{"id":20255,"date":"2022-07-01T01:53:53","date_gmt":"2022-06-30T18:53:53","guid":{"rendered":"https:\/\/yhoccongdong.org\/du-an-khac\/benh-ly-nha-chu-goc-nhin-tong-quan\/"},"modified":"2022-07-01T01:53:53","modified_gmt":"2022-06-30T18:53:53","slug":"benh-ly-nha-chu-goc-nhin-tong-quan","status":"publish","type":"post","link":"https:\/\/yhoccongdong.com\/du-an-khac\/benh-ly-nha-chu-goc-nhin-tong-quan\/","title":{"rendered":"B\u1ec7nh l\u00fd nha chu: G\u00f3c nh\u00ecn t\u1ed5ng quan"},"content":{"rendered":"

T\u00f3m t\u1eaft<\/strong><\/h2>\n

Vi\u00eam nha chu l\u00e0 b\u1ec7nh \u00fd kh\u00e1 ph\u1ed5 bi\u1ebfn trong th\u1eddi gian hi\u1ec7n nay, \u1ea3nh h\u01b0\u1edfng r\u1ea5t l\u1edbn \u0111\u1ebfn ch\u1ee9c n\u0103ng \u0103n nhai c\u0169ng nh\u01b0 giao ti\u1ebfp c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh. Tuy nhi\u00ean, vi\u1ec7c ph\u00e1t hi\u1ec7n v\u00e0 t\u1ea7m so\u00e1t b\u1ec7nh l\u00fd nha chu hi\u1ec7n t\u1ea1i v\u1eabn c\u00f2n r\u1ea5t nhi\u1ec1u b\u1ea5t c\u1eadp v\u00e0 ch\u01b0a \u0111\u01b0\u1ee3c ng\u01b0\u1eddi d\u00e2n th\u1eadt s\u1ef1 ch\u00fa tr\u1ecdng. B\u00e0i vi\u1ebft n\u00e0y hy v\u1ecdng c\u00f3 th\u1ec3 mang \u0111\u1ebfn cho m\u1ed9t g\u00f3c nh\u00ecn t\u1ed5ng quan v\u1ec1 b\u1ec7nh l\u00fd nha chu c\u0169ng nh\u01b0 c\u00e1c d\u1ea5u hi\u1ec7u v\u00e0 ph\u01b0\u01a1ng ph\u00e1p ph\u00f2ng b\u1ec7nh<\/span><\/p>\n

Kh\u00e1i ni\u1ec7m v\u00e0 t\u1ed5ng quan v\u1ec1 c\u1ea5u tr\u00fac gi\u1ea3i ph\u1eabu m\u00f4 nha chu<\/strong><\/h2>\n

M\u00f4 nha chu g\u1ed3m n\u01b0\u1edbu, d\u00e2y ch\u1eb1ng nha chu, cement ch\u00e2n r\u0103ng v\u00e0 x\u01b0\u01a1ng \u1ed5 r\u0103ng.<\/p>\n

N\u01b0\u1edbu<\/strong><\/h3>\n

N\u01b0\u1edbu \u0111\u01b0\u1ee3c chia th\u00e0nh: N\u01b0\u1edbu r\u1eddi (free gingival), n\u01b0\u1edbu d\u00ednh (attached gingival) v\u00e0 gai n\u01b0\u1edbu (interdental gingival). Ranh gi\u1edbi gi\u1eefa n\u01b0\u1edbu vi\u1ec1n v\u00e0 n\u01b0\u1edbu d\u00ednh l\u00e0 m\u1ed9t r\u00e3nh c\u1ea1n t\u01b0\u01a1ng \u1ee9ng v\u1edbi v\u1ecb tr\u00ed \u0111\u00e1y khe n\u01b0\u1edbu. \u0110\u01b0\u1eddng n\u1ed1i gi\u1eefa n\u01b0\u1edbu d\u00ednh v\u00e0 ni\u00eam m\u1ea1c x\u01b0\u01a1ng \u1ed5 r\u0103ng \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 \u0111\u01b0\u1eddng n\u1ed1i n\u01b0\u1edbu \u2013 ni\u00eam m\u1ea1c (mucogingival junction).<\/p>\n

\"T\u1ed5ng<\/p>\n

H\u00ecnh 1.\u00a0T\u1ed5ng quan c\u1ea5u tr\u00fac gi\u1ea3i ph\u1eabu c\u1ee7a n\u01b0\u1edbu r\u0103ng <\/span><\/strong>(Ghi ch\u00fa: NM: Ni\u00eam m\u1ea1c)<\/span><\/em><\/p>\n

N\u01b0\u1edbu r\u1eddi<\/strong><\/h4>\n

L\u00e0 ph\u1ea7n n\u01b0\u1edbu bao quanh c\u1ed5 r\u0103ng, r\u1ed9ng kho\u1ea3ng 1mm v\u00e0 l\u00e0m th\u00e0nh v\u00e1ch m\u1ec1m c\u1ee7a khe n\u01b0\u1edbu. S\u1edf d\u0129 g\u1ecdi l\u00e0 n\u01b0\u1edbu r\u1eddi hay n\u01b0\u1edbu t\u1ef1 do v\u00ec trong qu\u00e1 tr\u00ecnh th\u0103m kh\u00e1m, b\u00e1c s\u0129 c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng c\u00e2y th\u0103m d\u00f2 nha chu \u0111\u1ec3 t\u00e1ch r\u1eddi ra kh\u1ecfi b\u1ec1 m\u1eb7t r\u0103ng.<\/p>\n

N\u01b0\u1edbu d\u00ednh\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/strong><\/h4>\n

L\u00e0 ph\u1ea7n k\u1ebf ti\u1ebfp n\u01b0\u1edbu r\u1eddi, ch\u1ea1y t\u1eeb r\u00e3nh n\u01b0\u1edbu r\u1eddi \u0111\u1ebfn \u0111\u01b0\u1eddng n\u1ed1i n\u01b0\u1edbu \u2013 ni\u00eam m\u1ea1c di \u0111\u1ed9ng. M\u00e0u c\u1ee7a n\u01b0\u1edbu d\u00ednh l\u00e0 m\u00e0u h\u1ed3ng, b\u1ec1 m\u1eb7t c\u00f3 l\u1ea5m t\u1ea5m da cam. Chi\u1ec1u cao c\u1ee7a n\u01b0\u1edbu d\u00ednh thay \u0111\u1ed5i tu\u1ef3 t\u1eebng r\u0103ng v\u00e0 tu\u1ef3 t\u1eebng c\u00e1 th\u1ec3. C\u00f3 s\u1ef1 thay \u0111\u1ed5i r\u00f5 r\u1ec7t t\u1eeb r\u0103ng s\u1eefa \u0111\u1ebfn r\u0103ng v\u0129nh vi\u1ec5n v\u00e0 \u0111\u1ed1i x\u1ee9ng hai b\u00ean ph\u1ea7n h\u00e0m. Cao nh\u1ea5t l\u00e0 v\u00f9ng r\u0103ng c\u1eeda tr\u00ean v\u00e0 r\u0103ng s\u1ed1 6 h\u00e0m d\u01b0\u1edbi (\u1edf m\u1eb7t l\u01b0\u1ee1i) v\u1edbi \u0111\u1ed9 cao kho\u1ea3ng 6mm; th\u1ea5p nh\u1ea5t l\u00e0 m\u1eb7t ngo\u00e0i r\u0103ng 8 tr\u00ean v\u1edbi \u0111\u1ed9 cao kho\u1ea3ng 0,5mm. \u1ede v\u00f9ng kh\u1ea9u c\u00e1i kh\u00f4ng c\u00f3 ranh gi\u1edbi gi\u1eefa n\u01b0\u1edbu d\u00ednh v\u00e0 ni\u00eam m\u1ea1c kh\u1ea9u c\u00e1i.<\/p>\n

D\u00e2y ch\u1eb1ng nha chu<\/strong><\/h3>\n

L\u00e0 m\u1ed9t c\u1ea5u tr\u00fac m\u00f4 li\u00ean k\u1ebft c\u00f3 nhi\u1ec1u t\u1ebf b\u00e0o, nhi\u1ec1u b\u00f3 s\u1ee3i n\u1ed1i x\u00ea m\u0103ng ch\u00e2n r\u0103ng v\u00e0o x\u01b0\u01a1ng \u1ed5 r\u0103ng. Chi\u1ec1u r\u1ed9ng thay \u0111\u1ed5i t\u1eeb 0,1 \u0111\u1ebfn 0,25 mm tu\u1ef3 theo tu\u1ed5i, giai \u0111o\u1ea1n m\u1ecdc r\u0103ng v\u00e0 nh\u1eefng \u0111\u1eb7c \u0111i\u1ec3m ch\u1ee9c n\u0103ng c\u1ee7a r\u0103ng.<\/p>\n

\"C\u00e1c<\/p>\n

H\u00ecnh 2. C\u00e1c nh\u00f3m d\u00e2y ch\u1eb1ng nha chu.<\/em><\/strong><\/p>\n

Cement ch\u00e2n r\u0103ng<\/strong><\/h3>\n

L\u00e0 do m\u00f4 li\u00ean k\u1ebft kho\u00e1ng ho\u00e1 t\u1ea1o th\u00e0nh l\u1edbp m\u00e0ng bao b\u1ecdc l\u1edbp ng\u00e0 ch\u00e2n r\u0103ng, th\u00e0nh ph\u1ea7n kho\u00e1ng h\u00f3a th\u1ea5p h\u01a1n so v\u1edbi ng\u00e0 v\u00e0 men nh\u01b0ng v\u1eabn cao h\u01a1n x\u01b0\u01a1ng. \u0110\u00e2y l\u00e0 ch\u1ed7 b\u00e1m cho c\u00e1c d\u00e2y ch\u1eb3ng nha chu n\u1ed1i r\u0103ng v\u00e0o x\u01b0\u01a1ng \u1ed5.<\/p>\n

X<\/strong>\u01b0<\/strong>\u01a1ng \u1ed5 r\u0103ng<\/strong><\/h3>\n

L\u00e0 v\u00e1ch x\u01b0\u01a1ng bao chung quanh ch\u00e2n r\u0103ng, c\u00f3 nhi\u1ec1u l\u1ed7 th\u1ee7ng \u0111\u1ec3 m\u1ea1ch m\u00e1u v\u00e0 th\u1ea7n kinh chui qua.<\/p>\n

\"Gi\u1ea3i<\/p>\n

H\u00ecnh 3. Gi\u1ea3i ph\u1eabu x\u01b0\u01a1ng \u1ed5 r\u0103ng.<\/em><\/strong><\/p>\n

Kh\u00e1i ni\u1ec7m b\u1ec7nh nha chu<\/strong><\/h2>\n

B\u1ec7nh nha chu<\/strong>\u00a0l\u00e0 t\u00ecnh tr\u1ea1ng vi\u00eam nhi\u1ec5m c\u1ee7a t\u1ed5 ch\u1ee9c quanh r\u0103ng, d\u1ea7n d\u1ea7n khi\u1ebfn r\u0103ng m\u1ea5t li\u00ean k\u1ebft v\u1edbi t\u1ed5 ch\u1ee9c n\u00e2ng \u0111\u1ee1 n\u00e0y. B\u1ec7nh\u00a0nha chu<\/strong>\u00a0ban \u0111\u1ea7u ch\u1ec9 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ph\u1ea7n m\u00f4 m\u1ec1m \u2013 n\u01b0\u1edbu r\u0103ng, sau \u0111\u00f3 c\u00f3 th\u1ec3 ph\u00e1t tri\u1ec3n \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u1ea3 x\u01b0\u01a1ng \u1ed5 r\u0103ng (c\u00f3 vai tr\u00f2 quan tr\u1ecdng trong vi\u1ec7c gi\u1eef r\u0103ng). Trong tr\u01b0\u1eddng h\u1ee3p nghi\u00eam tr\u1ecdng, b\u1ec7nh\u00a0nha chu<\/strong>\u00a0c\u00f3 th\u1ec3 khi\u1ebfn cho r\u0103ng lung lay, d\u1eabn \u0111\u1ebfn m\u1ea5t r\u0103ng.<\/p>\n

\"\u1ea2nh<\/p>\n

H\u00ecnh 4. \u1ea2nh h\u01b0\u1edfng c\u1ee7a b\u1ec7nh nha chu \u0111\u1ed1i v\u1edbi c\u00e1c t\u1ed5 ch\u1ee9c quanh r\u0103ng<\/em><\/strong><\/p>\n

C\u00e1c giai \u0111o\u1ea1n c\u1ee7a b\u1ec7nh vi\u00eam nha chu<\/strong><\/h3>\n

B\u1ec7nh nha chu r\u1ea5t d\u1ec5 b\u1ecb b\u1ecf qua do di\u1ec5n ti\u1ebfn th\u1ea7m l\u1eb7ng. B\u1ec7nh th\u01b0\u1eddng ti\u1ebfn tri\u1ec3n qua 4 giai \u0111o\u1ea1n:<\/p>\n

    \n
  • Giai \u0111o\u1ea1n 1<\/u>:<\/strong> V\u00f4i r\u0103ng (cao r\u0103ng) h\u00ecnh th\u00e0nh do v\u1ec7 sinh r\u0103ng mi\u1ec7ng k\u00e9m, t\u1ea1o \u0111i\u1ec1u ki\u1ec7n \u0111\u1ec3 vi khu\u1ea9n t\u00edch t\u1ee5 \u1edf nh\u1eefng m\u1ea3ng b\u00e1m k\u1ebd r\u0103ng, c\u1ed5 r\u0103ng v\u00e0 \u0111\u01b0\u1eddng vi\u1ec1n n\u01b0\u1edbu v\u00e0 g\u00e2y k\u00edch th\u00edch n\u01b0\u1edbu, d\u1eabn \u0111\u1ebfn vi\u00eam n\u01b0\u1edbu.<\/li>\n
  • Giai \u0111o\u1ea1n 2<\/u>:<\/strong> Vi\u00eam n\u01b0\u1edbu g\u00e2y s\u01b0ng ph\u1ed3ng v\u00e0 ch\u1ea3y m\u00e1u n\u01b0\u1edbu, \u0111\u1eb7c bi\u1ec7t l\u00e0 khi nhai th\u1ee9c \u0103n ho\u1eb7c ch\u1ea3i r\u0103ng.<\/li>\n
  • Giai \u0111o\u1ea1n 3<\/u>:<\/strong> Vi\u00eam n\u01b0\u1edbu n\u1ebfu kh\u00f4ng \u0111i\u1ec1u tr\u1ecb s\u1ebd d\u1eabn \u0111\u1ebfn\u00a0vi\u00eam nha chu. \u0110\u00f3 l\u00e0 nh\u1eefng \u1ed5 vi khu\u1ea9n c\u00f3 ch\u1ee9a m\u1ee7 \u1edf n\u01b0\u1edbu.<\/li>\n
  • Giai \u0111o\u1ea1n 4<\/u>:<\/strong> Vi\u00eam nha chu ph\u00e1 hu\u1ef7 x\u01b0\u01a1ng c\u1ee7a \u1ed5 r\u0103ng, l\u00e0m\u00a0t\u1ee5t n\u01b0\u1edbu. Khi c\u00e1c t\u1ed5 ch\u1ee9c xung quanh r\u0103ng kh\u00f4ng c\u00f2n ch\u1eafc ch\u1eafn s\u1ebd khi\u1ebfn r\u0103ng b\u1ecb lung lay v\u00e0 d\u1eabn \u0111\u1ebfn m\u1ea5t r\u0103ng.<\/li>\n<\/ul>\n

    \"C\u00e1c<\/p>\n

    H\u00ecnh 5. C\u00e1c giai \u0111o\u1ea1n ti\u1ebfn tri\u1ec3n c\u1ee7a b\u1ec7nh vi\u00eam nha chu<\/em><\/strong><\/p>\n

    D\u1ea5u hi\u1ec7u c\u1ee7a b\u1ec7nh vi\u00eam nha chu l\u00e0 g\u00ec?<\/strong><\/h3>\n
      \n
    • N\u01b0\u1edbu b\u1ecb s\u01b0ng, c\u00f3 m\u00e0u \u0111\u1ecf t\u01b0\u01a1i, \u0111\u1ecf s\u1eabm, d\u1ec5 ch\u1ea3y m\u00e1u, kh\u00f4ng b\u00e1m ch\u1eafc v\u00e0o ch\u00e2n r\u0103ng, l\u00e0m cho r\u0103ng tr\u00f4ng d\u00e0i h\u01a1n b\u00ecnh th\u01b0\u1eddng.<\/li>\n
    • C\u00f3 nhi\u1ec1u m\u1ea3ng v\u00f4i r\u0103ng \u0111\u1ecdng l\u1ea1i \u1edf xung quanh th\u00e2n r\u0103ng.<\/li>\n
    • M\u1ee7 gi\u1eefa r\u0103ng v\u00e0 n\u01b0\u1edbu g\u00e2y \u0111au nh\u1ee9c.<\/li>\n
    • \u0110au khi nhai, b\u1ec7nh nh\u00e2n th\u01b0\u1eddng ch\u1ecdn m\u1ed9t b\u00ean kh\u00f4ng \u0111au \u0111\u1ec3 nhai.<\/li>\n
    • R\u0103ng lung lay, d\u1ec5 g\u00e3y r\u1ee5ng.<\/li>\n
    • B\u1eaft \u0111\u1ea7u xu\u1ea5t hi\u1ec7n t\u00ecnh tr\u1ea1ng h\u00f4i mi\u1ec7ng.<\/li>\n<\/ul>\n

      \"C\u00e1c<\/p>\n

      H\u00ecnh 6. C\u00e1c h\u00ecnh \u1ea3nh v\u1ec1 b\u1ec7nh vi\u00eam nha chu<\/em><\/strong><\/p>\n

      Ph\u00f2ng ng\u1eeba b\u1ec7nh vi\u00eam nha chu<\/strong><\/h2>\n

      V\u1ec7 sinh r\u0103ng mi\u1ec7ng \u0111\u00fang c\u00e1ch<\/strong><\/h3>\n
        \n
      • Ch\u1ea3i r\u0103ng \u00edt nh\u1ea5t 2 l\u1ea7n\/ng\u00e0y<\/li>\n
      • S\u00fac mi\u1ec7ng b\u1eb1ng n\u01b0\u1edbc s\u00fac mi\u1ec7ng chuy\u00ean d\u1ee5ng.<\/li>\n<\/ul>\n

        \"C\u00e1c<\/p>\n

        H\u00ecnh 7. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p v\u1ec7 sinh r\u0103ng mi\u1ec7ng<\/em><\/strong><\/p>\n

          \n
        • H\u1ea1n ch\u1ebf d\u00f9ng t\u0103m x\u1ec9a r\u0103ng hay c\u00e1c v\u1eadt c\u1ee9ng, nh\u1ecdn ti\u1ebfp x\u00fac v\u1edbi r\u0103ng<\/li>\n
        • H\u00e3y s\u1eed d\u1ee5ng ch\u1ec9 nha khoa, m\u00e1y t\u0103m n\u01b0\u1edbc \u0111\u1ec3 l\u00e0m s\u1ea1ch khoang mi\u1ec7ng to\u00e0n di\u1ec7n.<\/li>\n<\/ul>\n

          Kh\u00e1m nha v\u00e0 c\u1ea1o v\u00f4i r\u0103ng \u0111\u1ecbnh k\u1ef3 <\/strong><\/h3>\n
            \n
          • Th\u1eddi gian: 4-6 th\u00e1ng\/l\u1ea7n<\/li>\n
          • Kh\u00e1m nha v\u00e0 c\u1ea1o v\u00f4i r\u0103ng \u0111\u1ecbnh k\u1ef3 t\u1ea1i nha khoa uy t\u00edn \u0111\u1ec3 \u0111\u01b0\u1ee3c t\u01b0 v\u1ea5n, v\u1ec7 sinh r\u0103ng mi\u1ec7ng v\u00e0 ph\u00f2ng tr\u00e1nh c\u00e1c b\u1ec7nh v\u1ec1 r\u0103ng mi\u1ec7ng, nha chu.<\/li>\n<\/ul>\n

            \"C\u1ea1oH\u00ecnh 8. C\u1ea1o v\u00f4i r\u0103ng \u0111\u1ecbnh k\u1ef3.<\/em><\/strong><\/p>\n

            \u00c1p d\u1ee5ng ch\u1ebf \u0111\u1ed9 dinh d\u01b0\u1ee1ng h\u1ee3p l\u00fd<\/strong><\/h3>\n
              \n
            • X\u00e2y d\u1ef1ng ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng khoa h\u1ecdc \u0111\u1ee7 ch\u1ea5t, b\u1ed5 sung vitamin, c\u00e1c kho\u00e1ng ch\u1ea5t c\u00f3 l\u1ee3i cho r\u0103ng, gi\u00fap r\u0103ng ch\u1eafc kh\u1ecfe.<\/li>\n
            • C\u1ea7n h\u1ea1n ch\u1ebf c\u00e1c lo\u1ea1i th\u1ef1c ph\u1ea9m ch\u1ee9a ch\u1ea5t ng\u1ecdt, tinh b\u1ed9t,\u2026 b\u1edfi ch\u00fang s\u1ebd t\u1ea1o c\u00e1c m\u1ea3ng b\u00e1m tr\u00ean r\u0103ng, g\u00e2y vi\u00eam n\u01b0\u1edbu,\u00a0vi\u00eam nha chu.<\/li>\n<\/ul>\n

              Lo\u1ea1i b\u1ecf c\u00e1c th\u00f3i quen sinh ho\u1ea1t x\u1ea5u<\/strong><\/h3>\n

              H\u00fat thu\u1ed1c l\u00e1, s\u1eed d\u1ee5ng c\u00e1c ch\u1ea5t k\u00edch th\u00edch (bia, r\u01b0\u1ee3u,\u2026)<\/p>\n

              T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong><\/h2>\n
                \n
              1. BRR Varma, RP Nayak, Current concepts in Periodontics, chapter 2, Arya Publishing, 2002; 4-8.<\/li>\n
              2. BG Jansen Van Rensburg, Oral Biology, chapter 8, Quintessence Publishing Co Ltd, 1995; 301-7.<\/li>\n
              3. Tencate, Oral Histology, Development, Structure and Function, 3rd<\/sup> edition, Jaypee Bros, 228-43<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

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