Y HOC VIET NAM THANG - SO 2/2014 NHAN XET DAC DIEM LAM SANG VA TINH TRANG BENH VIEM QUANH RANG TAI TRITCTNG CAO DANG Y TE BINH DlTaNG Tran Tuan Anh^, Nguyen Phan Hong An*, Dao Thi Tarn* Vd Truong Nhu- Ngoc**, Nguyen Thi Thu Phu-ong** T O M TAT Muc tieu: Danh gia dac diem lam sang va tinh trang benh viem quanh rang tai Tru'dng Cao Dang Y Te Binh Du'dng. Phffdng phap: md ta cat ngang. Ket qua: sau trung binh tui quanh rang d nam la 3,28mm, nff la 3,19mm, tuoi tff 50 trd len: mffc mat bam dfnh quanh rang trung binh la 4,45mm, mffc mat bam dfnh trung binh vung rang ham la 4,03 mm va vung rang cya la 3,79 mm . Ket luan: sau trung binh tiii quanh rang ciia cac benh nhan tu'dng dUdng giiJa hai gidi nam va nff, tang dan tlieo dp tuoi. Dp sau till quanh rang ham tren va ham dUdl khdng c6 sy khac biet, mffc mat bam dfnh quanh rang cung tang dan theo dp tuoi. Tiy khoa: Viem quanh rang, tiii quanh rang, mat bam dfnh, SUMMARY EVALUATION OF CLINICAL FEATURES AND STATUS OF PERIODONTAL DISEASE AT B I N H DUONG MEDICAL COLLEGE Objectives: to assess the clinical features and status of periodontal disease at Binh Duong Medical College. Method: eross-seetional study. Results: The average periodontal pocket depth of male is 3,28mm while that of female is 3,19mm, about patients than 50 aged; the average periodontal attachment loss is 4,45mm, the average periodontal attachment loss of the molar sector is 4,03mm and that of the incisor area is 3,79mm. Conclusion: the average periodontal pocket depth of the patient is equivalent between the male and the female and it also increase on age range. There is no difference between the average depth at the maxilla teeth and mandible teeth; the periodontal attachment loss increase gradually together with the age range. Keywords: periodontal disease, periodontal pocket,. I. D A T VAN OE Viem quanh rang la benh phd bien eac benh rang ham mat. Benh gap d mpi lya tuoi, mpi qudc gia tren the gidi, chiem ti le cao cpng ddng va mang tfnh chat xa hdi. Benh khdng * Cao dang YTeBinhL ** Vien Dao tao RHM - DH Y HN Phan bign khoa hgc: PGS.TS Mai Oinh Hu'ng chi gay ton thffdng tai eho ma cdn anh hffdng den sffc khoe toan than va tham my ciia benh nhan. Nam 1986, WHO xep benh quanh rang la hiem hoa thff cua loai ngydi sau cae benh ung thff, tim mach. Tai Hoa ky, nghien ciTu ciia Walter va cpng s y da cho thay ty le viem quanh rang cpng ddng la - % [ l ] . Tai Viet Nam, qua dieu tra benh quanh rang d eac tfnh phfa Nam va phd Hd chf Minh, Nguyen Can va CS cho thay ti le viem ldi d tudi tff 15-19 la 97,7%, tff 20-29 la 8 , % [ ] , [ ] . Benh viing quanh rang ed hai benh phd bien la viem ldi va viem quanh rang. Viem quanh rang neu khong dieu tri kip thdi cd the gay mat rang hang loat Hien tai Binh Dffdng chffa cd nhieu nghien cffu ve van de nay, vay chiing tdi tien hanh nghien cffu de tai nham muc tieu md ta dac diem lam sang va tinh trang benh viem quanh rang tai trffdng Cao Gang y te Binh Dffdng. II. DOI TU'ONG VA PHU'ONG PHAP NGHIEN COXJ . . Ddi tu'dng nghien cuTu: Nghien cffu dffde thyc hien tren benh nhan den kham va dieu trj tai Bp mdn Rang Ham Mat Trydng Cao dang y te Binh Dydng, Tieu chuan iita chpn: hdp tac nghien cyu. Tieu chuan ioai trit: nhffng ngydi dang ed benh toan than tien trien; nhffng ngffdi khdng to mieng dffdc; nhtitig ngffdi khdng hdp tac . . . Dja d i e m nghien cu'u: Bd mdn Rang Ham Mat -Trffdng Cao Oang Y Te Binh Dffdng. 2.3. Thdi gian nghien cu'u: Tff thang 072013 den thang 11-2013 - Phu'dng phap nghien cu'u: Md ta cat ngang - Cd mau nghien cii'u: J\\QQ cdng thffc tinh c9 mau;n = Z ' , , ^ Chimg tdi tfnh dffdc cd mau nghien cffu cho moi nhdm la 71 ngffdi, thffc te chung tdi tien hanh nghien cyu d 101 benh nhan. - Phu'dng tien nghien cthj: ghe, may nha khoa, bd dyng cu kham rang mieng thong thydng gdm; khay, gffdng gap, tham cham, cay Y HQC VI&T NAM THANG • SO 2/2014 tham dd quanh rang cam tay, may lay cao rang sieu am. - Dao dffc nghien cffu: Giai thfch rd cho ddi tffdng nghien cffu ve muc dich nghien cffu, trach nhiem cua ngu'di nghien cffu, trach nhiem va quyen ldi ciia ngffdi tham gia nghien cffu. Nghien cii^j chi tien hanh tren nhffng ddi tu'png tff nguyen tham gia nghien cffu va tren tinh than hdp tae, khdng ep budc. Toan bd thdng tin thu thap chi phuc vu muc dfch nghien cffu ma khdng phuc vu bat cff muc dich nao khac. III. Kir QuA NGHIEN cCru 3.1. D3c diem chung cua doi tu'dng nghien cu'u Nghien cffu dffdc thffc hien tren 101 benh nhan, nff cd 58 ngffdi chien ty le 57,4%, nam cd 43 benh nhan chiem 42,6%. Giffa cac nhom tuoi, phan bo ty le nam va nff la tffdng dffdng. Tudi benh nhan thap nhat la 18, cao nhat la 65. Sd benh nhan tff < 34 tudi chiem ty le eao nhat la 51,5%, sau dd den nhdm tff 35 den 49 tuoi chiem 36,6%. Nhdm benh nhan cao tudi, tren 50, chi chiem 11,9%. Phan bo ty le benh nhan giffa cac nhdm tudi khac biet cd y nghia thdng ke vdi vdi p < 0,001. Trong cac ly den kham ciia benh nhan viem quanh rang, hay gap nhat la ehay mau Ipi, ehiem 41,6%, sau dd den dau rang 27,7%. Rat ft gap cac benh nhan di kham kiem tra dinh ky (7,9%), hdi mieng cd trffdng hdp chiem 6,9%, lung lay rang cd 11 trffdng hdp chiem ty le 10,9%, cac ly khac cd trffdng hdp chiem t/ le 5,0%. 3.2. Dac dlem lam sang cua b$nh VQR nghien cu'u 3.2.1. Do sau tui quanh rSng Bang 3.1, Do sau tui quanh rang (TQR) theo nhom tuoi Nhim tuoi N 1 50 tuoi 121 4,39±1,94 141 4,47±1,87 262 4,45±1,90 Tonq 1014 2217 3,87±1,72 1203 3,98±1,83 3,93±1,70 P >0,05 < 0,001 Nhan xet: Khac biet mat bam dfnh giffa rang ham tren va dffdi khac biet khdng co y nghTaJthong ke, Tren tffng ham rang: mffc mat bam dinh quanh rang tang dan theo cae nhdm tuoi, cang nhieu tuoi thi mffc mat bam dfnh quanh rang cang tang. Mffe mat bam dfnh quanh rang trung binh rang ham dffdi cao hdn ham tren xet rieng d tffng nhdm tudi (p 50 tuoi 254 3,51 ± 1,38 262 4,45±1,90 3,23 ± 1,09 2217 3,93±1,70 Tong 2240 < 0,001 P Nhan xet: Do sau trung binh tui quanh rang ty le thuan vcfi mii'c mat bam di'nh quang rang va tang dan theo cac lihom tuoi. Si/ l0,05). Bang 3.8 cho thay dd sau trung binh tiii quanh rang d cac rang ham tren la 3,17 mm va d cae rang ham du'di la 3,29 mm. Nhu' vay, dp sau till quanh rang d ham tren va ham dffdi la tu'dng dffdng nhau. Tren tffng ham rang, dp sau tui quanh rang tang dan theo cac nhdm tuoi, eang nhieu tudi thi dd sau tui quanh rang eang tang. Cd nghTa la sy tien trien eiia benh nang dan eung vdi sy gia tang ciia tudi tac. 4.2.2. i^at bam dinh quanh rang Ve myc mat bam dfnh quanh rang, ket qua d bang 3,9 cho thay cd s y khac biet rd ret ve myc mat bam dfnh d cac nhdm tuoi, nhdm tudi cang eao thi mffc mat bam dfnh eang Idn. Oen dp tudi t y 50 trd ien, mye mat bam dfnh quanh rang trung binh la 4,45mm. Nhff vay mffc mat bam dfnh quanh rang eung ed xu hffdng tang dan theo dp tudi. Ket qua ciia chung tdi kha phii hdp nghien cffu cua tac gia Le Thi Hang [4]. Oanh gia ve mffc mat bam dfnh quanh rang theo gidi, ket qua d bang 3.12, cho thay mffc mat bam dfnh quanh rang trung binh cac benh nhan nam la 4,11mm eao hdn so vdi d benh nhan nff la 3,90mm. Khdng thay cd sff khac biet ve mffe mat bam dfnh quanh rang giffa hai gidi nam va nff vdi p > 0,05, Mffe mat bam dfnh trung binh viing rang ham la 4,03 mm va viing rang cffa la 3,79 mm. Nhff vay, mffc mat bam dfnh trung binh d viing rang ham cao hdn viing rang cffa, Cung tffdng tff nhy tydng quan giffa dp sau trung binh tiii quanh rang d rang ham va rang eya, ehiing tdi thiet nghT cung ed the dac diem ve chye nang cung nhff vi trf ciia eae viing rang cd khac nhau, Viing rang ham cae rang chju Iffc nhai manh hdn, ben canh dd rang ham cijng d vi tri khd quan sat ve sinh rang mieng hdn va lai gan ndi ciia dng tuyen nffdc bpt nen de phat sinh mang bam rang, cao rang la nhffng yeu td thuan ldi cho sff phat trien eiia benh ly quanh rang. Ket qua ciia chung tdi eiing tffdng tff nhy nghien eyu eiia Le Thi Hang [4]. Khi so sanh myc mat bam dfnh quanh rang giffa rang ham tren va ham dffdi, ket qua d bang 3,6 eiing cho thay khdng cd sy khac biet ve mffc mat bam dfnh trung binh giffa cac rang d ham tren vdi eac rang d ham dffdi, Mffc mat bam dfnh Y HOC VIET NAM THANG - SO 2/2014 trung binh rang ham tren la 3,87 mm va rang ham dffdi la 3,98 mm, Oanh gia tren tffng ham rang, mffc mat bam dinh quanh rang tang dan theo cac nhdm tuoi, cang nhieu tudi thi mffc mat bam dfnh quanh rang cang tang. 4.2.3. Do sau tui quanh rang va mii'c mat bam dinh quanh rang Ket qua d bang 3.5 cho thay moi lien quan cua dp sau tiii quanh rang vdi mffc mat bam dinh quanh rang. Op sau tiii quanh rang cang Idn thi mffe mat bam dinh cang cao. Oen dp tuoi tff 50 trd len, dp sau trung binh tiii quanh rang la 3,51 mm, mat bam di'nh la 4,45 mm. Nhff vay, dp sau tui quanh rang ty le thuan vdi mffc mat bam dfnh quanh rang va thffdng mffc mat bam dfnh quanh rang Idn hdn dp sau till quanh rang. Sff khac biet la cd y nghTa thdng ke (p < 0,001). Dieu dd cd nghTa la nhffng rang bj viem quanh rang thffdng cd ed mdt khoang co ldi, gay hd cd, chan rang va cd the se gay dau budt eho benh nhan hoac gay nen mdt sd nhffng bien chffng khac.Xet tren tffng nhdm tudi, nghien cyu cho thay mffc mat bam dinh quanh rang cao hdn dp sau tiii quanh rang, khac biet cd y nghTa thdng ke vdi p . tham my ciia benh nhan. Nam 1986, WHO xep benh quanh rang la hiem hoa thff 3 cua loai ngydi sau cae benh ung thff, tim mach. Tai Hoa ky, nghien ciTu ciia Walter va cpng sy da cho thay ty. dffde thyc hien tren benh nhan den kham va dieu trj tai Bp mdn Rang Ham Mat Trydng Cao dang y te Binh Dydng, Tieu chuan iita chpn: hdp tac nghien cyu. Tieu chuan ioai trit: nhffng ngydi. hanh nghien cyu d 101 benh nhan. - Phu'dng tien nghien cthj: ghe, may nha khoa, bd dyng cu kham rang mieng thong thydng gdm; khay, gffdng gap, tham cham, cay Y HQC VI&T