H A NOI

Y HOC VIET NAM THANG 4 - SO 2C014

NHAN XET TINH TRANG MON CO RANG TRONG DO TUO! 25-60 TAI XA PHUC LAM, HUYEN MY BU'C- H A NOI

Tong Minh Soti*, Ha Ngoc Chi6u*, Tr5n Thi My Hanh*

TOIVI TAT

Muc tieu: Nhan xet tinh trang mon co rang trong dp tuoi 25-60 tai xa Phuc Lam, My Dffc, Ha Noi. D61 tu'dng va phu'dng phap nghien cu'u: Nghien ciru mo ta cat ngang. Ket qua: Ty le so ngUdi MCR chiem ty le 70.7%.Ty le MCR ciia nam va nff tUdng dUdng nhau.Ty le MCR d nhom RHN la cao nhat (44.46%), tiep den la nhom RHL (19.82%), nhdm rang cir^

(18.21%) va rang nanh la thap nhat (17.50%). Ty le MCR do 1 cao nhat (63.04%), tiep theo la dp 2 (30.36%), dp 3 chiem 5.54% va dp 4 la thap nhat (1.07%).Vj tri tdn thffdng MCR nhieu nhat d 1/3 cd rSng, m i t ngoai d tren ldi (90.36%). Tdn thUdng MCR dudi ldi chiem 8.21%, khdng cd ton thuong MCR mat trong. Ket lu|ln: Mon cd rang chiem ty le cao, thudng gSp d nhom rang ham nhd, vj tri ton thUOng d 1/3 co r3ng mat ngoai tren Ipi.

Tdkhoa: Mon co rang, tdn thUOng

S U M M A R Y

PREVALENCE OF CERVICAL TOOTH ABRASION I N 2 5 - 6 0 YEARS OLD

POPULATION I N PHUC LAM, MY DUC-HA N O I

Objectives: Assessing the prevalence of cervical tooth abrasion in 25-60 years old populaiton m Phuc Lam, I^y Duc, Ha Noi. Methods: This is a observational study, a cross-sectional study. Results:

The prevalence of population with cervical tooth abrasion is 70.7%. No significant difference was found in relation between tooth abrasion and gender. The cervical abrasion affects the bicuspid (44.46%) the most commonly, secondary injured tooh is the molar (19.82%), the next is the incisor (18.21%), and the cuspid is at least (17.50%). The prevalence of level 1 abrasion (63.04%) is the highest, level 2 is (30.36%), level 3 (5.54%) and level 4 is at least (1.07%). The region that injured the most commonly is the cervical third of the supragingival buccal surface (90.36%).

The subgingival abrasion includes 8,21%. There is no abrasion injury on the lingual or palatal suface.

Conclusions: the prevalence of cervical abrasion is high, often affects the bicuspid and the cervical third of the supragingival buccal surface is the common injured region.

Keywords: Q&nj'\zd\ abrasion, injury

* Vien DT RSng ham mSt Trung ddng Phan bipn khoa hpc: PGS.TS Mai Dinh Hffng

I. OAT V A N OE

Song song vdi benh sau rang, tdn thUOng ^ chffe cffng khdng do sau cting la mdt nhdm benh rat hay gap va da dang. Trong d d , mdn rang ehiem ty le rat eao, chiem 95,52% theo nghien cffu gan day cua Vu Duy Hffng [ 5 ] . Ton thuWng to chffe cffng d viing cd rang la ket qua cua nhieu qua trinh tac dpng vdi nhau, bao gom: sif mai mdn, sff an mdn hoa hpc. Ben canh do qua trinh nay cd the di kem vdi hien tffdng tieu co rang, la hien tffdng mat td chffe cffng do qua trinh chju Iffc uon ciia rang. Mon co rang neu keo dai se gay nen nhffng ton thffdng hinh chem d viing cd rang, anh hffdng den tham my cho benh nhan. Mat khac, mdn cd rang neu khdng phat hien kjp thdi se rat de dan den nhay cam nga, nhay cam tiiy rat khd dieu tn cho benh nhan, lam anli hffdng den an uong va sinh hoat. Chinh vi vay muc tieu dat ra la chung ta can phal phat hien sdm de ed eac bien phap dieu tn kip thdi, dat ket qua cao dong thdi cd cae bien phap dy phdng hdp ly. Xa Phuc Lam, huyen My Offc la dja ban thupc ngoai thanh Ha Npi, dan cff chii yeu la lam ndng nghiep va budn ban nhd, dai da so la ngffdi Cdng giao. Oe biet dffdc tinh hinh sffc khde rang mieng ndi chung va tinh trang mon co rang ndi rieng cua ngffdi dan tren dja ban, chung tdi tien hanh nghien cffu de tai nay nham muc tieu: Nhan xet tinh trang mon coring trong dp tuoi 25-60 tai xa Phuc Lim, huyen Mf Ddc - Ha Npi.

W. DOITLTQIMG VA PHUCTNG PHAP NGHIEN COU 2.1. Ooi tu'dng nghien cu'u: La nhifng ngffdi dan trong dp tuoi nghien cffu tff 20-65 tuoi dang sinh sdng tai xa Phuc Lam, huyen l^y Diit, Ha Npi

- Dia diem nghien cffu: xa Phuc Lam, huyen My Dffc, Ha Ndi

- Thdi gian nghien cffu: Nam 2011

2.2. Phu'dng phap nghien cuTu: Sff dung phffdng phap nghien cffu mo ta cat ngang C3 mau: Dffdc tfnh theo cdng thffc nghien cii\J md ta;

YHOC VIET NAM THANG 4 - SO 2/2014

, Pq x 2 ('-f> d-

Trong dd: P=0.5, d=0,14. Thay vao cdng thffc tinh dffdc ed mau la 98 benh nhan, thffc te da ehon 103 benh nhan.

2.3. Cach chpn mau: Lap danh sach tat ca ngudi dan trong do tud'i 25-60. Chon ngau nhien cho dil 103 ngffdi.

2.4. Cac chi so danh gia tinh trang mon rang: Ban^ danh gia dd_mdn rang ciia Smith va Knight. Mdi mat eiia mdi rang dffdc danh gia theo thang diem tff 0-4 du'a theo trieu chu^g:

Oiem 0 1 2 3 4

Tieu chuan Khong cd tdn thu'dng d men Khdnq ed sff thay doi dffdnq vdnq eo rang Co sff xuat hien tdn thffdng d men

Cd ton thffdnq mdt phan nhd d dffdnq vdng co ranq Mat men rang va bpc Id <1\3 nga effa be mat Mat men rang va bdc Id nga rang Mdn cd dd mdn dffdi 1mm ehieu sau Mat men rang va bpc Id > 1\3 nga be mat

Mat men rang va cliac chan ed bde Id nga rang nhffng chffa Id tiiy Mdn CO do mdn tff 1- 2mm chieu sau

Mat men hoan toan hoae Id tuy hoac Id nga thff phat Lp tiiy hoac lp nga thff phat

Mdn cd hdn 2mm ehieu sau hoac Id tiiy hoac Id nqa thff phat I. Kfr QuA

3.1. B^c di€m mon co rSng theo nhom tuoi va gidi Bang 1: Ty le so ngu'di mon co rang tiieo nhom tuoi

Nhoml Nhom 2 Nhom 3 3 nhom

Mon CO rSng 19 (54.28%) 27 (79.41%: 27 (79.41%) 73 (70.9%) Khong mon co rang 16 (45.72%) 7 (20.59%) 7 (20.59%) 30 (29.1%)

Tong so ngif6i 35 34 34 103

Nh$n x6t; Trong so 103 doi tu'dng nghien cii'u, so ngu'di MCR chiem ty ie rat cao vdi 70.7%. 6 nhom 1, ty ie MCR<54.28%) va I<h6ng MCR (45.72%) tu'ong du'dng nhau. 0 nhom 2 va nhdm 3, ty ie MCR dSu chiem 79,41%, Idn hdn gan 4 lan ty le I<h6ng MCR moi nhom (20.59%). Sir Ichac biet nay

ob y nghTa thong l<e vdi p<0.05.

Bang 2, Ty le so ngudi mon co rang theo gidi MCR

Khong MCR Tong

Nam 23 (69.7%) 10 (30.3%)

33

NO' 50(71.43%) 20 (28.57%)

70

long 73 (70.9%) 30(29.1%)

103

Nh$nx6t:\ACRc\ia nam va nff tffdng dffdng nhau (nff 71.43%, nam 69,7%).

3.2.0$c diem cua mdn co rSng Bang 3. Ty le rang bj MCR theo trai, phai

Ben trai Ben phai

Tong

Nhdml 59 (52.78%) 53 (47.32%)

112

Nhom 2 123 (49.80%) 124 (50.20%)

247

Nhom 3 106 (52.74%) 95 (47.26%)

201

3 nhom 288 (51.43%) 272 (48.57%)

560

Nh$n xSt: Ty le rang bi mdn co rang ca 3 nhdm d ben trai la 51.43%, nhieu hdn d ben phai

(48.57%). Tuy nhien sff khac biet nay khdng cd y nghia thong ke vdl p>0.05.

Y HOC VIET NAM THANG 4 - SO 2/2014

Bang 4. Ty le rang bl MCR theo nhdm Nhom rang cira

Rang nanh Nhom rang ham nho

Nhom rang ham Idn Tong sd rang

Nhom 1 11 (9.82%) 23 (20.54%) 57 (50.89%) 21 (18.75%) 112 (100%)

rang Nhom 2 52 (21.05%) 40(16.19%) 102 (41.30%)

53 (21.46%) 247 (100%)

Nhom 3 39(19.4%) 35 (17.41%) 90 (44.78%) 37 (18.41%) 201 (100%)

3 nhom 102 (18.21%J 98 (17.50%) 249 (44.46%) 111 (19.82%) 560 (100%) Nhan xet: Jy le mdn ed rang d nhdm RHN la eao nhat (44.46%), tiep den la nhdm RHL (19.S nhdm rang effa (18.21%) va rang nanh la thap nhat (17.50%).

Bang 5. Ty le rang bi MCR

Rang 1 Rang 2 Rang 3 Rang4 Rang 5 Rang 6 Rang 7 Rang 8 Tong

N h o m l

10(8.93%) 1 (0.89%) 23 (20.54%) 32 (28.57%) 25 (22.32%) 19 (16.96%) 1 (0.89%) 1 (0.89%) 112 (100%)

Nhom 2

25(10.12%) 27 (10.93%) 40 (16.19%) 55 (22.3%) 47 (19.03%) 38 (15.38%) 10(4.05%) 5 (2.02%) 247 (100%)

Nhom 3

21 (10.45%)

18 (8.96%) 35(17.41%) 49 (24.38%) 41(20.40%) 27 (13.43%)

8 (3.98%) 2 (1.00%) 201 (100%)

3 nhom

56 (10.00%)

46 (8,21%) 98 (17.50%) 136 (24.29%) 113 (20.18%) 84 (15.00%)

19 (3.39%) 8 (1.43%) 560 (100%) Nh$n xe'f;Ty le MCR rang 4 la cao nhat (24.29%), tiep den la rang 5 (20.18%), rang 3 (17.5 rang 6 (15.00%), thap nhat la rang 8 (1.43%).

Bang 6, Vi tri mon co ranq Mat trong

2/3 than, mat ngoai 1/3 CO mat ngoai, tren Idi Co rang mat ngoai, dudi idi

Tong

Nhom 1 0%

1 (0.89%) 98 ( 87.50%)

13 (11.61%) 112

Nhom 2 0%

3 (1.21%) 215 (87.04%)

29 (11.74%) 247

Nhom 3 0%

4 (1.99%) 193 (96.02%)

4 (1.99%) 201

3 nhdm 0%

8 (1.43%) 506 (90.36%)

46 (8.21%) 560 Nhin xet; Vj tri ton thu'dng MCR nhieu nhat d 1/3 co rang, mat ngoai 6 tren ldi (90.36%). Ton thu'dng d vj tri nay cd lien quan dong bien chat che vdi so MCR moi nhom vdi he so r=0.987. Ton thu'dng MCR dudi lc?i chiem 8.21%, i<hdng cd ton thu'dng MCR mat trong.

Bang 7, Ty le mon co rang theo do Nhdm 1 69 (61.61%) 39 (34.82%) 4 (3.57%)

Nhdm 2 168 (68.02%) 69 (27.94%) 10 (4.05%)

0 (0.00%) 0 (0.00%) 6 (2.99%) Nhdm 3

116 (57.71%) 353(63.

62 (30.85%) 17 (8.46%)

3 nhdm

170 (30.36°,<

31 (5.54%)

6 (1.07%)

I Tong I 112 (100%) I 247 (100%) I 201 (100%) | 560 (100%) ,

Nh$n xet; Ty le MCR dp 1 d ca 3 nhdm la cao nhat (63.04%), tiep theo la do 2 (30.36%), dp 3

chiem 5.54% va dp 4 la thap nhat (1.07%). So sanh 3 nhdm thay ty le mdn co rang dp 3 va dp 4 4

nhdm 3 cao hdn nhom 1 va nhdm 2.

YHOC VIET NAM THANG 4 - SO 2/2014

IV. BAN LUAN

4 . 1 . Oac diem mon co rang theo nhdm tuoi va gidi

Qua bang 1 eho thay trong sd 103 dot tffdng nghien effu cd sd ngu'di MCR chiem ty le rat cao (70.7%). Ket qua nay cao hdn ket qua nghien eiru cua Vu Duy Hffng (2008) nghien cffu tren nhdm ddi tffdng tff 60 tuoi t r d len tren 201 ngffdi tai phffdng Yen Sd, quan Hoang Mai, Ha Ndi [5]

vdl ty le cae trffdng hap mdn mat ngoai va viing CO rang la 34.83% sd di vi ehung tdi tien hanh nghien cffu d dp tuoi tre hdn tff 20 den 65 tuoi nen ty Ie mat rang cung thap hdn rat nhieu (theo ket qua nghien cffu ciia Vu Duy Hffng ty le mat rSng la 84.58% ngffdi cao tudi vdi sd rang mat b-ung binh la 9.89 rang mat/ngffdi). Ben canh dd xa Phiic Lam, huyen My Offc la viing ngoai d Ha Noi nen kien thffc cham sdc ve sinh rang mieng va cd hdi tiep can vdl cac dich vu kham chffa benh la thap hdn do khdng cd kinh phi hoac thay khdng can thiet phai di kham.

Ket qua nghien cffu eua chiing tdi eho thay ty le MCR d nhdm 1, ty le MCR (54.28%) va khdng I^CR (45.72%) tffdng dffdng nhau. O nhdm 2 va nhdm 3, ty le MCR deu chiem 79,41%, idn hon gan 4 lan ty le khdng MCR mol nhdm (20.59%).

Sff khac biet nay ed y nghTa thong ke vdi p <0.05.

Theo Blunek. U, d liici tudi trung nien va gia bat dau ed hien tffdng giam tiet nffdc bpt, do dd lam tang cffdng hieu qua ciia acid trong mdi trffdng mieng, lam xdp be mat men va nga rang. Day la dieu kien thuan ldi cho sff ep mdn trong qua trinh Sn nhai hay ve sinh rang mieng gay tdn thffdng vung CO rang ndi rieng va mdn be mat rang ndi diung.

Qua bang 2 cho thay ty le MCR ciia nam va nff d cpng ddng nghien ciTu nay tffflng dffdng nhau. Ket qua nay cijng phii hdp vdi nghien cirtj cua Vu Duy HUng [ 5 ] .

4.2. Ddc diem mon co r3ng

Theo bang 4 cho thay ty le mdn eo rang d nhdm RHN la cao nhat (44.46%), tiep den la nhdm RHL (19.82%), nhdm rang effa (18.21%) vS r3ng nanh la thap nhat (17.50%). Trong moi nhdm thi ty le MCR d nhdm RHN van cao hdn hSn so vdi nhutig nhdm rang khac. Va so RHN bi MCR cd tffdng quan dong bien chat ehe vdi MCR timg nhdm vdi he so r = 0.997. Ket qua nay cCing phii hdp vdi nghien ciru D3ng Que Dffdng Cho thay mdn co RHN gap nhieu nhat (63.6%), tigp dd 1^ nhdm RHL (28.8%), rang nanh thap

nhat chiem 7.6% [ 1 ] .

Ben canh dd, ket qua nghien ciTU bang 5 chi ra rang thff tff ty le rang bi MCR gap cao nhat d rang sd 4 (24.29%), rang 5 (20.18%), rang 3 (17.50%), rang 6 (15.00%), thap nhat la rang 8 (1.43%). Nhu* vay neu khdng gdp eac rang thanh nhdm thi ty le ciia rang 4, rang 5 van cao nhat nhffng tffdng quan ty le mdn eiia rang 3 eao hdn rang 6. Su phan bd nay cd le do:

- Nhdm rang ham nhd nam d vi tn' thuan Ipi cho sff tac ddng lu-c eiia ban chai khi chai rang - Rang nanh nam d vi tri gdc cong tren cung ham nen chiu Iffe tae ddng tff ban chai nhieu hdn eae rang khae

- Nhdm rang ham nhd va rang ham Idn la cac rang chiu Iffe chinh trong qua trinh an nhai hay cac rdi loan can chffe nang nhff nghien rang

Ket qua nghien effu bang 3cho thay ty le rang bi mdn co rang ca 3 nhdm d ben trai la 51.43%, nhieu hon d ben phai (48.57%). Tuy nhien sff khac biet nay khdng cd y nghia thdng ke vdi p = 0.05. Qua day ehiing ta thay ton thffPng mdn cd rang thffdng ddi xffng hai ben.

Theo bang 6, vj tri tdn thUPng MCR nhieu nhat d 1/3 eo rang, mat ngoai d tren Idi (90.36%). Ton thUdng d vj tri nay ed lien quan ddng bien chat ehe vdi sd MCR moi nhdm vdi he sd r = 0.987. Ton thffdng MCR dffdi Idi chiem 8 . 2 1 % , khdng ed tdn thffPng MCR mat trong.

Ket qua trinh bay trong bang 7 cho thay ty le MCR dd 1 d ca 3 nhdm la cao nhat (63.04%), tiep theo la dp 2 (30.36%), do 3 chiem 5.54% va dp 4 la thap nhat (1.07%). So sanh 3 nhdm thay ty le mdn eo rang dp 3 va do 4 d nhdm 3 eao hon nhdm 1 va nhdm 2. Nhff vay, mac du sd Iffpng rang bi mdn eo eiia nhdm 2 va nhdm 3 chenh lech khdng ro rang nhffng mffe dp mdn ed rang tang dan thi qua 3 nhdm tuoi. Dieu dd eho thay ed sff on djnh tffOng ddi ve sd Iffdng rang bj mdn nhffng cd tang ve mffc dp ciia ton thffdng.

Dieu nay cd the ly giai bang sff tich dan nhffng yeu t d anh hffdng (Iffc chai rang, sang ehan khdp can,..) theo thdi gian.

V. KET LUAN

Qua qua trinh nghien cffu tren nhdm 103 ddi tffdng dd tuoi tff 20-65 tuoi tai xa Phiic Lam, huyen My Dffc, Ha Ndi ehiing tdi rut ra dUde mpt sd ket luan nhff sau:

- Ty le sd ngffdi MCR chiem ty le 70.7%.

- Ty le MCR cua nam va nff tffdng dffdng nhau.

Y HOC VIET NAM THANG 4 • S O 2/2014

- Ty le MCR d nhdm RHN la eao nhat (44.46%), tiep den la nhdm RHL (19.82%), nhdm rang c u ^ (18.21%) va rang nanh la thap nhat (17.50%).

- Ty le MCR dp 1 cao nhat (63.04%), tiep theo la dp 2 (30.36%), dp 3 ehiem 5.54% va d d 4 la thap nhat (1.07%).

- Vi t r i tdn thffdng MCR nhieu nhat d 1/3 ed rang, mat ngoai d tren Ipi (90.36%). Ton thffdng MCR dffdi lpi ehiem 8 . 2 1 % , khdng ed tdn thffdng MCR mat trong.

TAI UEU T H A M KHAO

1. Vu Duy HUng (2008) "Nghien eiru tinh trang sau rang, mon rang va nhu cau dieu tri d ngUdi cao tud'i tai phffdng Yen Sd, quan Hoang Mai", Luan an thac sy y hpc, Trddng dal hpc Rang Ham Mat

10. Blunek U (2001), "Improving cen/ical restorations: a review of materials and techniques", 3Adhes Dent, Vol. 3, N" 1, pp.33-44.

Borcic J, Anic I , Urek MM, Ferreri S (2004),

"The prevalence of non- carious cervical lesions in permanent dentition", J Oral Rehabll, Vol.31, N02, pp.117-123.

Dang Que Du'dng (2004), "Nhan xet ket qua tram ton thUdng cd rang bang Composite co lot Glass loncmer Cement", Luan an thac sy y hoc, Trddng dai hoc Y Ha Npi

Kitchin PC (1941) " Associated with occlusal erosion and 5'&.r\t:\on" Aust Dent J 44, ppl76-186.

Neo 3,, Chew CL (1996), " Direct tooth- eotored matenals for noncarious lesions: a 3- year dlnial report", Quintessence Int, Vol. 27, N°3, pp.183-188.

DAC DIEM LAM SANG, NOI SOI, MO BENH HOC

VA HIEU QUA DIEU TRI LOET DA D A Y B A N G P H A C DO EAC

TAI BfiNH VIEN DA KHOA HUYEN TAM NONG (PHU THO)

T6IV1 TAT

Nghien ciru tren 96 benh nhan bi loet da day tff n3m 2010 cho biet: Nam gap nhieu hOn nff (ty le nam/nff la: 2,42), vdi tuoi trung binh la 48,3 ± 11,7.

Cac dau hieu lam sang noi bat gdm: Dau viing thUdng vj (97,9%), d ndng-p hdi (54,1%). Ve ket qua ngi soi:

01 6 loet, kich thudc o loet: 0,5-1,0 cm, vj tri hang vi"

tien mon vi chiem ty le cao nhat, tUdng ffng la:

84,4%; 85,4% va 53,4%. Ve md benh hpc: Viem hoat dgng (91,6%) va viem teo (83,3%) chiem ty le cao nhat. Ket qua dieu tri bang phac do EAC: Het dau viing thUOng vi: 87,5%, giam dau viing thUdng VJ: 12,5%.

Ty le lien seo dat; 86,4%, 6 loet dang lien seo: 13,6%.

SUMIVIARY

STUDY ON CLINICAL, ENDOSCOPIC IMAGES, HISTOPATHOLOGY, TREATMENT RESULTS E.A.C REGIMEN I N PEPTIC ULCER

PATIENS I N T A M N O N G D I S T R I C T HOSPITAL ( P H U T H O ) The research on 96 peptic ulcer patients shows In 2010 shows that: Male suffers more than female (the ratio is 2.42), the average age is 48.3 ± 11.7. About

* Bpnh vien Da khoa Huyen Tam Nong Phan bien khoa hpc: PGS.TS Vu Van Khien

Dao Nguyen Khai* vS cs

clinical signs; epigastric pain hold the highest rale (97.9%), acid regurgitation is subsequent (54.1%).

About endoscopy: one ulcer with the dimension in the range of 0.5 to 1.0 centimeter; the location at antnim - pyloric makes up the highest rate, 84.4%; 85.4%

and 53.4% respectively. Histological pathologic: Active chronic gasthbs (92.6%) and atrophic gastritis (83.3%) hold the highest rate. Result after treatment:

87.5% patients get over the pain, 12.5% of those have pain relieved. The ratio or sear is 86.4% and this of healing is 13.6%.

I. OAT VAN OE

Loet da day ta trang (DDTT) la mdt benh kha phd bien d Viet Nam va tren the gidi. Loet DDTT la sff pha hiiy cue bp niem mac da day ta trang do acid chlorhydrie va pepsin. Ton thffdng trong loet DDTT thffdng vffdt qua Idp cd niem va day la dae diem de phan biet giffa trdt ndng vdi loet DDTT (1). Theo thong ke cua td chffe y te the gidi (WHO), sd ngffdi loet DDTT chiem khoang 5 - 10% trong cpng dong. Vdi nhu'ng benh nhan loet DDTT neu khdng dffdc dieu trj kjp thdi thi se gay nen mpt sd cac bien chffng nhff: Thiing, chay mau tieu hda, hep mdn vj, suy kiet.. TLT nam 1983, sau phat hien quan trpng ciia