{"id":32805,"date":"2023-05-09T06:57:45","date_gmt":"2023-05-08T23:57:45","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=32805"},"modified":"2023-05-09T13:25:28","modified_gmt":"2023-05-09T06:25:28","slug":"thuoc-tai-cho-trong-viem-quanh-implant-nhin-nhan","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/09\/thuoc-tai-cho-trong-viem-quanh-implant-nhin-nhan\/","title":{"rendered":"Thu\u1ed1c t\u1ea1i ch\u1ed7 trong vi\u00eam quanh Implant – Nh\u00ecn nh\u1eadn."},"content":{"rendered":"

B\u1ec7nh nh\u00e2n c\u00f3 implant \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n b\u1ec7nh l\u00fd quanh implant c\u00f3 th\u1ec3 l\u00e0 \u1ee9ng vi\u00ean t\u1ed1t cho li\u1ec7u ph\u00e1p t\u00e1c nh\u00e2n thu\u1ed1c t\u1ea1i ch\u1ed7. B\u1ec7nh l\u00fd quanh implant l\u00e0 do m\u00e0ng sinh h\u1ecdc vi khu\u1ea9n b\u00e1m l\u00ean ph\u1ee5c h\u00ecnh tr\u00ean implant ho\u1eb7c abutment, v\u00e0 do \u0111\u00f3, s\u1ef1 k\u1ebft h\u1ee3p gi\u1eefa l\u00e0m s\u1ea1ch c\u01a1 h\u1ecdc v\u1edbi kh\u00e1ng sinh t\u1ea1i ch\u1ed7 ho\u1eb7c kh\u00e1ng sinh to\u00e0n th\u00e2n \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb t\u00ecnh tr\u1ea1ng n\u00e0y. C\u00f9ng t\u00ecm hi\u1ec3u t\u1ed5ng quan c\u00e1c lo\u1ea1i thu\u1ed1c t\u1ea1i ch\u1ed7 \u0111i\u1ec1u tr\u1ecb vi\u00eam quanh Implant v\u00e0 \u0111\u00e1nh gi\u00e1 t\u00e1c \u0111\u1ed9ng tr\u00ean l\u00e2m s\u00e0ng.<\/strong><\/p>\n

1. T\u1ed5ng quan c\u00e1c lo\u1ea1i thu\u1ed1c t\u1ea1i ch\u1ed7 \u0111i\u1ec1u tr\u1ecb vi\u00eam quanh Implant nha khoa<\/h2>\n

Arestin (minocycline HCI) 1 mg (H\u00ecnh d\u01b0\u1edbi \u0111\u00e2y), Elyzol\u00ae (metronidazole 25%), v\u00e0 Atridox\u00ae (doxycycline hyclate 10%) l\u00e0 nh\u1eefng kh\u00e1ng sinh t\u1ea1i ch\u1ed7 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb vi\u00eam nha chu.<\/p>\n

\"thuoc-tai-cho-1\"
B\u01a1m Arestin t\u1ea1i ch\u1ed7 v\u00e0o t\u00fai ngo\u00e0i g\u1ea7n c\u1ee7a implant #21 ngay sau khi n\u1ea1o s\u1ea1ch kh\u00f4ng ph\u1eabu thu\u1eadt.<\/figcaption><\/figure>\n
\"thuoc-tai-cho-2\"
T\u00e1i kh\u00e1m 2 th\u00e1ng sau khi \u0111\u1eb7t Arestin cho th\u1ea5y kh\u00f4ng c\u00f2n ch\u1ea3y m\u00e1u khi th\u0103m d\u00f2.<\/figcaption><\/figure>\n

Vi\u1ec7c s\u1eed d\u1ee5ng minocycline v\u00e0 doxycycline \u0111\u01b0\u1ee3c xem l\u00e0 “ngo\u00e0i h\u01b0\u1edbng d\u1eabn\u201d theo C\u1ee5c Qu\u1ea3n l\u00fd Th\u1ef1c ph\u1ea9m v\u00e0 D\u01b0\u1ee3c (FDA); tuy nhi\u00ean, ch\u00fang c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng an to\u00e0n cho implant, do c\u00e1c v\u1ecb tr\u00ed b\u1ecb b\u1ec7nh l\u00fd quanh implant c\u00f3 s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a vi khu\u1ea9n k\u1ef5 kh\u00ed Gram \u00e2m. Minocycline v\u00e0 doxycycline l\u00e0 tetracycline ph\u1ed5 r\u1ed9ng, n\u00ean c\u00f3 hi\u1ec7u qu\u1ea3 kh\u00e1ng vi khu\u1ea9n Gram d\u01b0\u01a1ng l\u1eabn Gram \u00e2m; tuy nhi\u00ean, n\u1ed3ng \u0111\u1ed9 c\u1ee7a thu\u1ed1c t\u1ea1i ch\u1ed7 th\u01b0\u1eddng cao h\u01a1n thu\u1ed1c to\u00e0n th\u00e2n. Metronidazole l\u00e0 m\u1ed9t nitroimidazole v\u00e0 nh\u1eafm v\u00e0o c\u00e1c vi khu\u1ea9n k\u1ef5 kh\u00ed; Elyzol kh\u00f4ng \u0111\u01b0\u1ee3c FDA ch\u1ea5p thu\u1eadn; do \u0111\u00f3, vi\u1ec7c s\u1eed d\u1ee5ng n\u00f3 \u0111\u01b0\u1ee3c xem l\u00e0 kh\u00f4ng an to\u00e0n v\u00e0 hi\u1ec7u qu\u1ea3, v\u00e0 kh\u00f4ng \u0111\u01b0\u1ee3c b\u00e1n \u1edf th\u1ecb tr\u01b0\u1eddng Hoa K\u1ef3. Chlorhexidine, m\u1eb7c d\u00f9 kh\u00f4ng ph\u1ea3i l\u00e0 kh\u00e1ng sinh, nh\u01b0ng c\u0169ng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb vi\u00eam ni\u00eam m\u1ea1c quanh implant. \u0110\u00e2y l\u00e0 m\u1ed9t t\u00e1c nh\u00e2n kh\u1eed khu\u1ea9n\/kh\u00e1ng hu\u1ea5n bisbiguanide c\u00f3 hi\u1ec7u qu\u1ea3 kh\u00e1ng vi sinh v\u1eadt ph\u1ed5 r\u1ed9ng. \u1ede Hoa K\u1ef3, n\u00f3 c\u00f3 d\u1ea1ng dung d\u1ecbch 0.12% ho\u1eb7c m\u00e0ng ph\u00e2n h\u1ee7y sinh h\u1ecdc ch\u1ee9a 2.5 mg chlorhexidine \u0111\u01b0\u1ee3c b\u00e1n tr\u00ean th\u1ecb tr\u01b0\u1eddng v\u1edbi t\u00ean g\u1ecdi Periochip”. \u1ede Ch\u00e2u \u00c2u, n\u00f3 \u0111\u01b0\u1ee3c b\u00e1n tr\u00ean th\u1ecb tr\u01b0\u1eddng d\u01b0\u1edbi d\u1ea1ng gel 1%.<\/p>\n

S\u1ee3i nha chu Actisite\u00ae \u0111\u00e3 t\u1eebng \u0111\u01b0\u1ee3c b\u00e1n tr\u00ean th\u1ecb tr\u01b0\u1eddng nh\u01b0 m\u1ed9t kh\u00e1ng sinh t\u1ea1i ch\u1ed7 d\u00f9ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb c\u00e1c v\u1ecb tr\u00ed nha chu; tuy nhi\u00ean, hi\u1ec7n nay n\u00f3 kh\u00f4ng c\u00f2n c\u00f3 m\u1eb7t \u1edf Hoa K\u1ef3 n\u1eefa. N\u00f3 g\u1ed3m m\u1ed9t s\u1ee3i ethylene\/vinyl acetate copolymer ch\u1ee9a fetracycline hydrochloride 25%. S\u1ee3i n\u00e0y \u0111\u01b0\u1ee3c nh\u1ed3i v\u00e0o t\u00fai nha chu, c\u1ed1 \u0111\u1ecbnh b\u1eb1ng ch\u1ea5t k\u1ebft d\u00ednh, v\u00e0 gi\u1eef t\u1ea1i ch\u1ed7 trong 7-12 ng\u00e0y \u0111\u1ec3 li\u00ean t\u1ee5c ph\u00f3ng th\u00edch tetracycline. S\u1ee3i nha chu Actisite k\u1ebft h\u1ee3p v\u1edbi c\u1ea1o v\u00f4i tr\u00ean n\u01b0\u1edbu v\u00e0 d\u01b0\u1edbi n\u01b0\u1edbu \u0111\u00e3 \u0111\u01b0\u1ee3c ghi nh\u1eadn l\u00e0 l\u00e0m gi\u1ea3m ch\u1ea3y m\u00e1u quanh implant b\u1ecb vi\u00eam ni\u00eam m\u1ea1c quanh implant trong th\u1eddi gian ng\u1eafn. Ngo\u00e0i ra, c\u00f3 m\u1ed9t s\u1ed1 b\u1eb1ng ch\u1ee9ng cho th\u1ea5y n\u00f3 c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m \u0111\u1ed9 s\u00e2u t\u00fai quanh implant b\u1ecb vi\u00eam quanh implant.<\/p>\n

2. \u0110\u00e1nh gi\u00e1 tr\u00ean b\u1ec7nh nh\u00e2n<\/h2>\n

B\u1ec7nh nh\u00e2n c\u00f3 implant \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n b\u1ec7nh l\u00fd quanh implant c\u00f3 th\u1ec3 l\u00e0 \u1ee9ng vi\u00ean t\u1ed1t cho li\u1ec7u ph\u00e1p t\u00e1c nh\u00e2n thu\u1ed1c t\u1ea1i ch\u1ed7. B\u1ec7nh l\u00fd quanh implant l\u00e0 do m\u00e0ng sinh h\u1ecdc vi khu\u1ea9n b\u00e1m l\u00ean ph\u1ee5c h\u00ecnh tr\u00ean implant ho\u1eb7c abutment, v\u00e0 do \u0111\u00f3, s\u1ef1 k\u1ebft h\u1ee3p gi\u1eefa l\u00e0m s\u1ea1ch c\u01a1 h\u1ecdc v\u1edbi kh\u00e1ng sinh t\u1ea1i ch\u1ed7 ho\u1eb7c kh\u00e1ng sinh to\u00e0n th\u00e2n \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb t\u00ecnh tr\u1ea1ng n\u00e0y. T\u00e0i li\u1ec7u tham kh\u1ea3o hi\u1ec7n nay gi\u00fap b\u00e1c s\u0129 l\u00e2m s\u00e0ng thi\u1ebft l\u1eadp ch\u1ea9n \u0111o\u00e1n \u0111\u00fang, d\u1ef1a tr\u00ean b\u00e1o c\u00e1o \u0111\u1ed3ng thu\u1eadn c\u1ee7a H\u1ed9i th\u1ea3o Nha chu Ch\u00e2u \u00c2u VI v\u00e0 VII. C\u00f3 hai lo\u1ea1i b\u1ec7nh l\u00fd quanh implant: vi\u00eam ni\u00eam m\u1ea1c quanh implant v\u00e0 vi\u00eam quanh implant. Th\u00f4ng s\u1ed1 ch\u00ednh \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n vi\u00eam ni\u00eam m\u1ea1c quanh implant l\u00e0 vi\u00eam khe ni\u00eam m\u1ea1c, k\u00e8m theo ch\u1ea3y m\u00e1u khi th\u0103m d\u00f2 nh\u1eb9 (< 0.25 N), nh\u01b0ng kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng ti\u00eau x\u01b0\u01a1ng tr\u00ean phim X-quang. Vi\u00eam quanh implant \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n khi c\u00f3 ti\u00eau m\u00e0o x\u01b0\u01a1ng quanh implant, ch\u1ea3y m\u00e1u khi th\u0103m d\u00f2, v\u00e0\/ho\u1eb7c ch\u1ea3y m\u1ee7, c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 k\u00e8m theo t\u00fai quanh implant tr\u1edf n\u00ean s\u00e2u h\u01a1n. Hai t\u1ed5ng quan g\u1ea7n \u0111\u00e2y cho th\u1ea5y c\u00e1c t\u00e1c nh\u00e2n thu\u1ed1c t\u1ea1i ch\u1ed7 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho c\u00e1c v\u1ecb tr\u00ed b\u1ecb vi\u00eam ni\u00eam m\u1ea1c quanh implant, c\u00f2n hi\u1ec7u qu\u1ea3 l\u00e2m s\u00e0ng c\u1ee7a ch\u00fang trong \u0111i\u1ec1u tr\u1ecb vi\u00eam quanh implant th\u00ec v\u1eabn ch\u01b0a r\u00f5.<\/p>\n

Kh\u00e1ng sinh t\u1ea1i ch\u1ed7 \u0111\u01b0\u1ee3c b\u01a1m tr\u1ef1c ti\u1ebfp v\u00e0o t\u00fai quanh implant. Arestin \u0111\u01b0\u1ee3c \u0111\u00f3ng g\u00f3i trong m\u1ed9t kim nh\u1ef1a c\u00f9n v\u1edbi li\u1ec1u l\u01b0\u1ee3ng nh\u1ecf, v\u00e0 g\u1eafn v\u00e0o \u1ed1ng b\u01a1m kim lo\u1ea1i. Elyzol \u0111\u01b0\u1ee3c \u0111\u00f3ng g\u00f3i trong m\u1ed9t th\u00f9ng cac-t\u00f4ng, bao g\u1ed3m m\u1ed9t d\u1ee5ng c\u1ee5 b\u01a1m d\u00f9ng m\u1ed9t l\u1ea7n v\u00e0 m\u1ed9t kim c\u00f9n. Arestin v\u00e0 Elyzol kh\u00f4ng c\u1ea7n ph\u1ea3i tr\u1ed9n. Atridox g\u1ed3m hai \u1ed1ng b\u01a1m kh\u00e1c nhau, v\u00e0 c\u00e1c th\u00e0nh ph\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c tr\u1ed9n r\u1ed3i b\u01a1m v\u00e0o t\u00fai nha chu qua m\u1ed9t \u1ed1ng th\u00f4ng c\u00f9n. Chlorhexidine c\u00f3 d\u1ea1ng dung d\u1ecbch ho\u1eb7c gel c\u00f3 th\u1ec3 b\u01a1m r\u1eeda t\u00fai d\u01b0\u1edbi n\u01b0\u1edbu b\u1eb1ng \u1ed1ng b\u01a1m nh\u1ef1a, ho\u1eb7c c\u00f3 d\u1ea1ng m\u00e0ng nh\u1ecf (Periochip”) c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c cho v\u00e0o t\u00fai b\u1eb1ng k\u1eb9p g\u1eafp. T\u1ea5t c\u1ea3 c\u00e1c t\u00e1c nh\u00e2n thu\u1ed1c t\u1ea1i ch\u1ed7 k\u1ec3 tr\u00ean \u0111\u1ec1u kh\u00f4ng c\u1ea7n l\u1ea5y ra b\u1edfi v\u00ec ch\u00fang ho\u00e0n to\u00e0n ti\u00eau sinh h\u1ecdc.<\/p>\n

T\u00e1c nh\u00e2n thu\u1ed1c t\u1ea1i ch\u1ed7 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u01b0 m\u1ed9t \u0111i\u1ec1u tr\u1ecb b\u1ed5 sung nh\u1eb1m n\u00e2ng cao hi\u1ec7u qu\u1ea3 n\u1ea1o c\u01a1 h\u1ecdc b\u1ec1 m\u1eb7t implant b\u1ecb nhi\u1ec5m khu\u1ea9n. Ch\u00fang kh\u00f4ng th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u01a1n \u0111\u1ed9c do m\u00e0ng sinh h\u1ecdc ho\u1ea1t \u0111\u1ed9ng nh\u01b0 m\u1ed9t h\u00e0ng r\u00e0o ng\u0103n c\u1ea3n s\u1ef1 x\u00e2m nh\u1eadp c\u1ee7a t\u00e1c nh\u00e2n (kh\u00e1ng khu\u1ea9n) ho\u1ea1t \u0111\u1ed9ng v\u00e0o v\u1ecb tr\u00ed b\u1ecb nhi\u1ec5m tr\u00f9ng. M\u1ee5c \u0111\u00edch c\u1ee7a vi\u1ec7c s\u1eed d\u1ee5ng t\u00e1c nh\u00e2n thu\u1ed1c t\u1ea1i ch\u1ed7 k\u1ebft h\u1ee3p v\u1edbi n\u1ea1o c\u01a1 h\u1ecdc m\u00e0ng sinh h\u1ecdc tr\u00ean v\u00e0 d\u01b0\u1edbi n\u01b0\u1edbu l\u00e0 \u0111\u1ec3 gi\u1ea3m s\u1ed1l\u01b0\u1ee3ng vi khu\u1ea9n, kh\u1eed khu\u1ea9n b\u1ec1 m\u1eb7t implant, \u0111\u1ed3ng th\u1eddi gi\u1ea3m \u0111\u1ed9 s\u00e2u t\u1ee7i v\u00e0 ch\u1ea3y m\u00e1u quanh implant. T\u00e1c nh\u00e2n thu\u1ed1c t\u1ea1i ch\u1ed7 c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb vi\u00eam ni\u00eam m\u1ea1c quanh implant th\u00e0nh c\u00f4ng khi k\u1ebft h\u1ee3p v\u1edbi n\u1ea1o c\u01a1 h\u1ecdc, b\u1edfi v\u00ec nh\u1eefng t\u1ed5n th\u01b0\u01a1ng n\u00e0y c\u00f3 gi\u1edbi h\u1ea1n r\u00f5, c\u00f2n nh\u1eefng d\u1ee5ng c\u1ee5 ki\u1ec3m so\u00e1t vi\u1ec7c ph\u00e2n ph\u1ed1i c\u00f3 th\u1ec3 ph\u00f3ng th\u00edch ch\u00ednh x\u00e1c t\u00e1c nh\u00e2n kh\u00e1ng khu\u1ea9n li\u1ec1u cao v\u00e0o v\u1ecb tr\u00ed b\u1ec7nh l\u00fd li\u00ean t\u1ee5c trong m\u1ed9t v\u00e0i ng\u00e0y.<\/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","protected":false},"excerpt":{"rendered":"

B\u1ec7nh nh\u00e2n c\u00f3 implant \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n b\u1ec7nh l\u00fd quanh implant c\u00f3 th\u1ec3 l\u00e0 \u1ee9ng vi\u00ean t\u1ed1t cho li\u1ec7u ph\u00e1p t\u00e1c nh\u00e2n thu\u1ed1c t\u1ea1i ch\u1ed7. B\u1ec7nh l\u00fd quanh implant l\u00e0 do m\u00e0ng sinh h\u1ecdc vi khu\u1ea9n b\u00e1m l\u00ean ph\u1ee5c h\u00ecnh tr\u00ean implant ho\u1eb7c abutment, v\u00e0 do \u0111\u00f3, s\u1ef1 k\u1ebft h\u1ee3p gi\u1eefa l\u00e0m s\u1ea1ch c\u01a1 h\u1ecdc […]<\/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":"\nThu\u1ed1c t\u1ea1i ch\u1ed7 trong vi\u00eam quanh Implant - Nh\u00ecn nh\u1eadn. - Vinmec<\/title>\n<meta name=\"description\" content=\"C\u00f9ng t\u00ecm hi\u1ec3u t\u1ed5ng quan c\u00e1c lo\u1ea1i thu\u1ed1c t\u1ea1i ch\u1ed7 \u0111i\u1ec1u tr\u1ecb vi\u00eam quanh Implant v\u00e0 \u0111\u00e1nh gi\u00e1 t\u00e1c \u0111\u1ed9ng tr\u00ean l\u00e2m s\u00e0ng.\" \/>\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=\"Thu\u1ed1c t\u1ea1i ch\u1ed7 trong vi\u00eam quanh Implant - 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