Y HOC VIET NAM THANG 4 - SC v
V . KET LUAN
Ty le hpe sinh khong can dieu tri la rat thap, nhu cau nan chinh rang-ham rat cao. Trong eae loai lech lae, sai khdp can loai I I la ioai cd ty le can dieu trj eao nhat.
TAI LIEU T H A M KHAO
1. Brook P.H. and Shaw W.C. ( 1 9 8 9 ) : "The development of sn index of orthodontic treatment prionty". Eur. J Orthod. 11 pp. 309 - 320 2. Shaw W. C, Richmond S. and O'Brien K. D
(1995): "The use of occlusal indices: a European perspective". Amencan Journal of Orthodontics and Dentofacial Orthopedics, 107 pp 1 - 10.
3. Hoang Thj Bach Du'dng ( 2 0 0 0 ) : "Dieu tra ve lech lac rang - ham tre em lu'a tuoi 12 tai tru'dng
(^p 2 Amsterdam Ha ndi". Luan van thac sy y hpc.
Trirdng_Dai Hoc Y Ha Ngi, tr. 36-47 Nguyen Vo Hoang Anh (2005): "Nhan xet ntiu cau dieu tn chinh nha cua hoc sinh tuoi 15 tru'dng THCS Tran Dang Nmh - Ha Oong theo chi so lOTN". Luan van thac sy y hgc. Tru'dng Dai hgc Y Ha noi^ tr. 32-45
Nguyen Thj Ngan Ha, Hoang TLT Hung ( 2 0 0 4 ) : "L/dc lUOng nhu t3u dieu tn chinh nha tai Da Ning". Trong tuyen tap: Cong trinh nghien CLfu khoa hoc rang ham mat. Oai hoc Y di/dc Thanh pho H6 Chi Minh, tr 3 0 ' - 36
Oong Mai Hu'dng (2012): "Nghien cuU tinh trang lech lac khdp can va nhu cau dieu tn chinh nha cua smh vien trPdng Dai hoc Y Hal Phdng". Luan van thac sy. TrUOng Dai hoc Y Ha npi, tr. 4 2 - 5 4 Wang G, Hagg U, Ling J " The orthodontic treatment need and demand of Hong Kong Chinese children " Am. J. Orthodontic, pp.24-36
DANH GIA HIEU QUA LAM SANG SU* DUNG TRAM XOAY NI-Tl PROTAPER TRONG DIEU TRI TUY RANG
Tran Thi Lan Anh*
T6M TAT
Nghien ciru Ap dung ky thuat sira soan ong tuy bSng tram xoay Ni-Ti Protaper, qua do nhan xet ket qua ifng dung lam sang.
Ooi tu'dng va phu'dng phap nghien cCru:
Nghien ciTu can thiep, theo doi doe tren 50 rang ham nho, rang ham I6n dUdc chuan bi ong tuy bang ky thuat Crown-Down vdi bg tram xoay Ni-Ti Protaper.
Danh gia thcJi gian chuan bi ong tuy, hinh dang tao hinh ong tuy, ket qua lam sang va X quang ngay sau han,sau han 6 thang
Ket qua: Thdi gian ehuan bj ong tuy nhom rang ham I6n la 31.57 + 12.96 phut, nhom rang ham nho la 11.46 + 6.62 phut, 98% rang dUOc tao dang ong tuy thuon deu hinh con, 42% rang chi can dieu tr; 1 fan, khong co rang dieu tri qua Sl'an, ty le rang du'pc chuan b| ong tiiy du ehieu dai la 90.0%, 94% rang khong dau sau han tuy, sau 6 thang ty le thanh cong la 95.6%,
Ket luan: Dieu tn tiiy bang tram xoay Ni-Ti Protaper nhanh, giam thdi gian va so ^ n dieu tq, tao dang ong tiiy thuon deu hinh con giiip cho dieu tn tiiy rSng de dang va an toan hOn, ty le thanh cong cao.
* Benh vien Rang ham mSt TW
Phan bign khoa hgc: PGS.TS Trjnh Oinh Hai
S U M M A R Y
REVIEWS THE EFFECTS OF ENDODONTIC TREATMENT BY ROTARY FILES PROTAPER
Aim: To evaluate the efficacy of Rotary Files Protaper in root canal preparation
Objectives and Methods:
A a follow- up study with 50 molars and premolars were prepared using Rotary Files Protaper, crown- down technique. Total time for shaping root canals, shape of prepared canals, length obturation, resulting treatment after 1 week and 6 months were evaluated.
Results: Average time to prepare root canal is 31.57 ± 12.96 minuts at molars and 11.46 ± 6.62 minuts at premolars. 98% has a tapering conical root canal form, 42% need 1 time treatment, no patient need 3 time over, 90.0% good length root canal preparation, 94% has no symptom after obturation, the success rate after 6 monhs is 95.6% .
Conctutions: Root canal preparation with Rotary Files Protaper Protaper fastly, less time, shape a continuously tapering conical root canal form which help the treatment of root canals is easier and safer, the success rate is higher.
Keywords: Rotary Files Protaper
Y HQC VI$T NAM THANG 4 • SO 1/2014
LDi^LTV^NOl
Benh tuy rSng chiem ty le cao trong eac benh rSng mieng. Oe dieu trj tuy rang thanh cong la lam sach - tao hinh ong tuy va han kin ong tuy theo 3 chieu. He thong tram xoay Ni-Ti Protaper sif dung cho lam sach - tao hinh ong tuy, vcfi thiet ke cai tien tang do mem deo d nhij'ng cay tram so Icfn hdn va thuon hdn nham lam saeh va tao hinh ong tuy tot hdn. Do do chung toi tien hanh nghien ecTu de tai: "£>^nh gia hieu qua ISm sang suf dung tram xoay Ni- Ti Protaper trong dieu tri tuy"
Vdi muc tieu: Ap dung ky thuat siici soan ong tuy bu'de xuong bang tram xoay Ni-Ti Protaper, Nh$n xet ket qua va CTng dung lam sang,
IL £)0I TLrQTJG VA PHU'CTNG PHAP NGHIEN CLTU 2.1. 061 tu'dng: Doi tu'dng nghien ciru la cae benh nhan tuoi tii 15 den 60, co rang ham nho, rang ham ldn vinh vien {trif rang 8) da dong kin cuong co ehi dinh ehUa tuy khong phau thuat tai Khoa dieu tri Theo yeu cau - Benh Vien Rang Ham Mat TW Ha Noi. So lu'dng rang: 50. Thdi gian nghien cu'u: Tir 1/3/2013 den 31/12/2013
2.2. Phu'dng phap nghien cu'u - Chuan bl ong tiiy bang ky thuat Crow/n-Down vdi bg tram xoay Ni-Ti Protaper.
- Tram bit ong tuy: Theo phu'dng phap len am 3 chieu con Gutta percha vdi eay len doc cam tay - Danh gia tong thdi gian chuan bj ong tiiy ciia rang dieu tri, so lan dieu tri. Oanh gia X Quang ngay sau dieu trj: hinh dang ong tiiy. Oanh gia lam sang sau han tuy 1 tuan. Oanh gia sau dieu trj 6 thang: lam sang va X quang
III. K ^ QuA vA BAN LUAN
50 rang ham so 4,5,6,7 ham tren va ham du'di da du'de dieu tri tiiy sir dung tram xoay Ni-TI Protaper, thu du'de mot so ket qua sau:
-Thdi gian chuan bj ong tiiy trung binh theo nhom rang
Bang 1. Thdi gian chuan bi ong tiiy trung binh theo nhom rang
Nhom rang So lu'dng R TGTB(phut) Thdi gian nglin nha't Thdi gian dai nhat
RSng hamJdn 31.57 ± 12.96 10 70
R5ng ham nho 13 11.46 ± 6.62 30
TTidi gian chuan bj ong tiiy nhom r5ng ham ldn trung binh la 31.57 phut, giam gan 1/2 thdi gian so vdi tram xoay Ni-Ti Profile ( 60 phut cho mgt rSng ham ldn theo nghien cii'u ciia Bui Que Du'dng), bang 1/3 thdi gian chuan bj ciia tram tay Ni-Ti Protaper( 97.77 phiit cho mot rang ham Wn theo nghien cifu ciia Bui thj Thanh Tam).
Nhom rSng ham nho thdi gian chuan bj dng tiiy trung binh 11.46 phiit, thdi gian ngSn nhat 5 phut, thdi gian dai nhat 30 phiit. Qua sir dung chiing toi nhan thay, khi ong tuy thong du'de tdi so 15 dil khong gian cho tram xoay Ni-Ti - Dinh gii ISm sang sau han tuy 1 tuan:
Bing 2. Trieu chirng lam sang sau han tuy:
Protaper hoat dpng thi tram xoay Ni-Ti Protaper dl xuong trong ong tuy rat nhanh, hoat dpng ehii dpng va hieu qua giup viec nong rpng dng tiiy chi ton rat it thdi gian.
- Hinh dang dng tiiy sau dieu tri va so ian dieu tn: (98%) ong tiiy co dang thuon deu, mi^ng loe, phan chdp ong tiiy that nho. Cd duy nhat 1 rSng ham nhd dieu tri tuy tai khi tao hinh dng tiiy co hinh bae thang d doan cuong. Viee tao dang ong tiiy tdt giiip de dang va an toan cho bdm rira lam sach va han kin ong tiiy, vi vay lam giam dang ke so lan dieu tri; 42% rang chi dieu tri 1 lan, khong CO rang nao can hdn 3 lan dieu trj.
Trl^u chu'ng I5m s^ng 5L rang
Khong stfng dau Dau nhg
Da sScac rSng khong dau sau han tuy, co 3 benh nhan dau vdl mdc do dau nhg, ngach Idt kh6ng suhg, het trigu chuhg sau I den 2 tuan.
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Y HOC VIET NAM THANG 4 - SO 1/2014
- Ket qua dieu trj sau 6 thang: Sau 6 thang ehung toi kham lai lam sang va X quang du'de 45 benh nhan, ketqua nhu"sau:
Bang 3. Ket qua dieu trj sau 6 thang
Ket qua
SL rang TL
Tot 43 95.6%
Kem 2 4.4%
Co 95.6% rang kham lai co ket qua tot: rang on dinh, khong su'ng dau, chiic nang an nhal tdt, CO 2 rang ket qua kem ehiem ty le 4 . 4 % . Ket qua dieu trj theo mpt so nghien eiru ciia cae tac gia nu'dc ngoai ty le thanh cong la tren 9 0 % . Theo mot so tae gia trong nu'dc nghien cu'u gan day, ty Ie thanh cong sau 6 thang la 86.67% (Bui Thj Thanh Tam), 84.38% ( Le Thj Hu'dng)
IV. KET LUAN
Til' ket qua nghien eiru tren lam sang sira scan dng tiiy bang tram xoay Ni-Ti Protaper cho 50 rang ehiing toi co mot so nhan xet sau:
4 . 1 . Ve ky t h u a t su'a soan ong t u y su*
dung t r a m xoay NI-TI Protaper:
Thdi gian chuan bj dng tiiy rut ngan dang ke;
giam gan 1/2 thdi gian so vdi tram xoay the he trUdc Ni-Ti Profile, bang 1/3 thdi gian chuan bj ciia tram tay Ni-Ti Protaper.
Hinh dang ong tuy sau dieu trj va sd lan dieu trj; 9 8 % dng tuy eo dang thuon deu, 9 0 % ong tiiy han dil chieu dai. Viee tao dang ong tiiy thuon deu, loe d mieng de dang va an toan cho bdm rira lam saeh va han kin ong tiiy, vi vay lam giam dang ke so lan dieu trj: 4 2 % rang ehi dieu trj 1 fan, khong co rang nao can hdn 3 lan dieu tr;.
4 . 2 . Ket qua dfeu t r i : Ket qua lam sang tot chiem 9 4 % sau dieu trj 1 tuan, 95.6% khi kham lai sau 6 thang. Ket qua Xquang tdt 9 1 . 1 % sau 6
thang. Ket qua nay kha tot khi so vdi ty le thanh eong eiia cae phu'dng phap dieu tri gan day dao ddng trong khoang 8 0 % den 9 5 % . LTng dyng lam sang dieu trj tuy vdi tram xoay Ni-Tl Protaper da giiip viec dieu trj tiiy de dang nhanh ehong va hieu qua hdn nhieu, ngu'di lam npi nha khong eon phai bo ra nhieu cong sire nong giua va lam sach ong tiiy nhu" tru'de dae biet vdi eac dung cu cam tay.
TAI LIEU T H A M KHAO
1. Bui Que Du'dng (1998): Nhij'ng phu'dng phap sira soan dng tuy. Cap nhat Nha khoa - Khoa Rang ham mat, Tru'dng Oai hoc Y Du'de TP.HCM, tr.35-37.
2. Mai Oinh Htfng (2001): Cac phu'dng phap chuan bl ong tuy. Bai giang cho Cao hpc RHM, Bo mon R5ng ham mat, Tru'dng Oai hgc Y Ha Noi.
3. Le Thj Hu'dng (2001): Nhan xet phudng ph^p chuan bi ong tuy bang giua may. Luan v3n Thac sy Y hoe, Trudng Dal hpc Y Ha Noi.
4. Bill Thj Thanh Tam (2004): Nhan xet hl^u qua dieu tn tuy vdi Nl-Ti Protaper cam tay. Luan v3n thac si y hpc, TrUdng Dai hoc Y Ha Noi.
5. Glickman G.N, Dumstia T.C (1997): Problems in cleaning and shaping in endodontics.3 ^ edition. Mosby, p.123-156.
6. John David West, James B, Roane (1998):
Cleaning and shaping the root canal system.
Pathways of the puip, p. 203- 223.
