Summary
Samenvatting Parodontologie 1
- Course
- Institution
samenvatting/notities
[Show more]
Seller
Follow
morgMOZ
Reviews received
Content preview
Parodontologie1. INTRODUCTIE ............................................................................................................................................... 5
1.1 GEREGLEMENTEERDE – BESCHERMDE BEROEPSTITELS BINNEN DE TANDHEELKUNDE ......................................................... 5
1.2 NIET GEREGLEMENTEERDE- NIET BESCHERMENDE BEROEPSTITELS BINNEN DE TANDHEELKUNDE ......................................... 5
1.3 OPLEIDING IN PARODONTOLOGIE (3J) .................................................................................................................... 5
1.4 HISTORIEK ........................................................................................................................................................ 6
1.4.1 verleden ................................................................................................................................................ 6
1.4.2 vandaag – doelstellingen ...................................................................................................................... 7
1.4.2.1 parodontologie ............................................................................................................................................... 7
1.4.4.2 beroepsverenigingen ...................................................................................................................................... 8
1.4.3 toekomst – doelstellingen ..................................................................................................................... 8
2. BOUW EN FUNCTIE VAN HET PARODONTIUM .............................................................................................. 9
2.1 GINGIVA......................................................................................................................................................... 10
2.1.1 breedte van de aangehechte (vaste) gingiva ...................................................................................... 11
2.2.2 natuurlijke variatie in gekeratiniseerde gingiva (belangrijk bij poetstrauma) ................................... 11
2.2.3 recessie: afname van gingiva breedte ................................................................................................ 11
2.2.4 epitheel/dekweefsel ............................................................................................................................ 12
2.2.4.1 de buitenzijde van het epitheel .................................................................................................................... 13
2.2.4.2 de binnenzijde van het epitheel ................................................................................................................... 13
2.2.4.3 histologisch en klinisch ................................................................................................................................. 14
2.2.4.4 lamina propria .............................................................................................................................................. 16
2.2.4.5 de col van de gingiva .................................................................................................................................... 17
2.2.4.6 de biologische breedte ................................................................................................................................. 17
2.2 DE ALVEOLAIRE MUCOSA ................................................................................................................................... 17
2.3 HET PARODONTAAL LIGAMENT............................................................................................................................ 17
2.3.1 vezels .................................................................................................................................................. 19
2.3.2 cellen ................................................................................................................................................... 19
2.3.2.1 PL fibroblasten .............................................................................................................................................. 19
2.3.3 groeifactoren ...................................................................................................................................... 20
2.4 VASCULARISATIE .............................................................................................................................................. 20
2.4.1 vaatplexus ........................................................................................................................................... 20
2.5 INNERVATIE EN NEUROFYSIOLOGIE....................................................................................................................... 21
2.5.1 N. Trigeminus ...................................................................................................................................... 21
2.6 HET WORTELCEMENT ........................................................................................................................................ 21
2.7 PROCESSUS ALVEOLARIS .................................................................................................................................... 22
2.7.1 lamina dura......................................................................................................................................... 23
2.7.2 afwijkingen van de processus alveolaris ............................................................................................. 23
3. PATHOLOGIE .............................................................................................................................................. 24
3.1 GINGIVITIS ...................................................................................................................................................... 24
3.1.1 klinische gezonde gingiva ................................................................................................................... 24
3.1.2 klinisch ongezonde gingiva ................................................................................................................. 24
3.1.3.1 afweermechanismen .................................................................................................................................... 25
3.1.3.2 ontstoken gingiva: meten is weten ............................................................................................................... 25
3.1.3 prevalentie gingivitis........................................................................................................................... 27
3.1.4 experimentele gingivitis ...................................................................................................................... 27
3.1.4.1 studie van H. Loë et al 1965.......................................................................................................................... 27
3.1.4.2 Page & schroeder 1976: ............................................................................................................................... 27
3.1.4.3 microbiologie van plaqueaccumulatie .......................................................................................................... 29
3.1.5 vormen van gingivitis .......................................................................................................................... 30
3.1.5.1 chronische gingivitis ..................................................................................................................................... 30
3.1.5.2 bloeding na sonderen ................................................................................................................................... 31
3.1.6 gingivitis take home............................................................................................................................ 32
3.2 PARODONTITIS ................................................................................................................................................ 32
3.2.1 histologie bij parodontitis ................................................................................................................... 33
1
, 3.2.2 kenmerken van parodontitis ............................................................................................................... 33
3.2.2.1 botafbraak (Rx) ............................................................................................................................................. 33
3.2.3 gingivitis versus parodontitis .............................................................................................................. 34
3.2.3 indeling classificatie ............................................................................................................................ 36
3.2.3.1 NVvP classificatie van parodontitis anno 2018 ............................................................................................. 36
3.2.4 necrotiserende parodontitis (NP) ........................................................................................................ 41
3.3 NIET-PLAQUE GERELATEERDE AANDOENINGEN ....................................................................................................... 43
3.3.1 virus .................................................................................................................................................... 43
3.3.2 auto-immuunziekte............................................................................................................................. 43
3.3.2.1 orgaan specifieke auto-immuunziekten ....................................................................................................... 43
3.3.2.2 gegeneraliseerde auto-immuunziekten ........................................................................................................ 43
3.3.3 verkleuringen ...................................................................................................................................... 44
3.3.3.1 witte verkleuringen ...................................................................................................................................... 44
3.3.3.2 blauw – zwarte verkleuringen ...................................................................................................................... 45
3.3.3.3 bruine verkleuringen .................................................................................................................................... 46
3.3.3.4 rood – purperen verkleuringen .................................................................................................................... 47
3.3.4 bullae en ulceratieve aandoeningen ................................................................................................... 47
3.3.5 tumoren .............................................................................................................................................. 49
3.4 TANDTRAUMA EN HYPERMOBILITEIT .................................................................................................................... 54
3.4.1 meten van de mobiliteit ...................................................................................................................... 54
3.4.2 incidentie van acute traumata aan het parodontium ........................................................................ 55
3.4.3 therapie .............................................................................................................................................. 56
3.4.3.1 therapie bij avulsie ....................................................................................................................................... 57
3.4.4 chronische trauma door occlusie ........................................................................................................ 60
3.4.5 trauma van occlusie op implantaten .................................................................................................. 63
3.4.6 praktische richtlijnen .......................................................................................................................... 63
3.4.7 conclusies ............................................................................................................................................ 64
3.5 GINGIVALE RECESSIES ........................................................................................................................................ 64
3.5.1 Recessie als gevolg van anatomische factoren ................................................................................... 64
3.5.2 recessies geassocieerd met trauma .................................................................................................... 65
3.5.3 recessies geassocieerd met pathologisch botverlies ........................................................................... 65
3.5.4 pathogenese van recessie ................................................................................................................... 65
4. ETIOLOGIE EN PATHOGENESE VAN PLAQUE-GERELATEERDE PARODONTALE AANDOENINGEN ................. 66
4.1 INLEIDING....................................................................................................................................................... 67
4.2 INNERVATIE EN NEUROFYSIOLOGIE....................................................................................................................... 67
4.2.1 speekslklieren produceren speeksel onder invloed van het zenuwstelsel ........................................... 67
4.2.2 eigenschappen en mondgezondheid .................................................................................................. 69
4.2.3 vorming van tandplaque ..................................................................................................................... 70
4.2.4 initiële hechting en energiebron van de subgingivale flora ................................................................ 71
4.2.5 xerostomie .......................................................................................................................................... 72
4.3 SUPRAGINGIVALE PLAQUEGROEI: MATURATIE EN MINERALISATIE ............................................................................... 74
4.3.1 inleiding .............................................................................................................................................. 74
4.3.2 mechanisme van bacteriële adhesie ................................................................................................... 76
4.3.3 kolonisatie van de mondholte............................................................................................................. 77
4.3.4 plaqueaccumulatie vanuit een klinisch oogpunt ................................................................................ 77
4.3.5 invloed van oppervlakte eigenschappen op de initiële adhesie .......................................................... 79
4.3.6 maturatie van plaque ......................................................................................................................... 80
4.3.7 mineralisatie van plaque (tandsteen) ................................................................................................. 81
4.4 MICROBIOLOGIE VAN PARODONTALE INFECTIES ...................................................................................................... 82
4.4.1 microbiologie van de parodontale infecties ........................................................................................ 82
4.4.2 geschiedenis........................................................................................................................................ 83
4.4.3 supra gingivale plaque ........................................................................................................................ 84
4.4.4 subgingivale plaque ............................................................................................................................ 86
4.4.5 microbiologie van parodontale infecties ............................................................................................ 87
4.4.5.1 gingivitis ........................................................................................................................................................ 87
4.4.5.2 van gingiitis naar parodontitis ...................................................................................................................... 88
4.4.5.3 parodontitis .................................................................................................................................................. 89
2
, 4.4.5.4 de aard van parodontale infecties ................................................................................................................ 89
4.4.5.5 op zoek naar de etiologie van parodontitis .................................................................................................. 90
4.4.5.6 de aard van parodontale infecties ................................................................................................................ 90
4.4.5.6 microscopisch onderzoek ............................................................................................................................. 91
4.4.5.7 kweekstudies of PCR onderzoek ................................................................................................................... 91
4.4.5.8 verschillende vormen van parodontitis ........................................................................................................ 92
4.4.5.9 speciële bacteriologie (vanbuiten kennen) ................................................................................................... 93
4.4.5.10 virulentie van paropathogenen bacterien .................................................................................................. 98
4.4.5.11 zijn alle paropathogene bacteriën normale mondbewoners? .................................................................. 100
4.5 VATBAARHEID VOOR PARODONTITIS (GENETISCHE FACTOREN)................................................................................. 101
4.5.1 inleiding ............................................................................................................................................ 101
4.5.2 epidemiologische aanwijzingen van de rol van erfelijke factoren bij parodontitis ........................... 104
4.5.3 het humaan genoom en genetische polymorfismen ........................................................................ 106
4.5.3 genetische parodontitis studies ........................................................................................................ 108
4.6 MODIFICERENDE FACTOREN: DIABETES, ROKEN, STRESS ......................................................................................... 109
4.6.1 diabetes ............................................................................................................................................ 109
4.6.2 roken ................................................................................................................................................. 111
4.6.3 psychische stress ............................................................................................................................... 115
4.7 IMMUNOLOGISCHE REACTIES BIJ PARODONTITIS ................................................................................................... 117
4.7.1 de parodontale infectie ..................................................................................................................... 120
4.7.2 de epitheliale barrière ....................................................................................................................... 121
4.7.3 de rol van het complement ............................................................................................................... 121
4.7.4 fagocytose ........................................................................................................................................ 121
4.7.5 de monocyt-macrofaag .................................................................................................................... 122
4.7.6 het cytokinenetwerk en andere onstekingsmediatoren ................................................................... 123
4.7.7 de rollen van de T-cellen ................................................................................................................... 124
4.7.8 de rollen van de B-cellen en de antilichaamproductie ...................................................................... 125
4.7.9 antilichaampresentatie ..................................................................................................................... 126
4.7.10 de pathogenese van parodontitis ................................................................................................... 127
4.8 PARODONTALE ONTSTEKINGEN: WEEFSELAFBRAAK................................................................................................ 129
4.8.1 afbraak van bind-steunweefsel en de cellen betrokken bij dit proces .............................................. 129
4.8.2 proteolytische enzymen .................................................................................................................... 131
4.8.3 hoe de afbraak stoppen? .................................................................................................................. 132
4.8.4 samenvatting .................................................................................................................................... 132
4.9 PARODONTITIS IN RELATIE TOT ALGEMENE GEZONDHEID ........................................................................................ 133
4.9.1 parodontitis en de acute fase reactie ............................................................................................... 134
4.9.2 parodontitis en cardiovasculaire aandoeningen .............................................................................. 135
4.9.3 parodontitis en zwangerschap.......................................................................................................... 142
4.9.4 parodontitis en diabetes mellitus ..................................................................................................... 143
4.9.5 parodontitis en rheumatoïde arthritis .............................................................................................. 147
4.9.6 parodontitis en respiratoire aandoeningen ...................................................................................... 148
3
, 4
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller morgMOZ. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $10.48. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
79271 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now