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Summary

Samenvatting Orthodontie

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Complete en overzichtelijke samenvatting van alle leerstof te kennen voor luik 1 van orthodontie: diagnostiek. Zie ook luik 2: behandeling om een complete samenvatting van dit vak te hebben.

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  • October 10, 2022
  • 416
  • 2021/2022
  • Summary
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Tandfeetje 3e Bachelor 2021



1. Spontane verbeteringen en interceptieve maatregelen ............................................................................... 7

Interceptief .......................................................................................................................................................... 7
Principes .......................................................................................................................................................... 7
Voordelen ........................................................................................................................................................ 7
Rol van melkgebit ............................................................................................................................................ 8
Wisselgebit ...................................................................................................................................................... 8
Functionele afwijkingen .................................................................................................................................. 8
Voornamelijk op letten als tandarts:............................................................................................................... 8
casus 1 ............................................................................................................................................................. 9
Interceptief handelen: .................................................................................................................................. 11
Casus 2 .......................................................................................................................................................... 11
Casus 3 .......................................................................................................................................................... 12

Serial extraction ................................................................................................................................................ 14
Wanneer........................................................................................................................................................ 14
Wat ................................................................................................................................................................ 14
Voordelen ...................................................................................................................................................... 15
Nadelen ......................................................................................................................................................... 15
(Studies) (niet kennen) .................................................................................................................................. 15

Space maintaining – space regaining................................................................................................................ 15
Casus ............................................................................................................................................................. 15
Space maintaining ......................................................................................................................................... 16
Apparatuur: ............................................................................................................................................... 17
Linguale boog (onder) ........................................................................................................................... 17
lip bumper (onder) ................................................................................................................................ 17
transpalatal arch (boven) ...................................................................................................................... 18
Retainer arch ......................................................................................................................................... 18
uitneembare beugel .............................................................................................................................. 18
Samenvattend: ...................................................................................................................................... 19
Space regaining ............................................................................................................................................. 19
Apparatuur: ............................................................................................................................................... 19
Crefcoeurveer........................................................................................................................................ 19
Lusveer .................................................................................................................................................. 19

Tekst: Uitgangspunten bij de behandelingsplanning ........................................................................................ 20

Tekst: vroegtijdige orthodontie, een diagnostische uitdaging .......................................................................... 24

2. Eruptiestoornissen ..................................................................................................................................... 30

Eruptiestoornissen ............................................................................................................................................. 30
Inleiding ......................................................................................................................................................... 30
Eruptie en tandontwikkeling ......................................................................................................................... 32
Stadia van eruptie ..................................................................................................................................... 32
Normale eruptie ........................................................................................................................................ 33
Tandontwikkeling ...................................................................................................................................... 34
Definities van eruptiestoornissen (!) ............................................................................................................. 35
Impactie .................................................................................................................................................... 36
Retentie ..................................................................................................................................................... 36
Stroomschema’s ............................................................................................................................................ 37


1

,Tandfeetje 3e Bachelor 2021


Diagnostische procedures - ankylose ............................................................................................................ 38
Gevolgen van dentale infra-occlusie ............................................................................................................. 39
Oorzaken van ankylose ................................................................................................................................. 40
Ankylose & infra-occlusie van melkmolaren ................................................................................................. 40
Ankylotische melkmolaren zonder definitieve opvolger........................................................................... 42
Hoe geïmpacteerde hoektand behandelen? ............................................................................................. 43
Voorbeeld casus 1: ................................................................................................................................ 45
Voorbeeld casus 2: ................................................................................................................................ 46
VOorbeeld casus 3:................................................................................................................................ 47
Autotransplantatie ........................................................................................................................................ 47
Intra-alveolaire autotranplantatie ............................................................................................................ 47
Voorbeeld casus 1: ................................................................................................................................ 47
Voorbeeld casus 2: ................................................................................................................................ 48
Trans-alveolaire autotransplantatie .......................................................................................................... 48
Voorbeeld casus 1: ................................................................................................................................ 48
Voorbeeld casus 2: ................................................................................................................................ 49
CONCLUSIES VAN DEZE LES: .......................................................................................................................... 49

Tekst: eruptiestoornissen .................................................................................................................................. 50

3. Sagittale afwijkingen .................................................................................................................................. 59

Klasse II.............................................................................................................................................................. 59
Functionele apparatuur: ............................................................................................................................... 59
Klasse II.1 behandeling .............................................................................................................................. 59
Prevalentie ............................................................................................................................................ 60
Behandelopties ..................................................................................................................................... 60
Functionele therapie! ............................................................................................................................ 62
Ongewenste efffecten activator............................................................................................................ 67
Vrijslijpen activator in 3 dimensies ....................................................................................................... 67
Types activatoren: ................................................................................................................................. 68
Tijdstip van behandelen ........................................................................................................................ 74
Studies: .................................................................................................................................................. 81
Tekst: behandelingsplanning bij klasse II: activatoren .............................................................................. 83
Extra-orale apparatuur: ............................................................................................................................... 118
extra-orale tractie ................................................................................................................................... 118
Groeimodificatie.................................................................................................................................. 118
Orthodontische behandeling gecombineerd met tandextractie ........................................................ 123
Chirugische correctie van de kaakrelatie ............................................................................................ 124
Prospectieve studies ........................................................................................................................... 124
Casus 1 ................................................................................................................................................ 126
Tekst: extra-oral appliances in orthodontic treatment ........................................................................... 132

Klasse III........................................................................................................................................................... 137
Klasse III behandeling met botankers ......................................................................................................... 137
Masker van delaire .................................................................................................................................. 138
Botankers ................................................................................................................................................ 139
Studies ................................................................................................................................................. 141
Schisis-patiënten ................................................................................................................................. 143
Tekst: behandeling bij klasse III-afwijking ................................................................................................... 145

4. Transversale afwijkingen – geen les over ................................................................................................. 155

2

,Tandfeetje 3e Bachelor 2021


Tekst: Behandelingsplanning bij afwijkende transversale occlusie ................................................................. 155

5. Ruimtegebrek ........................................................................................................................................... 167

Ruimtegebrek .................................................................................................................................................. 167
Non-extractie .............................................................................................................................................. 167
Extractie ...................................................................................................................................................... 168
Voorbeeld casus 1: 4 premolaarextraties ............................................................................................... 168
Welke elementen extraheren? ............................................................................................................... 174
Voorbeeld casus 2: mesio-occlusie ......................................................................................................... 175

Eerste molaren extractie ................................................................................................................................. 178
Voorbeeld: casus 1 ...................................................................................................................................... 179
Voorbeeld: casus 2 ...................................................................................................................................... 180
Vragen: ........................................................................................................................................................ 180
Protocol: ...................................................................................................................................................... 182
Klasse I:.................................................................................................................................................... 182
klasse I met zeer sterk ruimtegebrek ...................................................................................................... 182
Klasse II.1 malocclusie ............................................................................................................................. 182
Klasse II.2 malocclusie ............................................................................................................................. 183
Klasse III malocclusie ............................................................................................................................... 183
Autotransplantatie M3 ................................................................................................................................ 183
Voorbeeld: casus 3 .................................................................................................................................. 184
CONCLUSIE .................................................................................................................................................. 185

Tekst: a guideline for the extraction of first permanent molars in childern .................................................... 186

Tekst: essential orthodontics ........................................................................................................................... 194

6. Apparatuur ............................................................................................................................................... 204

Biomechanica .................................................................................................................................................. 204
Tooth displacement .................................................................................................................................... 204

Tekst: is uitneembare apparatuur verleden tijd? ............................................................................................ 213

Skeletale verankering ...................................................................................................................................... 217
Botankers .................................................................................................................................................... 217
Introductie............................................................................................................................................... 217
Voorbeeld: casus ................................................................................................................................. 218
Historische achtergronden ...................................................................................................................... 220
Voorbeeld casus 1: .............................................................................................................................. 222
Definities en classificaties ....................................................................................................................... 223
Klinische indicaties: casus presentaties .................................................................................................. 226
Voorbeeld casus 2: sluiten van diastemen .......................................................................................... 226
Voorbeeld casus 3: aligneren middellijnen ......................................................................................... 227
Voorbeeld casus 4: molaren intruderen ............................................................................................. 228
Voorbeeld casus 5: molaren distaliseren ............................................................................................ 229
Voorbeeld casus 6: asymmetrisch ....................................................................................................... 231
Voorbeeld casus 7: molaren mesialiseren .......................................................................................... 232
Voorbeeld casus 8: 4 schroeven, geen botplaat ................................................................................. 233
Voorbeeld casus 9: oprichten van molaren ........................................................................................ 235
Parameters voor succes: botankers en mini schroeven .......................................................................... 236
Studie (niet kennen): ........................................................................................................................... 236

3

, Tandfeetje 3e Bachelor 2021


Tekst: orthodontic bone anchor.................................................................................................................. 238
Tekst: botverankering ................................................................................................................................. 244

7. Autotransplantatie ................................................................................................................................... 270

autotransplantatie .......................................................................................................................................... 270
Historiek ...................................................................................................................................................... 270
Casus ....................................................................................................................................................... 271
Definities ..................................................................................................................................................... 272
Voorbeeld (A): intra-alveolaire transplantatie ........................................................................................ 273
Voorbeeld (B): transalveolaire transplantatie ......................................................................................... 273
Indicaties en voorbeelden ........................................................................................................................... 273
Trauma .................................................................................................................................................... 273
Voorbeeld casus 1: .............................................................................................................................. 273
Voorbeeld casus 2: .............................................................................................................................. 274
Tandverlies door cariës ........................................................................................................................... 275
Voorbeeld casus 1: .............................................................................................................................. 275
Ectopische positie ................................................................................................................................... 276
agenesieën .............................................................................................................................................. 276
Voorbeeld casus 1: .............................................................................................................................. 276
Voorbeeld casus 2: .............................................................................................................................. 277
Ontwikkelingsstoornissen ....................................................................................................................... 277
Chirurgische procedure ............................................................................................................................... 277
Succes en faling ........................................................................................................................................... 278
Parodontaal ligament genezing............................................................................................................... 278
Revascularisatie....................................................................................................................................... 279
Toename wortellengte ............................................................................................................................ 281
Botgenezing ............................................................................................................................................. 281
Lange termijn resultaten: ........................................................................................................................ 283
Immature tanden: ............................................................................................................................... 283
Mature tanden: ................................................................................................................................... 283
Voorbeeld casus succes: vervolg op casus Ectopische positie p 274 ...................................................... 284
Mogelijke problemen na tandtransplantatie .......................................................................................... 284
Voorbeeld 1 faling: .................................................................................................................................. 285
Voorbeeld 2 faling: .................................................................................................................................. 285
Voorbeeld 3 faling: .................................................................................................................................. 286
Alternatieven............................................................................................................................................... 287
Na trauma ............................................................................................................................................... 287
Bij agenesie ............................................................................................................................................. 287
Cryopreservatie ........................................................................................................................................... 288
Welke gebitselementen transplanteren? ................................................................................................... 290
Bovenpremolaren naar bovenfront ........................................................................................................ 290
Onderpremolaren naar bovenfront ........................................................................................................ 292
Onderpremolaren naar bovenkaak ......................................................................................................... 293
M3 onder naar zone M1 onder ............................................................................................................... 294
Bovenpremolaren naar onderkaak ......................................................................................................... 295

Tekst: Trauma en autotransplantatie ............................................................................................................. 297

Tekst: Trauma en replantatie .......................................................................................................................... 301

8. Agenesie en spacing ................................................................................................................................. 305

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