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1 nh ngha:Phc hnh rng c nh (PHRC) l loi phc hnh rngc thc hin bao bc nhng thn rng b mt cht

ln, thay th nhng thn rng b mt hay phc hinhng rng b mt hon ton, loi phc hnh ny cgn cht vo rng bnh nhn m bnh nhn khng th ttho c.

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2 Mc tiu ca mt PHRC:

Chc nng

Thm mBn vng

Phng bnh

* Vt liu: PHRC c lm bng kim loi, s, nha,composite, kt hp kim loi vi s/nha/composite.

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3 Cc loiPHRC: Inlay: L vtcbng kim loihoc lmbng

s/composite nm trong lngmt hay nhiumtcathn rng dng trm mt xoang rng hay dng nngcho mtrngkcn (trong curngngtlc); inlaythng lm mt nhai, ngoi, trong hay mtnilinmt

nhai v cc mt khc.

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Phn loi: inlay c 5 loi ty theo v tr t:

Loi 1: Inlay mt nhai R ci

Loi 2: Inlay mt nhai kt hp mt bn Loi 3: Inlay mt bn R ca

Loi 4: Inlay mt bn kt hp cnh cn R ca

Loi 5: Inlay mt ngoi cc rng

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Onlay: Khi inlay m rng bao ph c mt nhai v haimt gn xa th c gi l onlay; onlay thng c sdng khi thn rng b mt cht qu nhiu, kh nng chulc km khng trm thm m hay dng inlay c

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Pinlay, Pinledge: L inlay kim loi c cc cht nh gnvo ng rng; rng ci gi l pinlay, rng ca v rngnanh gi l pinledge.

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Mo rng: L mt chp c hnh dng thn rng phc hiton phn hoc mt phn rng trn mt rng ring r saukhi rng ny c mi ton phn hoc mt phn ty theo

loi mo ch nh. Mo ton din: bao ph ton b cc mt ca thn rng;

c lm t kim loi, composite, s, sn kim loi phs/nha

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Mo tng phn: l phc hnh bng kim loi, bao ph mtca thn R lm sng (khng bo ph ton b thn R lmsng), ty s mt/din tch bao ph c cc loi: 3/4, 4/5, 1/2,

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Rng cht v ci gi: thn rng gi c mt cht di cgn vo ng chn rng ca mt chn rng cha tyCht thng: phn cht ca rng c lm bng kim loi

tin ch (lm sn), c gn vi thn rng ton bng nhahay s.

Cht Richmond: Phn cht c c theo hnh dng ngty, thn rng tng t cht thng

Ci gi: phn cht c c theo hnh ng ty, phn thnc c tng t ci R

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Curng:lloiphc hnh tngphncnh dng phchimt hay nhiurngmtbng cch dng cc

rngkcn cc rngmt lm tr mang gnh cc rnggi thay th cho rngmtCurngcgncht vo cc rngtrbng ciment v

bnh nhn khng tht tho ra c

Curng c cng dng duy tr snnh cho cung rng vmtphngnhai,phchichcnng nhai,pht m v thmm

Curng km thmmhnphc hnh tho lpnht l trong

trnghpmtrng lu,tiu xngnhiu

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Cc thnhphncacurng:Trcu: l mt thn/chn rngtht dng chngcho

cu

Phngi: lphncacurng bm gi trn rngtr v nivirngnhpcu; n c th l inlay, onlay, mo tng

phn/ton din, rngchtPhncu (nhpcu): lphn thay th cho cc rngmt, gip

phchichcnng v hnh th cc rngmt

Phnni: l phnnilinnhpcuviphngi, n c th l loicngchc (hn/cdnhvinhpcu vphngi) hoc khngcngchc (dng khangm, cn gi l cu

rngngtlc/bn c

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Phn loi cu rng:

Theo hnh dng v tnh cht:

Cu R c nh Cu R c R tr 2 u tn cng

Cu R c R tr trung gian

Cu R c nhp cu tn cng: cu vi

Cu R bn c nh (cu R ngt lc)

Theo v tr:

Cu R trc: t R nanh tr v trc

Cu R sau: t R ci nh 1 tr v sau Cu R hn hp: mt bn hay ton hm (>10 n v)

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b id )

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bridge)

Trong thi gian ch i hon thnh mt phc hnh, cc ci

rng cn c bo v v to cho bnh nhn s thoimi, d chu, vic lm cu rng tm s nh hng ti ktqu cui cng v to mt s tin cy i vi bnh nhn.

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Yu cu:Bo v ty rng v m rng

n nh ci rngDuy tr tm chc nng nhai v thm m

D gi v sinh

Cnh ca phc hnh tm khng c lm kch thch vinnu

C tnh lu gi v chc chn

Vt liu: Nha t cng

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Np c nh (fixed splint): l 1 loi phng tin (?) dng n nh, bo tn cc R lng lo/yu v phn phi u

lc nhai trn cc RCc cng dng khc:

Ci thin hnh dng v chc nng ca R

iu chnh khp cn, tng quan 2 hm

Ci thin chc nng n nhai

Cc loi np c nh:

Da trn khong mt rng: np 1 bn, 2 bn hm

Da vo thi gian dng: np tm thi (hng tun/thng),vnh vin (khng gii hn thi gian)

Da vo v tr t: np trong R (intracoronal splint

np ngoi R (extracoronal splint)

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4 Tm tt cc giai on thc hin mt PHRC

Chn on, xc nh, ly du s khi (lm sng)

mu s khi, lm KLDCN, lm PH tm (labo)

Sa son rng, ly du sau cng, ghi du tng quan nucn, gn PH tm (lm sng)

mu sau cng, v , ca die, gt die, v gi khp,lm mu sp, gn kim c, v bt c, c, hn nhng

thnh phn ring l ca cu R, nh bng tm, pnha/p s giai on ny hoc sau khi th, iu chnhtrn ming bnh nhn (labo)

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Th PH trn ming bnh nhn, iu chnh ng c R,giao cho labo sa nu cn (lm sng)

Sa cha (nu cn), hon tt v nh bng (labo)

Gn PH hon tt trn ming bnh nhn, ti khm theodi kim tra (lm sng).