{"id":32813,"date":"2023-05-09T07:28:49","date_gmt":"2023-05-09T00:28:49","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=32813"},"modified":"2023-05-09T13:23:26","modified_gmt":"2023-05-09T06:23:26","slug":"khang-sinh-toan-than-trong-cay-ghep-implant-danh-gia-chung","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/09\/khang-sinh-toan-than-trong-cay-ghep-implant-danh-gia-chung\/","title":{"rendered":"Kh\u00e1ng sinh to\u00e0n th\u00e2n trong c\u1ea5y gh\u00e9p Implant – \u0110\u00e1nh gi\u00e1 chung."},"content":{"rendered":"

S\u1eed d\u1ee5ng kh\u00e1ng sinh to\u00e0n th\u00e2n trong \u0111i\u1ec1u tr\u1ecb c\u1ea5y gh\u00e9p v\u1eabn c\u00f2n g\u00e2y tranh c\u00e3i. M\u1ee5c ti\u00eau c\u1ee7a ch\u01b0\u01a1ng n\u00e0y l\u00e0 tr\u00ecnh b\u00e0y v\u1ec1 c\u00e1ch s\u1eed d\u1ee5ng kh\u00e1ng sinh trong \u0111i\u1ec1u tr\u1ecb c\u1ea5y gh\u00e9p v\u00ec l\u00fd do d\u1ef1 ph\u00f2ng h\u01a1n l\u00e0 \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m tr\u00f9ng ho\u1ea1t \u0111\u1ed9ng. M\u1eb7c d\u00f9 quy tr\u00ecnh nguy\u00ean th\u1ee7y c\u1ee7a Branemark \u0111\u00e3 \u0111\u1ec1 ngh\u1ecb s\u1eed d\u1ee5ng kh\u00e1ng sinh to\u00e0n th\u00e2n (penicillin V) nh\u01b0 m\u1ed9t \u0111i\u1ec1u tr\u1ecb b\u1ed5 sung \u0111\u1ec3 gi\u00fap ng\u0103n ng\u1eeba th\u1ea5t b\u1ea1i implant, nh\u01b0ng kh\u00f4ng ph\u1ea3i m\u1ecdi tr\u01b0\u1eddng h\u1ee3p \u0111\u1ec1u c\u1ea7n kh\u00e1ng sinh. C\u00f9ng t\u00ecm hi\u1ec3u v\u1ea5n \u0111\u1ec1 kh\u00e1ng sinh to\u00e0n th\u00e2n trong qu\u00e1 tr\u00ecnh c\u1ea5y gh\u00e9p Implant tr\u00ean l\u00e2m s\u00e0ng v\u00e0 nguy c\u01a1 l\u1ea1m d\u1ee5ng kh\u00e1ng sinh.<\/strong><\/p>\n

1. Kh\u00e1ng sinh to\u00e0n th\u00e2n trong qu\u00e1 tr\u00ecnh c\u1ea5y gh\u00e9p Implant – \u0110\u00e1nh gi\u00e1 chung<\/h2>\n

S\u1eed d\u1ee5ng kh\u00e1ng sinh to\u00e0n th\u00e2n trong \u0111i\u1ec1u tr\u1ecb c\u1ea5y gh\u00e9p v\u1eabn c\u00f2n g\u00e2y tranh c\u00e3i. M\u1ee5c ti\u00eau c\u1ee7a ch\u01b0\u01a1ng n\u00e0y l\u00e0 tr\u00ecnh b\u00e0y v\u1ec1 c\u00e1ch s\u1eed d\u1ee5ng kh\u00e1ng sinh trong \u0111i\u1ec1u tr\u1ecb c\u1ea5y gh\u00e9p v\u00ec l\u00fd do d\u1ef1 ph\u00f2ng h\u01a1n l\u00e0 \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m tr\u00f9ng ho\u1ea1t \u0111\u1ed9ng. M\u1eb7c d\u00f9 quy tr\u00ecnh nguy\u00ean th\u1ee7y c\u1ee7a Branemark \u0111\u00e3 \u0111\u1ec1 ngh\u1ecb s\u1eed d\u1ee5ng kh\u00e1ng sinh to\u00e0n th\u00e2n (penicillin V) nh\u01b0 m\u1ed9t \u0111i\u1ec1u tr\u1ecb b\u1ed5 sung \u0111\u1ec3 gi\u00fap ng\u0103n ng\u1eeba th\u1ea5t b\u1ea1i implant, nh\u01b0ng kh\u00f4ng ph\u1ea3i m\u1ecdi tr\u01b0\u1eddng h\u1ee3p \u0111\u1ec1u c\u1ea7n kh\u00e1ng sinh. Kh\u00e1ng sinh to\u00e0n th\u00e2n ch\u1ec9 n\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng khi c\u00f3 th\u1ec3 c\u1ea3i thi\u1ec7n k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb c\u1ee7a b\u1ec7nh nh\u00e2n [1]. N\u1ebfu b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed y khoa nhi\u1ec5m tr\u00f9ng t\u00e1i ph\u00e1t ho\u1eb7c d\u1ec5 b\u1ecb nhi\u1ec5m tr\u00f9ng th\u00ec kh\u00e1ng sinh \u0111\u1eb7c bi\u1ec7t \u0111\u01b0\u1ee3c xem x\u00e9t. Tham v\u1ea5n y khoa \u0111\u1ec3 th\u1eadn tr\u1ecdng trong vi\u1ec7c ra quy\u1ebft \u0111\u1ecbnh. C\u00e1c y\u1ebfu t\u1ed1 c\u1ea7n xem x\u00e9t bao g\u1ed3m t\u00ecnh tr\u1ea1ng to\u00e0n th\u00e2n c\u1ee7a b\u1ec7nh nh\u00e2n, v\u1ecb tr\u00ed ph\u1eabu thu\u1eadt v\u00e0 m\u1ee9c \u0111\u1ed9 \u0111i\u1ec1u tr\u1ecb, ch\u1ea9n \u0111o\u00e1n tr\u01b0\u1edbc ph\u1eabu thu\u1eadt, v\u00e0 quan \u0111i\u1ec3m c\u1ee7a b\u00e1c s\u0129 ph\u1eabu thu\u1eadt [2]. Ph\u1ea3i gi\u1ea3m thi\u1ec3u vi\u1ec7c s\u1eed d\u1ee5ng kh\u00e1ng sinh do nguy c\u01a1 ph\u00e1t tri\u1ec3n vi khu\u1ea9n kh\u00e1ng thu\u1ed1c.<\/p>\n

N\u1ebfu kh\u00e1ng sinh \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh, c\u1ea7n quy\u1ebft \u0111\u1ecbnh xem n\u00f3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng d\u1ef1 ph\u00f2ng tr\u01b0\u1edbc hay sau ph\u1eabu thu\u1eadt. M\u1ed1i quan t\u00e2m ch\u00ednh c\u1ee7a quy\u1ebft \u0111\u1ecbnh n\u00e0y l\u00e0 m\u1ee9c \u0111\u1ed9 c\u1ee7a nguy c\u01a1 nhi\u1ec5m tr\u00f9ng sau ph\u1eabu thu\u1eadt. Hi\u1ec7n nay, ng\u01b0\u1eddi ta v\u1eabn ch\u01b0a bi\u1ebft r\u00f5 \u0111\u01b0\u1ee3c \u1edf b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 cao th\u00ec ph\u00e1c \u0111\u1ed3 d\u1ef1 ph\u00f2ng tr\u01b0\u1edbc ph\u1eabu thu\u1eadt c\u00f3 t\u1ed1t h\u01a1n ph\u00e1c \u0111\u1ed3 sau ph\u1eabu thu\u1eadt hay kh\u00f4ng. Tuy nhi\u00ean, v\u00e0o n\u0103m 2008, Resnik v\u00e0 Misch \u0111\u00e3 \u0111\u01b0a ra c\u00e1c khuy\u1ebfn c\u00e1o v\u1ec1 vi\u1ec7c s\u1eed d\u1ee5ng ph\u00e1c \u0111\u1ed3 kh\u00e1ng sinh tr\u01b0\u1edbc l\u1eabn sau ph\u1eabu thu\u1eadt trong ph\u1eabu thu\u1eadt c\u1ea5y gh\u00e9p. \u0110\u1ed1i v\u1edbi ph\u00e1c \u0111\u1ed3 tr\u01b0\u1edbc ph\u1eabu thu\u1eadt, c\u00e1c t\u00e1c gi\u1ea3 ph\u00e2n lo\u1ea1i quy tr\u00ecnh theo m\u1ee9c \u0111\u1ed9 c\u1ee7a nguy c\u01a1 nhi\u1ec5m tr\u00f9ng, v\u00e0 khuy\u1ebfn c\u00e1o ph\u00e1c \u0111\u1ed3 kh\u00e1ng sinh \u0111\u1eb7c hi\u1ec7u cho t\u1eebng quy tr\u00ecnh [3]. \u0110\u1ed1i v\u1edbi ph\u00e1c \u0111\u1ed3 sau ph\u1eabu thu\u1eadt, c\u00e1c t\u00e1c gi\u1ea3 \u0111\u00e1nh gi\u00e1 \u0111\u1eb7c \u0111i\u1ec3m c\u1ee7a t\u1eebng ph\u00e1c \u0111\u1ed3 \u0111\u1ec3 \u0111\u01b0a ra khuy\u1ebfn c\u00e1o v\u1ec1 lo\u1ea1i b\u1ec7nh nh\u00e2n v\u00e0 ch\u1ec9 \u0111\u1ecbnh ph\u00f9 h\u1ee3p nh\u1ea5t.<\/p>\n

Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p l\u00e2m s\u00e0ng c\u1ee5 th\u1ec3, b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 m\u1eafc c\u00e1c b\u1ec7nh l\u00fd to\u00e0n th\u00e2n, v\u00ed d\u1ee5 kinh \u0111i\u1ec3n l\u00e0 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng d\u1eabn t\u1edbi lo\u00e9t b\u00e0n ch\u00e2n, n\u00ean \u0111\u01b0\u1ee3c xem l\u00e0 c\u00f3 nguy c\u01a1 nhi\u1ec5m tr\u00f9ng cao. Tuy nhi\u00ean, m\u1ee9c \u0111\u1ed9 nguy c\u01a1 kh\u00f4ng \u0111\u1ee7 cao \u0111\u1ec3 xem x\u00e9t ph\u00e1c \u0111\u1ed3 tr\u01b0\u1edbc ph\u1eabu thu\u1eadt. Ngo\u00e0i ra, b\u1edfi v\u00ec ch\u00fang t\u00f4i ch\u01b0a bi\u1ebft \u0111\u01b0\u1ee3c ph\u00e1c \u0111\u1ed3 tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb c\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn k\u1ebft qu\u1ea3 hay kh\u00f4ng, n\u00ean kh\u00e1ng sinh sau \u0111i\u1ec1u tr\u1ecb \u0111\u00e3 \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn. Theo t\u1ed5ng quan c\u1ee7a Resnick v\u00e0 Misch, amoxicillin l\u00e0 l\u1ef1a ch\u1ecdn \u01b0u ti\u00ean \u1edf b\u1ec7nh nh\u00e2n kh\u00f4ng d\u1ecb \u1ee9ng, n\u00ean amoxicillin \u0111\u00e3 \u0111\u01b0\u1ee3c k\u00ea [3]. Nh\u1eefng l\u01b0u \u00fd kh\u00e1c khi l\u1ef1a ch\u1ecdn kh\u00e1ng sinh l\u00e0 c\u00f3 vi khu\u1ea9n kh\u00e1ng thu\u1ed1c hay kh\u00f4ng.<\/p>\n

\u0110\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n tu\u00e2n th\u1ee7 ph\u00e1c \u0111\u1ed3 kh\u00e1c sinh v\u00e0 c\u00e1c h\u01b0\u1edbng d\u1eabn kh\u00e1c, \u0111\u1ed3ng th\u1eddi \u0111\u00e1p \u1ee9ng t\u1ed1t v\u1edbi \u0111i\u1ec1u tr\u1ecb, qu\u00e1 tr\u00ecnh c\u1ea5y gh\u00e9p s\u1ebd r\u1ea5t th\u00e0nh c\u00f4ng v\u00e0 di\u1ec5n ra thu\u1eadn l\u1ee3i. S\u1eed d\u1ee5ng \u0111\u00fang kh\u00e1ng sinh \u1edf b\u1ec7nh nh\u00e2n ph\u00f9 h\u1ee3p s\u1ebd t\u0103ng kh\u1ea3 n\u0103ng th\u00e0nh c\u00f4ng l\u00e2u d\u00e0i cho implant [1].<\/p>\n

2. L\u1ea1m d\u1ee5ng kh\u00e1ng sinh<\/h2>\n

C\u1ea7n tr\u00e1nh \u00e1p d\u1ee5ng nguy\u00ean t\u1eafc chung trong vi\u1ec7c ph\u00e2n lo\u1ea1i b\u1ec7nh nh\u00e2n s\u1eed d\u1ee5ng kh\u00e1ng sinh d\u1ef1 ph\u00f2ng tr\u01b0\u1edbc hay sau ph\u1eabu thu\u1eadt. Th\u00f4ng tin thu \u0111\u01b0\u1ee3c t\u1eeb tham v\u1ea5n y khoa n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc c\u00f9ng v\u1edbi c\u00e1c th\u00f4ng tin l\u00e2m s\u00e0ng kh\u00e1c \u0111\u1ec3 \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh d\u1ef1a tr\u00ean t\u1eebng t\u00ecnh hu\u1ed1ng. Theo y v\u0103n \u0111\u01b0\u1ee3c tr\u00edch d\u1eabn trong ca n\u00e0y, vi\u1ec7c s\u1eed d\u1ee5ng kh\u00e1ng sinh to\u00e0n th\u00e2n s\u1ebd \u0111\u1ea3m b\u1ea3o ng\u0103n ng\u1eeba th\u1ea5t b\u1ea1i implant s\u1edbm. \u0110i\u1ec1u n\u00e0y \u0111\u1eb7t ra h\u00e0ng lo\u1ea1t c\u00e2u h\u1ecfi v\u1ec1 vi\u1ec7c “l\u1ea1m d\u1ee5ng” kh\u00e1ng sinh to\u00e0n th\u00e2n v\u00e0 s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a vi khu\u1ea9n kh\u00e1ng thu\u1ed1c. R\u00f5 r\u00e0ng l\u00e0 kh\u00f4ng h\u1ec1 d\u1ec5 d\u00e0ng \u0111\u1ec3 tr\u1ea3 l\u1eddi. Gi\u1ea3 s\u1eed y v\u0103n l\u00e0 \u0111\u00fang, v\u00e0 nguy c\u01a1 th\u1ea5t b\u1ea1i implant s\u1edbm n\u1ebfu kh\u00f4ng s\u1eed d\u1ee5ng kh\u00e1ng sinh d\u1ef1 ph\u00f2ng l\u00e0 cao, th\u00ec vi\u1ec7c s\u1eed d\u1ee5ng ch\u00fang ph\u1ea3i \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh theo g\u00f3c \u0111\u1ed9 nha khoa. \u0110i\u1ec1u quan tr\u1ecdng l\u00e0 nh\u1eefng th\u1ea3o lu\u1eadn th\u1ef1c t\u1ebf n\u00ean \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng cho b\u1ec7nh nh\u00e2n v\u00e0 t\u1ea5t c\u1ea3 b\u00e1c s\u0129 l\u00e2m s\u00e0ng tham gia \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh h\u1ee3p l\u00fd cho b\u1ec7nh nh\u00e2n. M\u1eb7c d\u00f9 vi\u1ec7c “l\u1ea1m d\u1ee5ng\u201d kh\u00e1ng sinh s\u1ebd d\u1eabn t\u1edbi s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a c\u00e1c lo\u00e0i kh\u00e1ng thu\u1ed1c, nh\u01b0ng vi\u1ec7c s\u1eed d\u1ee5ng kh\u00e1ng sinh \u1edf b\u1ec7nh nh\u00e2n \u0111\u1eb7c bi\u1ec7t l\u00e0 nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 v\u1ea5n \u0111\u1ec1 y khoa d\u01b0\u1edbi s\u1ef1 tham v\u1ea5n c\u1ee7a b\u00e1c s\u0129 v\u1eabn \u0111\u01b0\u1ee3c \u0111\u1ea3m b\u1ea3o. S\u1eed d\u1ee5ng h\u1ee3p l\u00fd kh\u00e1ng sinh d\u1ef1 ph\u00f2ng trong \u0111i\u1ec1u tr\u1ecb c\u1ea5y gh\u00e9p l\u00e0 ti\u00eau chu\u1ea9n ch\u0103m s\u00f3c hi\u1ec7n nay.<\/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. Esposito M, Grusovin MG, Talati M, et al. Interventions for replacing missing teeth: antibiotics at dental implant placement to prevent complications. Cochrane Database Syst Rev 2008;(3):CD004152.<\/em>
\n2. Tan SK, Lo J, Zwahlen RA. Perioperative antibiotic prophylaxis in orthognathic surgery: a systematic review and meta-analysis of clinical trials. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;112:19-27.<\/em>
\n3. Resnik RR, Misch C. Prophylactic antibiotic regimens in oral implantology: rationale and protocol. Implant Dent 2008;17:142-150.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

S\u1eed d\u1ee5ng kh\u00e1ng sinh to\u00e0n th\u00e2n trong \u0111i\u1ec1u tr\u1ecb c\u1ea5y gh\u00e9p v\u1eabn c\u00f2n g\u00e2y tranh c\u00e3i. M\u1ee5c ti\u00eau c\u1ee7a ch\u01b0\u01a1ng n\u00e0y l\u00e0 tr\u00ecnh b\u00e0y v\u1ec1 c\u00e1ch s\u1eed d\u1ee5ng kh\u00e1ng sinh trong \u0111i\u1ec1u tr\u1ecb c\u1ea5y gh\u00e9p v\u00ec l\u00fd do d\u1ef1 ph\u00f2ng h\u01a1n l\u00e0 \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m tr\u00f9ng ho\u1ea1t \u0111\u1ed9ng. M\u1eb7c d\u00f9 quy tr\u00ecnh nguy\u00ean th\u1ee7y c\u1ee7a […]<\/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":"\nKh\u00e1ng sinh to\u00e0n th\u00e2n trong c\u1ea5y gh\u00e9p Implant - \u0110\u00e1nh gi\u00e1 chung.<\/title>\n<meta name=\"description\" content=\"C\u00f9ng t\u00ecm hi\u1ec3u v\u1ea5n \u0111\u1ec1 kh\u00e1ng sinh to\u00e0n th\u00e2n trong qu\u00e1 tr\u00ecnh c\u1ea5y gh\u00e9p Implant tr\u00ean l\u00e2m s\u00e0ng v\u00e0 nguy c\u01a1 l\u1ea1m d\u1ee5ng kh\u00e1ng sinh.\" \/>\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=\"Kh\u00e1ng sinh to\u00e0n th\u00e2n trong c\u1ea5y gh\u00e9p Implant - \u0110\u00e1nh gi\u00e1 chung.\" \/>\n<meta property=\"og:description\" content=\"C\u00f9ng t\u00ecm hi\u1ec3u v\u1ea5n \u0111\u1ec1 kh\u00e1ng sinh to\u00e0n th\u00e2n trong qu\u00e1 tr\u00ecnh c\u1ea5y gh\u00e9p Implant tr\u00ean l\u00e2m s\u00e0ng v\u00e0 nguy c\u01a1 l\u1ea1m d\u1ee5ng kh\u00e1ng sinh.\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/09\/khang-sinh-toan-than-trong-cay-ghep-implant-danh-gia-chung\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-05-09T00:28:49+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-05-09T06:23:26+00:00\" \/>\n<meta name=\"author\" content=\"Tr\u1ea7n Ti\u1ebfn Th\u00e0nh\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Tr\u1ea7n Ti\u1ebfn Th\u00e0nh\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/09\/khang-sinh-toan-than-trong-cay-ghep-implant-danh-gia-chung\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/09\/khang-sinh-toan-than-trong-cay-ghep-implant-danh-gia-chung\/\",\"name\":\"Kh\u00e1ng sinh to\u00e0n th\u00e2n trong c\u1ea5y gh\u00e9p Implant - 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