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Samenvatting parodontologie 1
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Zeer uitgebreide en duidelijke samenvatting van parodontologie 1 gegeven door Mevr. Van Strydonck. Met oefenvragen om je kennis te testen.
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InhoudsopgaveInleiding........................................................................................................................................................ 4
Historie van het beroep MH.................................................................................................................................4
Doelstelling van het beroep MH...........................................................................................................................4
Verwachtingen......................................................................................................................................................5
Bouw en functie............................................................................................................................................. 6
Inleiding................................................................................................................................................................6
Gingiva.................................................................................................................................................................6
Epitheel............................................................................................................................................................6
Sulcus epitheel.................................................................................................................................................7
Aanhechtingsepitheel......................................................................................................................................7
Sulcus gebied...................................................................................................................................................7
Lamina propria.................................................................................................................................................8
De col...............................................................................................................................................................8
Biologische breedte.........................................................................................................................................8
Alveolaire mucosa = wangslijmvlies................................................................................................................8
Parodontaal ligament...........................................................................................................................................8
Vezels...............................................................................................................................................................9
Cellen...............................................................................................................................................................9
Vascularisatie en innervatie.............................................................................................................................9
Wortelcement................................................................................................................................................10
Processus alveolaris.......................................................................................................................................11
Pathologie................................................................................................................................................... 12
Gingivitis.............................................................................................................................................................12
Histologisch....................................................................................................................................................12
Sonderen........................................................................................................................................................12
Studie van H. Loe 1965..................................................................................................................................13
Animal study Page & Schroeder 1976...........................................................................................................13
Microbiologie van plaque accumulatie.........................................................................................................14
Vormen van gingivits.....................................................................................................................................15
Parodontitis........................................................................................................................................................16
Gingivitis vs. parodontitis..............................................................................................................................17
Classificatie van parodontitis.........................................................................................................................18
Niet plaque-gerelateerd.....................................................................................................................................20
Necrotiserende parodontitis.........................................................................................................................20
Niet plaquqe gerelateerde aandoening..............................................................................................................22
Vrius...............................................................................................................................................................22
Auto-immuunziekte.......................................................................................................................................22
Verkleuringen................................................................................................................................................23
Bullae en ulceratieve aandoeningen.............................................................................................................24
Dermatologisch..............................................................................................................................................25
Virale aandoening..........................................................................................................................................25
Tumoren........................................................................................................................................................25
Plaveisel carcinoom.......................................................................................................................................27
Hypermobiliteit...................................................................................................................................................27
Tandtrauma parodontium..................................................................................................................................28
1
, Tandtrauma chronisch, door occlusie.................................................................................................................29
Primaire occlusaal trauma.............................................................................................................................29
Secundair occlusaal trauma...........................................................................................................................30
Andere factoren.............................................................................................................................................30
Gingivale recessie...............................................................................................................................................30
Oorzaken........................................................................................................................................................31
Pathogenese..................................................................................................................................................31
Etiologie en pathogenese............................................................................................................................. 31
Speeksel..............................................................................................................................................................32
Speekselklieren..............................................................................................................................................32
Samenstelling.................................................................................................................................................32
Anti-microbieel effect....................................................................................................................................33
Droge mond...................................................................................................................................................34
Xerostomie.....................................................................................................................................................34
Supragingivale plaquegroei................................................................................................................................35
Pathogenese..................................................................................................................................................36
Kolonisatie.....................................................................................................................................................36
Plaqueaccumulatie........................................................................................................................................37
Maturatie.......................................................................................................................................................38
Mineralisatie van plaque...............................................................................................................................38
Microbiologie van parodontale infecties............................................................................................................39
Supragingivale plaque....................................................................................................................................40
Subgingivale plaque.......................................................................................................................................41
Parodontale infecties.....................................................................................................................................41
Speciële bacteriën..........................................................................................................................................43
Vatbaarheid voor parodontitis...........................................................................................................................45
Epidemiologische aanwijzingen.....................................................................................................................45
Humane genoom & genetische polymorfismen............................................................................................46
Modificerende factoren......................................................................................................................................48
Diabetes.........................................................................................................................................................48
Roken.............................................................................................................................................................49
Psychische stress...........................................................................................................................................51
Voeding..........................................................................................................................................................51
Vitamine D.....................................................................................................................................................51
Immunologische reacties bij parodontitis..........................................................................................................51
Inleiding.........................................................................................................................................................52
Parodontale infectie......................................................................................................................................54
Epitheliale barrière........................................................................................................................................54
Rol van het complement...............................................................................................................................55
Fagocytose.....................................................................................................................................................55
Monocyt-macrofaag......................................................................................................................................56
Cytokine netwerk en andere ontstekingsmediatoren...................................................................................56
De rol van T-cellen.........................................................................................................................................57
Antilichaamproductie....................................................................................................................................57
Pathogenese van parodontitis.......................................................................................................................59
Weefselafbraak..................................................................................................................................................60
Proces............................................................................................................................................................60
Proteolitische enzymen.................................................................................................................................61
Hoe de afbraak stoppen?..............................................................................................................................61
Parodontitis en de relatie tot algemene gezondheid.........................................................................................62
Inleiding.........................................................................................................................................................62
2
, Parodontitis en de acute fase reactie............................................................................................................62
Parodontitis en cardiovasculaire aandoeningen...........................................................................................63
Zwangerschap................................................................................................................................................68
Rheumaoïde Arthritis.....................................................................................................................................69
Respiratoir.....................................................................................................................................................69
Diabetes.........................................................................................................................................................69
Oefenvragen................................................................................................................................................ 72
3
, Inleiding
Parodontologie is een gereglementeerd en beschermt specialisme binnen de tandheelkunde,
dat zich richt op de steunweefsels rondom gebitselementen.
Historie van het beroep MH
USA Dr. Fones is de grondlegger van MH
1906: Irene Newman is de eerste MH
1923: eerste MH-vereniging: American Dental Hygiënists Association
1947: school of dental hygiëne, 2-jarige opleiding
1971: MH starten met geven van lokale anesthesie
o Nederland, 57 jaar
1964: eerste MH als preventie medewerker naar USA, Canada en VK gegaan
1967: NVM opgericht
1968: Utrecht, 2-jarige opleiding
1992: 3-jarige opleiding van gemaakt
2002: 4-jarige opleiding van gemaakt (Utrecht, Amsterdam en Nijmegen). Onder controle
van en op aanwijzing van een TA.
2006: vrije vestiging
2020: uitbreiding van werkzaamheden: boren, RX nemen, verdoven en meer zelfstandigheid.
o Italië, 40 jaar
1978: Universiteit van Bari, eerste opleiding MH
1981: eerste 14 MH afgestudeerd.
o België, 2 jaar
2015: NVAO beslist voor 3-jarige opleiding, bachelor in de mondzorg. KB78: enkel TA mag
handelingen uitvoeren in de mond (1967).
18/6/18: wetaanpassing KB78: MH mag in de mond werken onder verantwoordelijkheid van
een TA of TA-specialist.
Doelstelling van het beroep MH
Neemt delen van de mondzorg over in overleg en onder supervisie van de TA.
o Verleent kwalitatieve mondzorg vanuit een correcte beroepshouding.
o Stelt de behoefte van mondzorg vast, indiceert en verleent en evalueert mondzorg
o.b.v. klinische redenen.
o Bied mondzorg vanuit een specifieke deskundigheid binnen de eigen bevoegdheid in
complexe situaties.
o Zorgt voor continuïteit in de mondzorg door het toepassen van een mondzorg traject.
o Redeneert over gezondheidsproblemen van de patiënt, interventies en doelen.
4
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