{"id":32619,"date":"2023-05-08T05:04:24","date_gmt":"2023-05-07T22:04:24","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=32619"},"modified":"2023-05-08T16:19:45","modified_gmt":"2023-05-08T09:19:45","slug":"rang-roi-ra-ngoai-o-tre-vi-thanh-nien-phuong-an-va-bien-chung","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/08\/rang-roi-ra-ngoai-o-tre-vi-thanh-nien-phuong-an-va-bien-chung\/","title":{"rendered":"R\u0103ng r\u01a1i ra ngo\u00e0i \u1edf tr\u1ebb v\u1ecb th\u00e0nh ni\u00ean – Ph\u01b0\u01a1ng \u00e1n v\u00e0 bi\u1ebfn ch\u1ee9ng."},"content":{"rendered":"

\u0110i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn trong tr\u01b0\u1eddng h\u1ee3p r\u0103ng b\u1ecb r\u01a1i ra ngo\u00e0i l\u00e0 c\u1eafm l\u1ea1i r\u0103ng t\u1ee9c th\u00ec. Ti\u00ean l\u01b0\u1ee3ng c\u1ee7a r\u0103ng r\u01a1i ra ngo\u00e0i ch\u1ecbu \u1ea3nh h\u01b0\u1edfng tr\u1ef1c ti\u1ebfp c\u1ee7a th\u1eddi gian b\u1ea3o qu\u1ea3n ngo\u00e0i mi\u1ec7ng, c\u00e1ch b\u1ea3o qu\u1ea3n, giai \u0111o\u1ea1n ph\u00e1t tri\u1ec3n c\u1ee7a ch\u00e2n r\u0103ng, v\u00e0 tu\u1ed5i c\u1ee7a b\u1ec7nh nh\u00e2n. Ti\u00ean l\u01b0\u1ee3ng k\u00e9m h\u01a1n n\u1ebfu c\u1eafm l\u1ea1i sau h\u01a1n 5 ph\u00fat v\u00e0 ch\u00f3p r\u0103ng \u0111\u00e3 tr\u01b0\u1edfng th\u00e0nh. C\u00f9ng t\u00ecm hi\u1ec3u c\u1ee5 th\u1ec3 c\u00e1c ph\u01b0\u01a1ng \u00e1n \u0111i\u1ec1u tr\u1ecb cho t\u1eebng tr\u01b0\u1eddng h\u1ee3p v\u00e0 bi\u1ebfn ch\u1ee9ng chung c\u1ee7a th\u1ee7 thu\u1eadt n\u00e0y<\/strong><\/p>\n

\"rang-roi-ra-ngoai-1\"<\/p>\n

1. Ph\u01b0\u01a1ng \u00e1n \u0111i\u1ec1u tr\u1ecb cho tr\u01b0\u1eddng h\u1ee3p r\u0103ng r\u01a1i ra ngo\u00e0i \u1edf tr\u1ebb v\u1ecb th\u00e0nh ni\u00ean<\/h2>\n

\u0110i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn trong tr\u01b0\u1eddng h\u1ee3p r\u0103ng b\u1ecb r\u01a1i ra ngo\u00e0i l\u00e0 c\u1eafm l\u1ea1i r\u0103ng t\u1ee9c th\u00ec. Ti\u00ean l\u01b0\u1ee3ng c\u1ee7a r\u0103ng r\u01a1i ra ngo\u00e0i ch\u1ecbu \u1ea3nh h\u01b0\u1edfng tr\u1ef1c ti\u1ebfp c\u1ee7a th\u1eddi gian b\u1ea3o qu\u1ea3n ngo\u00e0i mi\u1ec7ng, c\u00e1ch b\u1ea3o qu\u1ea3n, giai \u0111o\u1ea1n ph\u00e1t tri\u1ec3n c\u1ee7a ch\u00e2n r\u0103ng, v\u00e0 tu\u1ed5i c\u1ee7a b\u1ec7nh nh\u00e2n [2]. Ti\u00ean l\u01b0\u1ee3ng k\u00e9m h\u01a1n n\u1ebfu c\u1eafm l\u1ea1i sau h\u01a1n 5 ph\u00fat v\u00e0 ch\u00f3p r\u0103ng \u0111\u00e3 tr\u01b0\u1edfng th\u00e0nh [3-5].<\/p>\n

\u1ede b\u1ec7nh nh\u00e2n v\u1ecb th\u00e0nh ni\u00ean c\u00f3 r\u0103ng r\u01a1i ra ngo\u00e0i \u0111\u00e3 \u0111\u00f3ng ch\u00f3p, th\u00ec c\u1eafm l\u1ea1i nh\u1eefng r\u0103ng n\u00e0y \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh khi th\u1eddi gian b\u1ea3o qu\u1ea3n ngo\u00e0i mi\u1ec7ng d\u01b0\u1edbi 60 ph\u00fat v\u00e0 r\u0103ng \u0111\u01b0\u1ee3c gi\u1eef trong dung d\u1ecbch mu\u1ed1i \u0111\u1ec7m Hanks, s\u1eefa, n\u01b0\u1edbc mu\u1ed1i, ho\u1eb7c n\u01b0\u1edbc b\u1ecdt. \u0110\u1ec3 gi\u1ea3m nguy c\u01a1 c\u1ee9ng kh\u1edbp, n\u00ean n\u1eb9p r\u0103ng b\u1ecb r\u01a1i ra ngo\u00e0i v\u00e0o c\u00e1c r\u0103ng l\u00e0nh m\u1ea1nh b\u00ean c\u1ea1nh trong kh\u00f4ng qu\u00e1 2 tu\u1ea7n [6, 7]. \u0110i\u1ec1u tr\u1ecb n\u1ed9i nha ban \u0111\u1ea7u n\u00ean b\u1eaft \u0111\u1ea7u trong v\u00f2ng 7-10 ng\u00e0y sau khi c\u1eafm l\u1ea1i r\u0103ng v\u00e0 tr\u01b0\u1edbc khi th\u00e1o n\u1eb9p [2]. N\u00ean \u0111\u1eb7t calcium hydroxide trong \u1ed1ng t\u1ee7y \u0111\u1ec3 t\u1ea1o m\u00f4i tr\u01b0\u1eddng ki\u1ec1m, nh\u1eb1m \u1ee9c ch\u1ebf s\u1ef1 t\u0103ng tr\u01b0\u1edfng vi khu\u1ea9n v\u00e0 gi\u1ea3m nguy c\u01a1 ti\u00eau ch\u00e2n r\u0103ng.<\/p>\n

Khi th\u1eddi gian b\u1ea3o qu\u1ea3n ngo\u00e0i mi\u1ec7ng qu\u00e1 60 ph\u00fat th\u00ec c\u1eafm l\u1ea1i r\u0103ng th\u01b0\u1eddng kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh. Trong nh\u1eefng t\u00ecnh hu\u1ed1ng nh\u01b0 v\u1eady, m\u00e3o tr\u00ean implant l\u00e0 \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn n\u1ebfu t\u0103ng tr\u01b0\u1edfng x\u01b0\u01a1ng \u0111\u00e3 ho\u00e0n t\u1ea5t. Tuy nhi\u00ean, \u1edf tr\u1ebb em v\u00e0 tr\u1ebb v\u1ecb th\u00e0nh ni\u00ean, c\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n c\u1eafm l\u1ea1i r\u0103ng tr\u1ec5 \u0111\u1ec3 gi\u1eef kho\u1ea3ng v\u00e0 b\u1ea3o t\u1ed3n k\u00edch th\u01b0\u1edbc s\u1ed1ng h\u00e0m cho \u0111i\u1ec1u tr\u1ecb c\u1ea5y gh\u00e9p sau n\u00e0y. Trong tr\u01b0\u1eddng h\u1ee3p th\u1eddi gian ch\u1edd gi\u1eefa th\u1eddi \u0111i\u1ec3m nh\u1ed5 r\u0103ng v\u1edbi \u0111\u1eb7t implant d\u00e0i do ch\u01b0a ho\u00e0n t\u1ea5t t\u0103ng tr\u01b0\u1edfng x\u01b0\u01a1ng, th\u00ec n\u00ean c\u1eaft b\u1ecf th\u00e2n r\u0103ng v\u00e0 gi\u1eef l\u1ea1i ch\u00e2n r\u0103ng trong x\u01b0\u01a1ng \u1ed5 \u0111\u1ec3 duy tr\u00ec th\u1ec3 t\u00edch x\u01b0\u01a1ng cho implant t\u01b0\u01a1ng lai. Tuy nhi\u00ean, n\u1ebfu ch\u00e2n r\u0103ng b\u1ecb nhi\u1ec5m tr\u00f9ng, th\u00ec gi\u1eef l\u1ea1i ch\u00e2n r\u0103ng l\u00e0 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh. Trong tr\u01b0\u1eddng h\u1ee3p \u0111\u00f3, n\u00ean th\u1ef1c hi\u1ec7n b\u1ea3o t\u1ed3n s\u1ed1ng h\u00e0m t\u1ea1i th\u1eddi \u0111i\u1ec3m nh\u1ed5 r\u0103ng \u0111\u1ec3 duy tr\u00ec k\u00edch th\u01b0\u1edbc s\u1ed1ng h\u00e0m.<\/p>\n

2. Bi\u1ebfn ch\u1ee9ng c\u1ee7a th\u1ee7 thu\u1eadt n\u00e0y<\/h2>\n

Sau khi c\u1eafm l\u1ea1i r\u0103ng b\u1ecb r\u01a1i ra ngo\u00e0i, c\u00f3 th\u1ec3 x\u1ea3y ra m\u1ed9t s\u1ed1 hi\u1ec7n t\u01b0\u1ee3ng. Th\u00f4ng th\u01b0\u1eddng, r\u0103ng b\u1ecb r\u01a1i ra ngo\u00e0i c\u00f3 ti\u00ean l\u01b0\u1ee3ng d\u00e0i h\u1ea1n k\u00e9m n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c c\u1eafm l\u1ea1i l\u1eadp t\u1ee9c. Ng\u01b0\u1eddi ta nh\u1eadn th\u1ea5y ti\u00eau ch\u00e2n r\u0103ng x\u1ea3y ra trong 95% tr\u01b0\u1eddng h\u1ee3p c\u1eafm l\u1ea1i r\u0103ng sau h\u01a1n 2 gi\u1edd [8]. Ti\u00eau ch\u00e2n r\u0103ng sau khi c\u1eafm l\u1ea1i c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c chia th\u00e0nh ngo\u1ea1i ti\u00eau ch\u00e2n r\u0103ng vi\u00eam v\u00e0 ngo\u1ea1i ti\u00eau ch\u00e2n r\u0103ng thay th\u1ebf (c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 c\u1ee9ng kh\u1edbp).<\/p>\n

Ngo\u1ea1i ti\u00eau ch\u00e2n r\u0103ng vi\u00eam th\u01b0\u1eddng \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n tr\u00ean phim X-quang trong v\u00f2ng 6 th\u00e1ng sau khi c\u1eafm l\u1ea1i. Ti\u00eau ch\u00e2n r\u0103ng vi\u00eam l\u00e0 do t\u1ed5n th\u01b0\u01a1ng x\u00ea m\u0103ng sau ch\u1ea5n th\u01b0\u01a1ng. N\u00f3 x\u1ea3y ra l\u00e0 do qu\u00e1 tr\u00ecnh vi\u00eam \u1edf m\u00f4 quanh ch\u00f3p nh\u1eb1m \u0111\u00e1p \u1ee9ng v\u1edbi s\u1ef1 x\u00e2m nh\u1eadp c\u1ee7a vi khu\u1ea9n v\u00e0 s\u1ea3n ph\u1ea9m g\u00e2y \u0111\u1ed9c t\u1eeb t\u1ee7y ho\u1ea1i t\u1eed nhi\u1ec5m tr\u00f9ng v\u00e0o b\u1ec1 m\u1eb7t ch\u00e2n r\u0103ng [9]. Qu\u00e1 tr\u00ecnh vi\u00eam n\u00e0y c\u00f3 th\u1ec3 g\u00e2y ti\u00eau ch\u00e2n r\u0103ng ti\u1ebfn tri\u1ec3n n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c gi\u1ea3i quy\u1ebft. Ngo\u1ea1i ti\u00eau ch\u00e2n r\u0103ng vi\u00eam c\u00f3 th\u1ec3 ng\u01b0ng l\u1ea1i b\u1eb1ng c\u00e1ch lo\u1ea1i b\u1ecf k\u00edch th\u00edch vi khu\u1ea9n t\u1eeb \u1ed1ng ng\u00e0 v\u00e0 \u0111\u1eb7t calcium hydroxide trong \u1ed1ng t\u1ee7y trong 6-24 th\u00e1ng.<\/p>\n

Ngo\u1ea1i ti\u00eau ch\u00e2n r\u0103ng thay th\u1ebf s\u1ebd thay th\u1ebf m\u00f4 r\u0103ng d\u1ea7n d\u1ea7n b\u1eb1ng x\u01b0\u01a1ng. Ti\u00eau ch\u00e2n r\u0103ng d\u1ea1ng n\u00e0y th\u01b0\u1eddng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n tr\u00ean l\u00e2m s\u00e0ng l\u00e0 r\u0103ng kh\u00f4ng di \u0111\u1ed9ng v\u00e0 g\u00f5 c\u00f3 ti\u1ebfng kim lo\u1ea1i [1]. N\u00f3 x\u1ea3y ra l\u00e0 do ch\u1ea5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng nha chu n\u1eb7ng. Trong nh\u1eefng t\u00ecnh hu\u1ed1ng nh\u01b0 v\u1eady, t\u1ebf b\u00e0o t\u1eeb x\u01b0\u01a1ng \u1ed5 r\u0103ng s\u1ebd ph\u1ee5c h\u1ed3i tr\u00ean b\u1ec1 m\u1eb7t ch\u00e2n r\u0103ng b\u1ecb l\u1ed9 v\u00e0 thay th\u1ebf d\u00e2y ch\u1eb1ng nha chu b\u1eb1ng m\u00f4 x\u01b0\u01a1ng, g\u00e2y c\u1ee9ng kh\u1edbp r\u0103ng-x\u01b0\u01a1ng \u1ed5 r\u0103ng. Ti\u00eau ch\u00e2n r\u0103ng thay th\u1ebf \u1edf tr\u1ebb em \u0111ang t\u0103ng tr\u01b0\u1edfng l\u00e0 m\u1ed9t m\u1ed1i lo ng\u1ea1i do gi\u1ea3m s\u1ef1 t\u0103ng tr\u01b0\u1edfng x\u01b0\u01a1ng \u1ed5 v\u00e0 g\u00e2y khi\u1ebfm khuy\u1ebft \u0111\u00e1ng k\u1ec3.<\/p>\n

M\u1eb7c d\u00f9 nhi\u1ec1u tr\u01b0\u1eddng h\u1ee3p c\u00f3 th\u1ec3 c\u1eafm l\u1ea1i r\u0103ng th\u00e0nh c\u00f4ng, nh\u01b0ng v\u1eabn c\u00f3 m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, c\u00e1c bi\u1ebfn ch\u1ee9ng sau ch\u1ea5n th\u01b0\u01a1ng cu\u1ed1i c\u00f9ng s\u1ebd \u0111\u01b0a \u0111\u1ebfn vi\u1ec7c ph\u1ea3i nh\u1ed5 r\u0103ng ho\u1eb7c c\u1eaft b\u1ecf th\u00e2n r\u0103ng v\u00e0 gi\u1eef l\u1ea1i ch\u00e2n r\u0103ng trong x\u01b0\u01a1ng \u1ed5 \u0111\u1ec3 duy tr\u00ec th\u1ec3 t\u00edch x\u01b0\u01a1ng cho \u0111i\u1ec1u tr\u1ecb c\u1ea5y gh\u00e9p trong t\u01b0\u01a1ng lai.<\/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. Block MS, Casadaban MC. Implant restoration of external resorption teeth in the esthetic zone. J Oral Maxillofac Surg 2005;63(11):1653-1661.<\/p>\n

2. Andersson L, Andreasen JO, Day P, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dent Traumatol 2012;28(2):88-96.<\/p>\n

3. Heithersay GS. Replantation of avulsed teeth. A review. Aust Dent J 1975;20(2):63-72.<\/p>\n

4. Andreasen JO, Borum MK, Jacobsen HL, Andreasen FM. Replantation of 400 avulsed permanent incisors. 2. Factors related to pulpal healing. Endod Dent Traumatol 1995;11(2):59-68.<\/p>\n

5. Flores MT, Andersson L, Andreasen JO, et al. Guidelines for the management of traumatic dental injuries. II. Avulsion of permanent teeth. Dent Traumatol 2007;23(3):130-136.<\/p>\n

6. Nasjleti CE, Castelli WA, Caffesse RG. The effects of different splinting times on replantation of teeth in monkeys. Oral Surg Oral Med Oral Pathol 1982;53(6):557-566.<\/p>\n

7. Kahler B, Heithersay GS. An evidence-based appraisal of splinting luxated, avulsed and root-fractured teeth. Dent Traumatol 2008;24(1):2-10.<\/p>\n

8. Andreasen JO, Hjorting-Hansen E. Replantation of teeth. 1. Radiographic and clinical study of 110 human teeth replanted after accidental loss. Acta Odontol Scand 1966;24(3):263\u2013286.<\/p>\n","protected":false},"excerpt":{"rendered":"

\u0110i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn trong tr\u01b0\u1eddng h\u1ee3p r\u0103ng b\u1ecb r\u01a1i ra ngo\u00e0i l\u00e0 c\u1eafm l\u1ea1i r\u0103ng t\u1ee9c th\u00ec. Ti\u00ean l\u01b0\u1ee3ng c\u1ee7a r\u0103ng r\u01a1i ra ngo\u00e0i ch\u1ecbu \u1ea3nh h\u01b0\u1edfng tr\u1ef1c ti\u1ebfp c\u1ee7a th\u1eddi gian b\u1ea3o qu\u1ea3n ngo\u00e0i mi\u1ec7ng, c\u00e1ch b\u1ea3o qu\u1ea3n, giai \u0111o\u1ea1n ph\u00e1t tri\u1ec3n c\u1ee7a ch\u00e2n r\u0103ng, v\u00e0 tu\u1ed5i c\u1ee7a b\u1ec7nh nh\u00e2n. Ti\u00ean l\u01b0\u1ee3ng […]<\/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":"\nR\u0103ng r\u01a1i ra ngo\u00e0i \u1edf tr\u1ebb v\u1ecb th\u00e0nh ni\u00ean - Ph\u01b0\u01a1ng \u00e1n v\u00e0 bi\u1ebfn ch\u1ee9ng.<\/title>\n<meta name=\"description\" content=\"C\u00f9ng t\u00ecm hi\u1ec3u c\u1ee5 th\u1ec3 c\u00e1c ph\u01b0\u01a1ng \u00e1n \u0111i\u1ec1u tr\u1ecb cho t\u1eebng tr\u01b0\u1eddng h\u1ee3p v\u00e0 bi\u1ebfn ch\u1ee9ng chung c\u1ee7a th\u1ee7 thu\u1eadt x\u1eed tr\u00ed r\u0103ng r\u01a1i ra ngo\u00e0i\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"R\u0103ng r\u01a1i ra ngo\u00e0i \u1edf tr\u1ebb v\u1ecb th\u00e0nh ni\u00ean - 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