k\u1ebft qu\u1ea3 th\u1ea9m m\u1ef9 mong mu\u1ed1n sau khi g\u1eafn ph\u1ee5c h\u00ecnh sau c\u00f9ng. (A) Thi\u1ebft k\u1ebf \u0111\u1ed9 c\u1eafn ch\u00eca v\u00e0 c\u1eafn ph\u1ee7 t\u1ed1i thi\u1ec3u c\u00f9ng v\u1edbi l\u00e0m m\u00e1ng nhai \u0111\u1ec3 ki\u1ec3m so\u00e1t ch\u1ea5n th\u01b0\u01a1ng kh\u1edbp c\u1eafn. (B) Phim quanh ch\u00f3p cho th\u1ea5y s\u1ef1 t\u00e1i c\u1ea5u tr\u00fac m\u00e0o x\u01b0\u01a1ng \u1ed5n \u0111\u1ecbnh sau khi t\u1ea3i l\u1ef1c ch\u1ee9c n\u0103ng.<\/figcaption><\/figure>\n

    V\u00ed d\u1ee5 trong tr\u01b0\u1eddng n\u00e0y, kh\u00f4ng ph\u00e1t hi\u1ec7n khi\u1ebfm khuy\u1ebft c\u1eeda s\u1ed5 tr\u00ean l\u00e2m s\u00e0ng, bi\u1ebfn ch\u1ee9ng c\u1ee7a \u0111i\u1ec1u tr\u1ecb ch\u1ec9nh nha l\u00e0 ti\u00eau ch\u00e2n r\u0103ng nghi\u00eam tr\u1ecdng, \u0111\u1eb7c bi\u1ec7t l\u00e0 hai r\u0103ng c\u1eeda gi\u1eefa. M\u1eb7c d\u00f9 \u0111\u1ed9 lung lay l\u00e2m s\u00e0ng kh\u00f4ng t\u01b0\u01a1ng quan tuy\u1ebfn t\u00ednh v\u1edbi t\u1ef7 l\u1ec7 th\u00e2n\/ch\u00e2n k\u00e9m, nh\u01b0ng ti\u00ean l\u01b0\u1ee3ng c\u1ee7a c\u00e1c r\u0103ng l\u00e0 d\u00e8 d\u1eb7t. Ph\u01b0\u01a1ng \u00e1n thay th\u1ebf c\u00f3 th\u1ec3 l\u00e0 nh\u1ed5 hai r\u0103ng c\u1eeda gi\u1eefa v\u00e0 l\u00e0m c\u1ea7u r\u0103ng 4 \u0111\u01a1n v\u1ecb tr\u00ean 2 implant \u0111\u1ec3 \u0111\u1ea1t k\u1ebft qu\u1ea3 l\u00e2u d\u00e0i v\u00e0 \u1ed5n \u0111\u1ecbnh h\u01a1n. Quy\u1ebft \u0111\u1ecbnh sau c\u00f9ng d\u1ef1a tr\u00ean \u00fd ki\u1ebfn c\u1ee7a b\u1ec7nh nh\u00e2n \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u01b0a ra sau khi t\u01b0 v\u1ea5n chi ti\u1ebft cho b\u1ec7nh nh\u00e2n v\u00e0 ph\u1ee5 huynh. K\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb sau c\u00f9ng \u0111\u01b0\u1ee3c thay \u0111\u1ed5i l\u00e0 s\u1eed d\u1ee5ng m\u00e1ng b\u1ea3o v\u1ec7 ban \u0111\u00eam v\u00e0 thi\u1ebft k\u1ebf kh\u1edbp c\u1eafn b\u1ea3o v\u1ec7 \u0111\u1ec3 tr\u00e1nh l\u1ef1c nhai qu\u00e1 m\u1ee9c l\u00ean c\u00e1c r\u0103ng c\u1eeda gi\u1eefa. \u0110i\u1ec1u quan tr\u1ecdng l\u00e0 ph\u1ea3i trao \u0111\u1ed5i v\u1edbi b\u1ec7nh nh\u00e2n v\u1ec1 nh\u1eefng bi\u1ebfn ch\u1ee9ng nguy c\u01a1, v\u00e0 tr\u00ecnh b\u00e0y ph\u01b0\u01a1ng \u00e1n \u0111i\u1ec1u tr\u1ecb thay th\u1ebf cho b\u1ec7nh nh\u00e2n n\u1ebfu x\u1ea3y ra bi\u1ebfn ch\u1ee9ng. Lo\u1ea1t ca b\u00e1o c\u00e1o v\u1ec1 vi\u1ec7c gi\u1eef l\u1ea1i c\u00e1c r\u0103ng c\u1eeda h\u00e0m tr\u00ean b\u1ecb ti\u00eau ch\u00e2n r\u0103ng nghi\u00eam tr\u1ecdng trong th\u1eddi gian theo d\u00f5i d\u00e0i h\u1ea1n \u0111\u00e3 \u0111\u01b0\u1ee3c tr\u00ecnh b\u00e0y b\u1edfi Savage v\u00e0 Kokich [12]. Trong lo\u1ea1t ca \u0111\u00f3, thi\u1ebft k\u1ebf kh\u1edbp c\u1eafn b\u1ea3o v\u1ec7, n\u1eb9p d\u00e2y m\u1eb7t trong, v\u00e0 theo d\u00f5i ch\u1eb7t ch\u1ebd d\u01b0\u1eddng nh\u01b0 l\u00e0 ch\u00eca kh\u00f3a cho s\u1ef1 th\u00e0nh c\u00f4ng.<\/p>\n

    T\u00f3m l\u1ea1i, b\u00e0i vi\u1ebft n\u00e0y tr\u00ecnh b\u00e0y m\u1ed9t s\u1ed1 v\u1ea5n \u0111\u1ec1 n\u1ed5i b\u1eadt v\u1ec1 vi\u1ec7c t\u00edch h\u1ee3p \u0111i\u1ec1u tr\u1ecb c\u1ea5y gh\u00e9p \u1edf b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb ch\u1ec9nh nha. \u0110\u1ed9i ng\u0169 \u0111a chuy\u00ean khoa ph\u1ed1i h\u1ee3p t\u1ed1t l\u00e0 r\u1ea5t quan tr\u1ecdng cho vi\u1ec7c ki\u1ec3m so\u00e1t nh\u1eefng t\u00ecnh hu\u1ed1ng nh\u01b0 v\u1eady.<\/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. Polder BJ, van’t Hof MA, van der Linden FP, Kuijpers- Jagtman AM. A meta-analysis of the prevalence of dental agenesis of permanent teeth. Community Dent Oral Epidemiol 2004;32:217-226.<\/p>\n

    2. Kinzer GA, Kokich Jr VO. Managing congenitally missing lateral incisors. Part I: canine substitution. J Esthet Restor Dent 2005;17:5-10.<\/p>\n

    3. Kinzer GA, Kokich Jr VO. Managing congenitally missing lateral incisors. Part II: tooth-supported restorations. J Esthet Restor Dent 2005;17:76-84.<\/p>\n

    4. Kinzer GA, Kokich Jr VO. Managing congenitally missing lateral incisors. Part III: single-tooth implants. J Esthet Restor Dent 2005;17:202-210.<\/p>\n

    5. Zachrisson BU, Rosa M, Toreskog S. Congenitally missing maxillary lateral incisors: canine substitution. Point. Am J Orthod Dentofacial Orthop 2011;139:434, 436, 438.<\/p>\n

    6. Kokich JrVO, Kinzer GA, Janakievski J. Congenitally missing maxillary lateral incisors: restorative replacement. Counterpoint. Am J Orthod Dentofacial Orthop 2011;139:435, 437, 439.<\/p>\n

    7. Kokich VG. Maxillary lateral incisor implants: planning with the aid of orthodontics. J Oral Maxillofac Surg
    \n2004;62:48-56.<\/p>\n

    8. Spear FM, Kokich VG. A multidisciplinary approach to esthetic dentistry. Dent Clin North Am 2007;51(2):487-505.<\/p>\n

    9. De Avila \u00c9D, de Molon RS, de Assis Mollo Jr F, et al. Multidisciplinary approach for the aesthetic treatment of maxillary lateral incisors agenesis: thinking about implants? Oral Surg Oral Med Oral Pathol Oral Radiol 2012;114(5):e22-e28.<\/p>\n

    10. Uribe F, Padala S, Allareddy V, Nanda R. Cone-beam computed tomography evaluation of alveolar ridge width and height changes after orthodontic space opening in patients with congenitally missing maxillary lateral incisors. Am J Orthod Dentofacial Orthop 2013;144(6):848-859.<\/p>\n

    11. Chan HL, Garaicoa-Pazmino C, Suarez F, et al. Incidence of implant buccal plate fenestration in the esthetic zone: a cone beam computed tomography study. Int J Oral Maxillofac Implants 2014;29(1):171-177.<\/p>\n

    12. Savage RR, Kokich Sr VG. Restoration and retention of maxillary anteriors with severe root resorption. J Am Dent Assoc 2002;133(1):67-71.<\/p>\n","protected":false},"excerpt":{"rendered":"

    Thi\u1ebfu b\u1ea9m sinh c\u00e1c r\u0103ng c\u1eeda b\u00ean l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng thi\u1ebfu r\u0103ng v\u0129nh vi\u1ec5n th\u01b0\u1eddng g\u1eb7p. T\u1ef7 l\u1ec7 thay \u0111\u1ed5i gi\u1eefa c\u00e1c d\u00e2n t\u1ed9c kh\u00e1c nhau nh\u01b0ng \u0111\u01b0\u1ee3c \u01b0\u1edbc t\u00ednh l\u00e0 kho\u1ea3ng 1-2%. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb bao g\u1ed3m h\u00e0m gi\u1ea3 th\u00e1o l\u1eafp b\u00e1n ph\u1ea7n, c\u1ea7u r\u0103ng th\u00f4ng th\u01b0\u1eddng, c\u1ea7u r\u0103ng d\u00e1n, c\u1ea5y […]<\/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":"\nThi\u1ebfu r\u0103ng b\u1ea9m sinh - Ch\u1ec9 \u0111\u1ecbnh Implant k\u1ebft h\u1ee3p ch\u1ec9nh nha. - Vinmec<\/title>\n<meta name=\"description\" content=\"Thi\u1ebfu b\u1ea9m sinh c\u00e1c r\u0103ng l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng thi\u1ebfu r\u0103ng v\u0129nh vi\u1ec5n th\u01b0\u1eddng g\u1eb7p. 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