Uitgebreide samenvatting van het onderdeel MKA van het vak Mondzorg bij de bijzondere doelgroep. Deze samenvatting bevat ALLES wat je moet weten voor dit examenonderdeel! Inclusief tips over welke onderwerpen zeker in het examen zullen zitten, super handig dus!!
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MKA – Mondzorg bij de bijzondere
doelgroep
Puck Schoonen – MOZ 3 D1
Inhoudsopgave
1. MKA ....................................................................................................................................................... 2
1.1 Dentomaxillofaciale radiologie ..................................................................................................................... 2
Historie ........................................................................................................................................................... 2
Heden ............................................................................................................................................................. 4
Bewegende X-stralen bronnen ....................................................................................................................... 7
Niet ioniserende stralen ............................................................................................................................... 10
1.2 Dento-alveolaire traumatologie & kaakfracturen....................................................................................... 13
Dentale traumatologie – EHBTO ‘eerste hulp bij tandongevallen ................................................................ 13
Kaakfracturen ............................................................................................................................................... 19
Sfeerbeelden ................................................................................................................................................ 22
1.3 Frenula & Frenulectomie ............................................................................................................................. 26
1.4 Schisis .......................................................................................................................................................... 28
Voorbeelden ................................................................................................................................................. 32
1.5 Ontwikkelingsstoornissen ........................................................................................................................... 33
Aantal tanden ............................................................................................................................................... 33
Vormafwijking van het gebit......................................................................................................................... 36
Ontwikkelingsstoornis in het gebit ............................................................................................................... 39
Kleurafwijkingen in het gebit ........................................................................................................................ 43
Doorbraak- of eruptiestoornissen in het gebit ............................................................................................. 44
1.6 Oncologie en de mond ................................................................................................................................ 45
1.7 Temporomandibulaire dysfuncties & Orofaciale pijn .................................................................................. 47
Articulatio Temporomandibularis ATM ........................................................................................................ 47
12 Craniale zenuwen .................................................................................................................................... 50
Dysfunctie en pijn ......................................................................................................................................... 51
1.8 Omgaan met kinderen en special needs ..................................................................................................... 57
1.8.1. Omgaan met patiënten met beperkingen .......................................................................................... 61
1.9 Behandelingen & procedures kindertandheelkunde ................................................................................... 62
, 1. MKA
1.1 Dentomaxillofaciale radiologie
Historie
De ontdekker van de X-stralen: William Roentgen
- William Conrad Roentgen (027/3/1845 - ⱡ10/2/1923)
Accidentally made an important discovery on 8 November 1895. One morning when he came
into his laboratory, he discovered that a key in a book, lying on his desk, had left a shadow on
a photographic glass plate which he had stored away in the drawer of his desk.
- Waarom het X-stralen heet: hij had echt geen idee wat hij had gevonden.
- The day before he had been experimenting with electromagnetic radiation and he was sure
the key had always been in the book and that the photographic glass plate never left the
drawer.
- Because he did not know exactly what he had discovered, he called these mysterious rays, X-
rays. (x as in mathematics, the unknown)
- He also discovered that these X-rays we able to fluoresce barium platino cyanide.
- He therefore continued his experiments and the most famous of them all, was a radiographic
image of his wife’s hand. Bertha placed her hand on top of a photographic glass plate for
15 minutes, with the X-rays continuously on (22 December 1895).
13 January 1896, WC Roentgen presents his work to
Emperor Wilhelm II in Berlin.
EN 23 January 1896, “New Kind of Ray” was presented before the Physical Medical Society of the
University of Wuerzburg. There he took the radiograph of Professor Albert von Koelliker’s hand.
Thompson (physicist) presented Roentgen’s discovery at the British Roentgen Society on 5 November
1897 in London and subsequently publiched it in the 2nd volume of the world’s first journal of
radiology: English Archives of Skiagraphy. Later the journal’s name was changed to Archives of the
Roentgen Ray.
W.C. Röntgen made his discovery public on 28 December 1895.
The painting by Robert Alan Tom, painted in 1961 and represents Röntgen on January 23rd 1896.
Professor Kölliker’s hand is radiographed for 20 minutes
X-rays in tandheelkunde
On 12 January 1896, Dr. Otto Walkhoff, from Braunschweig, makes the first dental radiograph in the
world. This was only about 14 days after Roentgen made his discovery known to the public.
He made a radiographic image of his own teeth, by placing the photographic glass plate in his mouth,
lying on his back, with the radiation source 25 minutes continuously irradiating above him
à Ze werkte toen met aanzienlijk minder milliampère
Korreligere beelden = te laag aantal milliampère, te laat aantal elektroden
Dr. Walter König, later on professor at the University of Giessen in Germany, made 14 attempts in
February 1896. He irradiated himself continuously for 9 minutes.
William Conrad Röntgen received the Nobel Prize for Physics in 1901 for his discovery of X-rays and
their multiple applications.
2
,Ter info:
- Sheffield (UK): Dr. Frank Harrison (DDS, 1859-1912) used 10 minutes exposures to be able to
see the outlines of the pulp chambers.
- Dr. William James Morton (DDS) was the first to announce that dental radiographs were a
fact. His father, William Thomas Green Morton, introduced anaesthesia (1846)
- Dr. Charles Edmund Kells (DDS, 1856-1928) designed his own dental radiography machine
between January and May 1896!
This was published in 1899 (Dental Cosmos) and he mentioned it was important to keep the
film and the teeth at right angles to obtain the best images. He is acknowledged for training
and educating dental professionals in radiography. He was also the first to show the
detrimental effects of frequent exposures.
Vacuum glass tubes:
- Cromwell Varley
- Julius Pluecker
- Hittorf (probably used by WC Roentgen)
- Heinrich Hertz
- Eugen Goldstein (coined the term cathode ray)
- Otto Von Guericke
- Philippe Lenard (Nobel prize winner for cathode rays) (tubes used by WC Roentgen)
- William Crookes (most famous for the glass tubes – definitely used by WC Roentgen)
Induction coils and other electromagnetic devices: Heinrich Ruhmkorff
In een röntgentoestel wordt licht geproduceerd: foto-elektrisch effect
Hoe voorkomen dat de röntgenstralen in het rond vliegen: lood à vangt de energie van de
röntgenstralen op waardoor het neutraliseert
Op de plek van de anode worden de x-stralen geproduceerd (rood bolletje op het toestel)
Sommige toestellen hebben een korte buis en sommige een lange, omdat de ene fabrikant zijn
röntgenbuis vanachter in het toestel (dan korte buis) en de andere van voren (dus lange buis), want
minimaal 20 cm tussen de huis en röntgenbuis.
Vroeger kwamen de X-stralen van achter de patiënt en röntgenoloog zat ervoor en hield een
fluorescerende plaat vast, hij kijkt rechtstreeks in de stralen à geen statische beelden
- Vaak last van blindheid, huidkanker, cataract, afsterving van de vingers\
- Behandelaar krijgt alle de zwakke stralingen en absorbeert die, die zijn juist het gevaarlijkst
want sterke gaan door je heen.
Important dates in time
(Fosforplaatjes)
3
, Heden
IONISERENDE STRALING
- Tweedimensionele radiografie
o Intra-orale radiografie
§ Bitewing radiografie
§ Peri-apicale radiografie
§ Occlusale radiografie
o Extra-orale radiografie
§ Panoramische radiografie
§ Cefalometrische radiografie (typische schedelprofielfoto voor chirurgie en
ortho)
§ Schuine laterale radiografie (techniek bv. Bij gehandicapte)
- Driedimensionele radiografie
o Cone Beam Computed Tomography (CBCT) (x-stralen in piramidevorm)
o Multislice Computed Tomography (CT) (x-stralen komen eruit als een waaier)
(Ioniserende straling is straling die kanker veroorzaakt)
NIET IONISERENDE STRALING
- Ultrasonografie = echografie (gebruikt geluidsgolven)
- Magnetic Resonance Imaging (MRI) (waterstofatomen in je lichaam worden gebruikt om het
beeld te vormen)
o Soms bij MRI: contrastvloeistof drinken (gastr-intestinaalstelsel) of inspuiten in aders
Radiografie = schaduw –grafie (Shadowgraphs) à we kijken eigenlijk naar schaduwen
Beeld je in dat:
• RX-toestel is een zaklamp
• De muur is de beeldreceptor (fosforplaat/ solid state sensor/ analoge film)
• Tand/ kaak/ schedel = het voorwerp
De schaduw op de muur gaat bepaald worden door de positie van:
• Zaklamp ten opzichte van het voorwerp
• Zaklamp ten opzichte van de muur
• Voorwerp ten opzichte van de muur
• à Beelddetector moet loodrecht staat op je voorwerp!
Het beste beeld bekom je door:
- Voorwerp parallel met de muur te zetten
- Voorwerp zo dicht mogelijk bij de muur te zetten (scherp beeld)
- Zaklamp van parallelle lichtstralen te voorzien
- Zaklamp loodrecht op het voorwerp te richten
Enige variatie (bijv. voorwerp niet parallel aan de muur of zaklamp niet loodrecht op voorwerp
gericht), zorgt voor vervorming in het beeld.
Dus het ideale beeld wordt bekomen door middel van de zogenaamde parallel techniek (zie MOZ-
lessen radiologie), waarvoor je richtapparatuur nodig hebt die de beeld detector vasthoudt en die je
in staat stelt om de X- stralen loodrecht op de beeld detector te richten.
4
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