hsCRP dffdc coi la yeu t d nguy cd benh tim mach mdi. Vay, ndng dd hsCRP lieu cd khae biet giffa nhdm BN mdi dieu trj ARV va nhdm BN da dieu tri ARV lau nam hay khdng? Ket qua nghien effu cua ehung tdi cho thay: nong dd hsCRP huyet tffdng d nhdm BN mdi dieu tri ARV la 3,l±2,24mg/L eao hdn cd y nghla so vdi nhdm BN da dieu tri ARV > 1 nam la 2,01±l,50mg/L.
Tang ndng dp hsCRP huyet tffdng ed the do ddc tinh cua thude khang virus gay thay ddi ve hinh thai eiing nhff qua trinh ehuyen hda d thanh mach va gay xd v u ^ dpng mach. Hdn nffa, d nhom BN mdi dieu t n ARV, ndng dp hsCRP huyet tffdng cdn tang hdn so vdi nhdm BN da dieu trj lau cd the do virus HIV gay doe te bao T trong qua trinh loai bd nhffng te bao nay gay ra hien tffdng viem man tinh [ 7 ] .
Tac gia Nordell va epng sff da nghien cffu d 9764 benh nhan HIV khdng ed tien sff benh tim mach va dffde xae djnh cac ehi sd hsCRP, interleukin 6 (IL6) tai thdi diem nghien cffu, benh nhan difdc theo ddi ve cae bien ed benh tim mach trong vdng 5 nam. Ket qua nghien cffu cho thay sau 5 nam cd 74 BN tff vong do eae bien cd BTM (nhdm 1), 214 BN tff vong khdng do cac bien ed BTI^ (nhdm 2), va 9476 BN khdng cd cac bien cd BTM (nhdm 3), ndng dp IL6 va hsCRP d nhdm cd bien co EfTM la cao nliat, nhdm 3 la thap nhat. Nhdm BN cd ndng dd hsCRP>3,3 mg/L CO nguy ed BTM eao hdn gap 9 lan so vdi nhdm BN CO nong dp hsCRP <9,9mg/L (b-ieh dan theo [5]).
V. KET LUAN
1. Nong dp hsCRP d BN HIV la 2,20+l,69mg/L,
ty le BN ed ndng dd hsCRP huyet tffdng > 3mg/L la 28,1%.
2. a nhdm BN khdng dong nhiem viem gan C va BN mdi dieu trj ARV cd nong dp hsCRP huyet tffdng cao hdn so vdi nhdm BN ddng nhiem viem gan C va BN da dieu tri ARV>1 nam.
TAI UEU T H A M KHAO
1. Nguyen Tien Hoa (2012), "Tinh trang nhiem HIV, HBV, HCV va yeu td lien quan cf mot so nhom nguy cd cao tai Ha Noi, 2008-2010", Luan an tien sT Y hpc, Vien Ve smh Dich te Tw, 123 trang.
2. Boger M.S, Ayumi Shintani, Leigh Anne Redhage, et all (2009), "Highly-sensitive c- reactive protein, body mass mdex, and serum lipids in HIV-infected persons receiving antiretrovirai therapy: a longitudinal study", J Acquir Immune Defic Syndr, 52(4), pp 480^87.
3. Khan R, Quaiser S and Vishwanath A (2015),
"Role of hsCRP Measurements in HIV Patients", Biol Med (Aligarh), 1, pp 1-15.
4. Lau B, Sharrett AR, Kingsley LA, Post W, Patella F3, et al (2006), "C- reactive protein is a marker for human immunodeficiency virus disease progression". Arch Intern Med 166: 64-70.
5. Reingold J, Wanke C, Kotier D, Lewis C, Tracy R (2008) "Association of HIV infection and HIV/HCV coinfection with C-reactive protein levels:
the fat redistribution and metabolic change in HIV infection (FRAM) study", J Acquir Immune Defic Syndr, 48, pp 142-148.
6. Waters L, Nelson M (2007), "Long-term complications of antiretrovirai therapy: lipoatrophy", I n t : Clin Pract, 61(6), pp 999-1014.
7. Zhou D.T, Kodogo V, Dzafitita M, et all (2015), "2 Lipids and Hscrp as markers of coronary heart disease risk in HIV infected adults", Internationa! Joumal of scientific & technology, 4 (8), pp 252-257.
DAC DIEM LAM SANG CAC THE BENH VIEM KHOT Tir PHAT THIEU NIEN
TOM TAT
Muc tieu: mo ta dac diem lam sang cac the benh viem khdp tff phat thieu nien d tre em. Doi tffdng nghien cffu: 107 benh nhan dffdc chan doan viem khdp tu phat thieu nien tai benh vien Nhi tff 9 nam 2010 den Oiang 9 nam 2013. Phu'dng phap nghien cffu; mo ta cat ngang. Ket qua: VKTPTN gap chu yeu
*Benh vien Nhi Trung ffdng
Chiu trach nhiem chinh: TrUdng Thi Mai HSng Email: [email protected] Ngay nhan bai: 14.01.2017 Ngay phan bien khoa hgc: 20.4.2017 Ngay duyet bai; 28.4.2017
Truo-ng Thi Mai Hong*
tre > 5 tuoi, nam nhieu hdn nff, gap cac the lam sang:
viem it khdp, viem da khdp, viem khdp he thong, viem diem bam gan, viem khdp khong phan loai. Trieu ehffng toan than: sot, met moi, chan an, thieu mau g§p >50% 6 the da khdp va viem khdp he thong. Vi tri khdp ton thUOng: gdi 72%, co chanJ91,7% d the bam gan), eac khdp nho chi gap d the da khdp. So khdp viem: (1,65 ± 0,85) d the it khdp; (8,70 ± 3,54) the da khdp. Mffc do dau, mffc do hoat dong benh d the it khdp thap^hdn the da khdp. Ket luan: VKTPTN gap tre > 5 tuoi, nhieu the lam sang; ton thu'dng khdp goi (gap d tat ca cac the), cac khdp nhd( chi gap the da khdp).
T&khoa: viem khdp tU phat thieu nien (Juvenile Idiopathic Arthritis-JIA),
SUMMARY
JUVENILE IDIOPATHIC ARTHRITIS I N CHILDREN: OINICAL FEATURES OF DIFFERENT
TYPES CLASSIFIED BY ILAR CRITERIA Objective: to investigate the clinical features of different types for children with JIA. Subjects: 107 patients were diagnosed of juvenile idiopathic arthritis in the Viet Nam children hospital from September of 2010 to September of 2013, Methods: a cross sectional study. Results: Idiopathic arthritis was common in children over 5 years old. Males were more likely to develop aliment than females. The clinical classification induded: systemic arthritis, oligo- arthritis, poly-arthritis, enthesitis related arthritis, and unclassified arthntis. Systemic features such as fever, tiredness, anorexia, anemia were found in over 50%
of patients with systemic arthritis and poly-arthritis.
The most common infected joints in children were laiee (72%), ankle (91,7% in enthesitis related arthritis), and small joints in poly-arthritis. The pain and activity of the disease in oligo-arthritis were less litely dian in poly-arthritis. The numbers of joints with inflammation were different. 1.65±0,85 in oligo- arthritis; and 8,70±3,54 in poly-arthritis. Conclusion:
Juvenile idiopathic arthritis were common in children over 5 years old, with various clinical types. Knees were the most common joint of inflammation in all types, but inflammation of small joints were more common in poly-arthritis.
Keywords: iuvenWe Idiopathic Arthritis-JIA, I. DAT VAN OE
Viem khdp tff phat thieu nien (VKTPTN) la mdt benh khdp viem man tinh phd bien nhat d tre em va lffa tuoi thieu nien. Ty le mac benh
khoang 1-10/1.000 tre em d eae nffdc [1]. Benh gay nhffng bien ehffng lam anh hffdng tram trpng den chffc nang van dpng khdp, doi khi'dan den tan phe. Do vay, chan doan sdm va chirih- xac benh, la rat can thiet nham dieu tri cd hieu qua, tranh huy khdp, tranh tan phe, b f t thffdng hda qua trinh phat trien va eai thien chat Iu'dng cupe sdng cho tre mac benh. Chung toi tien hanh de tai nay ydi mue tieu: Mo ta dac diim iam sang cac the binh Viem khdp tii phat thiiu niin theo tieu chuan phan loai binh cua ILAR. (Internatinal League of Associations for Rheumatology- Hiep hdi thap khdp hoc quoctg).
II. o 6 l TUONG VA PHU'ONG PHAP NGHIEN OhJ 1 . Doi tu'dng nghi§n cu'u
Tiiu chuan l&a chgn binh nhan: theo tieu chuan cua ILAR
Tiiu chuan ioai tr&: Cac benh ly khac co bieu hien dau khdp, benh nhan va gia dinh khdng ddng y tham gia nghien effu.
2.Phu'dng phap nghien cffu: md ta tien cu\i Tff thang 9 nam 2010 den thang 9 nam 2013 tai Benh vien Nhi Trung ffdng.
III. KET QUA NGHIEN CU'U
1 . Dac dii'm chung cua nhom doi tffcrng nghiSn cu'u: Sd Iffdng benh nhan: 107 tre
- Phan bd nhom ddl tu'dng nghiin aiu theo tuoi, gidi
Bang 1; PhSn bo nhom doi tWdng nghien cii'u theo tuoi.
—~~~—-»-^ ^'*'
Nhom tuoT" — — ^ 0 - 5 tuoi (3)
> 5 tuoi (4) Tong
Nam ( 1 ) n 15 42 57
»/o 26,3 73,7 100,0
NO'(2) n 17 33 50
34,0
%
66,0 100
gidi Chung N 32 75 107
»/o 29,9 70,1 100,0
p ( 3 & 4 )
< 0,005 Nhanxet:Ty le mac benh cua nhdm tre tren 5 tudi ehiem da sd (70%).
- Phin bdcac dol t&dng nghiin c&u theo the lam sang theo ILAR Q Q-. B \'ieui iHdioiJ
• \"ieiii eta khq) RF (-) 0 04 ^ 4 O . T M fe ""''^i"^^ ^^^^^ ^ (•^>
^ ^ ' i S » I. iX'ieinkhqshethoua K\'iein diem bam ami
Bii'u dol. Tyle mac benh Viim khdp t&phat thiiu niin theo t&ng the lam sang Nhanxet'Ty le mac benh cao nhat la the viem it khdp (43,0%),
- Phan bo d i e doi tu'dng nghien cihi theo tuoi va theo the b i n h
TAP CHi Y HOC VIET NAM TAP 454 - THANG 5 - SO 2 - 2017
Bang2. Tuoi Ididi benh, tuoi tai tiidi diem nghien dht va thdi gian mac benh theo tuhg the lam sang (Tai thdi diem nghiin ahi T(0) cttna la Uc benh nhan bat dau difdc chin doin)
The lam sang The viem it khdp (n= 46) The viem da l<hap RF ( + ) (n = 201
Tiie viem da l<hap RF (-) (n = 23) Tlie viem khdp he thonq fn = 4) The viem diem bam qan fn = 12) The viem khdp khonq phan ioai (n = 2)
Chunq (N = 107) P
TUOI khdi benh X ± SD (tuoi)
5,34 ± 3,51 6,89 ± 3,20 5,79 ± 4,18 7,44 ± 3,69 10,30± 3,27 8,0 ± 7,07 6,59 ± 4,31
> 0 , 0 5
Tuoi tai thdi diem nqhien cu'u TCO)
X ± SD (tuoi) 5,84 ± 3,65 7,45 ± 3,95 6,57 ± 4,53 8,21 ± 3,22 11,90 ± 3,31
8,17± 6,83 7,12 ± 4,27
> 0 , 0 5
Thdi gian mac benh A ± SD (thang)
6,67 ± 9,29 7,1 ± 11,15 8,05 ± 8,39 1,05 ± 0,02 14,02 ± 22,89
2,25 ± 2,47 8,89 ± 12,42
< 0,05 Nhan xet: The viem khdp he thdng cd thdi gian mae benh ngan nhat (1,05 ± 0,02) thang.- Tuoi khdi benh thap nhat la the viem it khdp: (5,34 ± 3,51) tudi;
2. Cac dac diem lam sang
Bac diim toan than cua nhom nghiin c&u Bang 3. Bac dii'm ^an than tiieo t&ng the lam sang The benh
Trieu chu'ng
sst
Met mdi Chan an Sut can Da xanh Phat ban Gan,lach to
NhSn X The It
khdp 1 = 46 (%)
1(2,2) 11(23,9) 10(21,7) 4(8,7)
0(0) 0 0 et: Cac biet
I^e da khdp RF(+) n = 20 (%)
13(65,0) 11(55,0) 10(50,0) 7(35,0) 13(65,0)
0 1(5,0) hien toan t
The da khdp RF(-) n = 23 (%)
15(65,2) 18(78,3) 17(73,9) 3(13,0) 12(52,2)
0 0 an nhu sot.
The he thong n = 4(%)
4(100,0) 4(100,0) 4(100,0) 2(50,0) 4(100,0) 3(75,0) 4(100,0) met mdi, ch
The viem qan n = 12(%)
1(8,3) 3(25,0) 2(16,7) 1(8,3) 1(8,3) 0(0) 0(0)
The khong phan ioai n = 2(%) 0(0) 1(50,0)
0(0) 0(0) 0(0) 0 0(0)
Chung n = 107(%)
34(31,8) 48(44,86) 43(40,2 ) 17(15,9) 25(23,4) 3(2,8) 5(4,7) an an, da xanh gap chii yeu d hai the viem da khdp RF (-), RF (+'), va the viem khdp he thong (tren 50%).
- Bac diem ton thu'dng Ichdp tai thdi diem nghien cu'u (TO) Bang4: Iff tri ichdp ton thu'dng
The benh V! trf cac khdp
The It khdp n=46(%)
The da khdp RF
(+) n=20(%)
The da khdp RF
(-)
n=23(%) The viem
khdp he thong
The viem gan n=12(%)
The khong phan ioai
n=2(%) Tong n=107(%)
2,6) 10(50,0) 15(65,2)
3(75,0)9(75,0) 2(100)
77(72,0) Co tay11(23,9) 17(60,0) 14(47,8)
2(50,0) 1(8,3) 0(0) 45(42,0) 27(58,7)9(45,0) 13(56,5) 1(25,0) 11(91,7) 1(50) 62(57,9)
Hang
6(13,0)
4(33,3) 0(0)10(9,3)
Khuyu
5(10,9) 1(5,0) 3(13,0)
0(0)9(8,4)
Ban ngdn tay 2(4,3)
15(75,0) 13(56,5) 32(6,8)
Ban ngdn chan
1(5,0)
2(8,7)2(16,7)
4(3,7)Khac
1(4,3)
4(3,7)Nhan xet: Vi tri ton thu'dng khdp: khdp goi (72%), khdp co chan (57,9%). Cac khdp nhd gap chu yeu d the viem da khdp RF (+) va RF (-) vdi ty le tren 50%.
Bangs. Bac diem so khdp viem cua cac the lam sang The benh
Sd khdp viem Theft khdp (1)
(n=46) The da khdp RF (-) (2) (n-23)
The da khdp RF
( + ) ( 3 ) (n=20)
The viem khdp he thdng (4) (n=4)
The viem diem bam gan (5) (n=12)
The viem khdp khdng
phan loai (n = 2)
Tong
SdJihdp viem ( X ±SD) (min - max)
1,65±0,85 (1-4) 7,38±1,8£
(5 - 14) 8,70±3,5^ 4,50± 1,0 (5 - 14)
( 2 - 5 )3,0±2,38
(2-6)
1,5 ±0,71 (1-2) 4,52±3,60
(1 -14)
P < 0,05Nhin xet: sd khdp viem nhieu nhat la the viem da khdp.
IV. BAN LUAN
1. Nhan xet ve dac diim chung cua cac doi t&dng nghiin c&u
Chung tdi gap VKTPTN ehu yeu tre > 5 tuoi chiem 7 0 , 1 % va phan bd theo eac the lam sang gdm: the viem it khdp cd 43,0%, viem da khdp RF (-) cd chiem 21,5%, viem da khdp RF(-H) ed 18,7%, ... so cac nghien cffu ve VKTPTF^ d Chau Au va Bae My: the lam sang phd bien la the viem it khdp (ehiem 30% - 60%), cdn viem diem bam gan thap hdn (7 -13%) nhffng day lai la the lam sang pho bien d chau A, dffa tren cac nghien cffu cua Oai Loan, Canada va An Dp. Ngffdi I^y gde phi lai hay gap the viem da khdp RF(+) [2].
* Gid^: Chiing tdi eo benh nhan nff la 50/107 (46,7%), khae tac gia H.M. Albers cd ket qua nff chiem 68,8% [3].
*Tu6'i: Chung tdi gap tre nho nhat la 12 thang tuoi va ldn nhat la 16 tudi. Tuoi khdi benh cua VKTPTN thay doi tuy tffng the benh: t h ^ it khdp vdi tudi khdi benh thap nhat la: 5,34±3,51 tudi; the da khdp RF(-H): 6 , 8 9 ± 3 , 2 0 tuoi. Tac gia Ellen Nordal thi tudi khdi benh khae nhau theo tffng the lam sang. The viem it khdp vdi tuoi khdi benh trung binh la 4,9 (2,2-8,5) tuoi; the viem da khdp RF 4,8 (2,3-8,5) tudi; [4].
2. Trifu chihig lam sang cua ddl t&dng nghiin c&u
Toan than: ram rd d the viem da khdp, viem khdp he thdng: thieu mau, sdt gap tren 65%, (viem da khdp); sdt, met mdi, clian an, thieu mau (100% -viem khdp he thdng). Theo Samia Nazi trong viem khdp thieu nien the da khdp sdt ehiem (68,4%), phat ban (4,5%) [5]. Cac the khac it gap trieu ehffng toan than.
Tai Ichdp
- The viim it khdp, ehung tdi gap ehu yeu la khdp goi (82,6%); Theo Chang-Ching Shen;
khdp hang chiem 6,3%, khdp gdi cung ehiem ty le eao nhat 68,8%.
- The viim da khdp. sd khdp viem trung binh ia 7 - 9 khdp. Khdp ton thffdng hay gap cua
the viem da khdp RF(-) la khdp gdi 65,2%; RF {+) la khdp ban ngdn tay 75,0%. Dac diem \rfem khdp ddi xffng thffdng gap nhat la khdp co tay, va cac khdp nhd d ban ngdn. Khac ket qua James Chipeta gap nhieu la nhffng khdp Idn (ty le 100%), va tonthffdng eae khdp nhd (78,9%), ngoai ra cor gap tdn thffdng d khdp edt sdng eo va khdp thai dffdng ham, vdi dac diem ddi xffng [7].
- Thi viem khdp hi tiidng. khdp goi, co tay, ed chan; The viim dii'm bam gan. ton thffdng cae khdp eua ehi dffdi. The viem kh^p vay nin: Chung tdi eijng chffa gap benh nlian nao. Tuy vay chung tdi gap hai benh nhan thu6c the viem khdp khdng phan loai. Do la mot beiih nhan nhd dffdi 6 tuoi cd ton thffdng dffdi 4 klidp nhffng lai ed HLA-B27(-i-), va mot tre nam co viem It khdp nhffng lai cd RF(+),
*^Ve cac dac diem hoat tinh cua binh;
Viem da khdp hau het deu co hoat tinh benh cf mffe dp cao, khae vdi the viem it khdp hoat tinh eua^ benh chu yeu d mffc dp trung binh la 63%.
The da khdp RF(-) va viem da khdp RF(+) co 85,0% va 87,0% sd benh nhan ed hoat tinh benh cao tai thdi diem nghien cffu. Theo Samia Naz hau nhff eac tre deu cd mffc dp hoat tinh benh cao d cae the lam sang, dae biet la the viem khdp he thdng va viem da khdp tai thcfi diem bat dau nghien effu khi benh nhan ctiira dffdc dieu tri [5]. Ket qua nay cung phu hdp veil nghien effu eua ehung tdi.
V. KET LUAN
VKTPTN gap chu yeu tre > 5 tudi, nam nhfiu hdn nff, gap nhieu the lam sang: viem it khdp, viem da khdp, viem khdp he thdng, viem diem bam gan, viem khdp khdng phan loai. Tri?u ehffng toan than: sdt, met mdi, chan an, thieu mau gap >50% d the da khdp va viem khdp he thdng. Vj tri khdp tdn thffdng: gdi 72%, cac khdp nho chi gap d the da khdp. Mffc dp dau, mffc dp hoat ddng benh d the it khdp thap hdn the da khdp.
I At- ^^Hl 1 tHJU V i t I HAW I flK 454 - I HANG 5 - SO Z - 2017
TAI LI?U T H A M KHAO
1. Prahalad S, Glass DN, (2002), Is juvenile rheumatoid arthritis/juvenile idiopathic arthtitis different from rheumatoid arthritis', Arthntis Res, 4 (suppl 3): 303- 10.
2. Zannin ME et al (2012), timing of uveitis onset in oligoarljcular juvenile idioapathic (JIA) is the main predictor of severe course uveitis. Acta Ophdjaimol, 90 il): 91-5.
3. H. M. Albers, (2010), Ciinical Course ancJ Prognostic Value of Disease Activity in die First Two Years in Different Subtypes of Juvenile Idiopathic Arthritis, Arthritis Care & Research, 62, (2), 204-212
4. Nordal E et al (2011), Ongoing disease activity and changing categories in a long-term nordic cohort
study of juvenile idiopathic arthritis. Ongoing disease activity and changing categories in a long-term nordic cohort study of juvenile idiopathic arthritis, (2011), Arthnds Rheum;63{9): 2809-18.
A. Samia Naz, Asma Mushtaq, Saira Rehman (2013), Juvenile Rheumatoid Arthritis, Joumal of the College of Physicians and Surgeons Pakistan, 23 (6): 409-412
6. Chang-Ching Shen et al (2013), Clinical features of children with juvenile idiopathic arthritis using the ILAR cJassificatton criteria: A community-based cohort study in Taiwan, Journal of Micrdjioiogy, Immundogy andlnlecdon, 46, 288 - 294
7. James Chipeta et al (2013), Clinical patterns of juvenile idiopathic arthritis in Zambiam,. Pediatric Rheumatology, 11(33), 1 - 6 .
KET QUA HAN PHUC HOI TON THU-ffNG MO CU-NG CO RANG BANG COMPOSITE TIT DAN DINH
Pham Thi TuySt Nga*, Hoang Thi Thu Trang*, Vii Thi Quynh Ha*
TOM TAT
Composite tU dan dinh la vat lieu nha khoa m6i co nhieu ffu diem nhu' it kfch thich tuy rSng, thao tac ddn gian do do cd the dffde ap dung de tram phuc hoi tdn thUOng mo cffng cua rang vdi nhieu loai xoang tram.
Tuy nhien, hien chu^a co nhieu nghien cffu ve hieu qua ciia loai composite nay trong phuc hoi xoang tram loai V, do do chung toi ben hanh nghien cffu nay vdi muc tieu: nhan xet ket qua han phuc hdi ton thUdng mo culig CO rang bang Composite t u dan dinh. Nghien culj dffdc thyc hien tren 21 benh nhan vdi 38 rang.
Ket qua dUdc danh gia ngay sau han, 1 tuan, 1 thang va 3 thang cho thay 71,1% mieng tram dat ket qua tot, khong co mieng tram dat ket qua kem.
T& khoa: mo cffng co rang, composite tU dan dinh.
SUMIVIARY
RESULTS RESTORED CERVICAL LESSION INJURY BY COMPOSITE SELF-ADHESIVE Composite self-adhesive are new dental materials has many advantages such as less stimulating pulp, simple operation can thus be applied to filling restoration of dental hard tissue damage with a vanety of cavity. However, there is no research on the effectiveness of this type composite on the restoration cavity classe V, so we conducted this study with the object: comment recovery results using composite
*Viin Dao tao Rang Ham Mat, tn/dng Dai hpc Y HN Chju trach nhiem chi'nh: Pham Thj Tuyet Nga Email: [email protected] Ngay nhan bai: 6.01.2017 Ngay phan bien khoa hoc: 40.4.2017 Ngay duyet bai: 20.4.2017
self-adhesive on damages of hard tissue cervicai lesions. The study was performed on 21 patients with 38 teeth. Results were evaluated immediately, 1 week, 1 month and 3 months after execution showed that 71.1% fillings achieved good results, no fillings achieved poor results.
Keywords: hard tissue cervical lesions, composite self-adhesive.
I. OAT VAN OE
Composite ldng tff dan dinh la vat lieu ket hdp nhffng ffu diem ve sff on dinh mau va tinh chju Iffc cua vat lieu composite ndi chung va cdng nghe dan dfnh Optibond mdi nhat hien nay giup giam nhay cam sau dieu tri. Nhff vay, sff dung composite tff dan dinh da giup eho ba bffdc thffdng quy tren lam sang gdp lam mot dem lai nhieu ldi fch eho benh nhan va nha sT. Tuy nhien sff ben vffng eua mieng tram loai V ludn la mdt thach thffe Idn ddi vdi cac nha lam sang ciing nhff nha san xuat vat lieu. Nghien cffu cua Dang Que Dffdng (2004) [1] eho thay tram eo rang bang composite (Tetric Cream va Tetrie Flow) ty le lffu giff sau 6 thang dat 100%, nhffng ty le e budt cao (5,6%). Lffu Thj Thanh i^ai (2006) [2]
da nghien effu tram eo rang bang composite Tetric Cream sau 3 thang ty le lffu giff 96,3%, ty le e budt 7,7%. Tuy nhien, hien chffa cd nghien effu nao ve hieu qua cua composite tff dan dinh tren lo han loai V, do dd chung tdi tien hanh nghien cffu nay vdi mye tieu: Nhan xet kit qua han phijc hoi to'n thffdng md cffng co' rang bang Composite tff dan dinh.
