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Bonamie LaurenceBachelor in de Mondzorg – 2022-2023
MATERIALEN EN PRODUCTEN
,INHOUD
INLEIDING......................................................................................................................... 4
1 INSTRUMENTARIUM VOOR MONDONDERZOEK EN NIET-CHIRURGISCHE PARODONTALE THERAPIE...................... 4
1.1 Terminologie ......................................................................................................................................................... 4
1.2 Types van instrumenten ........................................................................................................................................ 4
1.2.1 Handinstrumenten.................................................................................................................................... 4
1.2.2 Mechanisch (elektrisch en lucht) aangedreven instrumenten ................................................................ 10
2 MATERIALEN GEBRUIKT BINNEN DE PREVENTIEVE ZORG .................................................................. 11
2.1 Introductie .......................................................................................................................................................... 11
2.2 Beschermende vernissen en gelen ...................................................................................................................... 13
2.2.1 Vernissen en gelen op basis van fluoride ................................................................................................ 13
2.2.2 Vernissen en gelen op basis van chloorhexidine (CHX) ........................................................................... 15
2.3 Pit – en fissuur sealants ....................................................................................................................................... 17
2.3.1 Sealants op basis van kunsthars ............................................................................................................. 18
2.3.2 Sealants op basis van glasionomeer (GIC) ............................................................................................... 19
2.4 Mondbeschermers .............................................................................................................................................. 20
2.4.1 Inleiding .................................................................................................................................................. 20
2.4.2 Prefab mondbeschermers ...................................................................................................................... 20
2.4.3 Boil-and-bite mondbeschermers ............................................................................................................ 20
2.4.4 Individueel aangepaste mondbeschermers ............................................................................................ 21
3 MATERIALEN GEBRUIKT BINNEN DE RESTAURATIEVE ZORG ............................................................... 22
3.1 Inleiding .............................................................................................................................................................. 22
3.2 Geschiedenis ....................................................................................................................................................... 22
3.2.1 Oude tijd tot 18 e eeuw ........................................................................................................................... 22
3.2.2 18e – 19e eeuw ........................................................................................................................................ 22
3.2.3 20ste eeuw ............................................................................................................................................... 22
3.2.4 21ste eeuw ............................................................................................................................................... 22
3.3 Biomaterialen...................................................................................................................................................... 22
3.3.1 Metalen .................................................................................................................................................. 23
3.3.2 Polymeren (plastiek, kunststof, rubber,…) .............................................................................................. 23
3.3.3 Keramieken ............................................................................................................................................. 24
3.3.4 Composieten .......................................................................................................................................... 24
3.4 Vullingsmaterialen .............................................................................................................................................. 24
3.4.1 Amalgaam ............................................................................................................................................... 25
3.4.2 Composieten .......................................................................................................................................... 25
3.4.3 Glasionomeer cementen ........................................................................................................................ 27
3.4.4 Compomeren .......................................................................................................................................... 28
3.5 Cementen en voorlopige vullingsmaterialen ........................................................................................................ 28
3.5.1 Onderlaag ............................................................................................................................................... 28
3.5.2 Voorlopig vullingsmateriaal .................................................................................................................... 28
3.5.3 Zink oxide eugenol cement ..................................................................................................................... 29
3.5.4 Calcium hydroxide (CaOH) ...................................................................................................................... 29
3.5.5 Zink oxide in combinatie ......................................................................................................................... 29
3.5.6 Polycarboxylaat cementen...................................................................................................................... 30
3.5.7 Zink fosfaat cementen ............................................................................................................................ 30
3.5.8 Glasionomeer cementen (zie 3.4.3) ........................................................................................................ 30
3.6 Vaste prothetische voorzieningen ....................................................................................................................... 31
3.6.1 Inlays ...................................................................................................................................................... 31
3.6.2 Onlays / overlays .................................................................................................................................... 31
3.6.3 Kroon ...................................................................................................................................................... 32
3.6.4 Brug ........................................................................................................................................................ 32
3.6.5 Facetten of veneers ................................................................................................................................ 32
3.6.6 Gebruikte materialen.............................................................................................................................. 33
3.7 Uitneembare prothetische voorzieningen............................................................................................................ 34
3.7.1 Prothese basis ........................................................................................................................................ 34
3.7.2 Prothese tanden ..................................................................................................................................... 35
3.8 Reproductie van het werkterrein ......................................................................................................................... 35
3.8.1 Analoog proces ....................................................................................................................................... 35
3.8.2 Digitaal proces ........................................................................................................................................ 42
2
,4 POLIJSTMATERIALEN ........................................................................................................ 43
4.1 Belangrijke termen .............................................................................................................................................. 43
4.2 Types abrasieven................................................................................................................................................. 43
4.2.1 Kalk ......................................................................................................................................................... 43
4.2.2 Puimsteen ............................................................................................................................................... 43
4.2.3 Aluminiumoxide ...................................................................................................................................... 43
4.2.4 Silex (vuursteen) ..................................................................................................................................... 43
4.2.5 Tin oxide ................................................................................................................................................. 43
4.2.6 Tungsten carbide .................................................................................................................................... 43
4.3 Factoren die mate van abrasie bepalen ............................................................................................................... 44
4.3.1 Hardheid ................................................................................................................................................. 44
4.3.2 Grootte en vorm ..................................................................................................................................... 44
4.3.3 Druk en snelheid ..................................................................................................................................... 44
4.3.4 combineren – coaten .............................................................................................................................. 44
4.4 Gebonden en gecoate abrasieve middelen .......................................................................................................... 45
4.4.1 Diamant boren ........................................................................................................................................ 45
4.4.2 Arkansas Steentjes .................................................................................................................................. 45
4.4.3 Rubber wieltjes en punten, rubber cups ................................................................................................. 45
4.4.4 Schijfjes en strips .................................................................................................................................... 45
4.4.5 Profylaxe pasta’s – polijstpasta’s ............................................................................................................ 45
4.4.6 Poeders................................................................................................................................................... 47
4.4.7 Therapeutische additieven ..................................................................................................................... 47
5 SPECIFIEKE MATERIALEN .................................................................................................... 48
5.1 Orthodontie ........................................................................................................................................................ 48
5.1.1 Materialen gemeenschappelijk met andere vakgebieden binnen de tandheelkunde ............................. 48
5.1.2 Specifieke materialen ............................................................................................................................. 49
5.2 Endodontie ......................................................................................................................................................... 51
5.2.1 Gutta-percha .......................................................................................................................................... 51
5.2.2 Endodontische sealers ............................................................................................................................ 51
5.2.3 Mineral Trioxide Aggregate (MTA) .......................................................................................................... 51
5.3 Parodontologie ................................................................................................................................................... 52
5.3.1 Parodontaal verband .............................................................................................................................. 52
5.4 Pedodontie ......................................................................................................................................................... 53
5.4.1 Vullingsmatieralen – calciumsilicaten ..................................................................................................... 53
5.4.2 Confectie kroontje .................................................................................................................................. 54
5.4.3 Ruimtehouder ......................................................................................................................................... 54
5.5 Bleken van tanden............................................................................................................................................... 55
5.5.1 Non-vitaal bleken.................................................................................................................................... 56
5.5.2 vitaal bleken ........................................................................................................................................... 56
5.5.3 Nieuwe Europese wetgeving .................................................................................................................. 57
6 Ergonomie ................................................................................................................... 58
6.1 Definitie .............................................................................................................................................................. 58
6.2 Doel .................................................................................................................................................................... 58
6.3 Algemene oorzaak ............................................................................................................................................... 58
6.4 Werkgerelateerde aandoeningen van bewegingsapparaat ................................................................................... 58
6.5 Enkele feiten ....................................................................................................................................................... 59
6.6 Ergonomische maatregelen voor mondhygiënist ................................................................................................. 59
6.6.1 Plaatsing van patiënt .............................................................................................................................. 59
6.6.2 Werkhouding .......................................................................................................................................... 60
6.6.3 Zittend beroep = sedentair beroep ......................................................................................................... 60
6.6.4 Gebruik van tandartslamp ...................................................................................................................... 61
6.6.5 Werkstoel ............................................................................................................................................... 62
6.6.6 Werkhoogte ............................................................................................................................................ 62
6.6.7 Dynamiseren van werkhouding .............................................................................................................. 63
6.6.8 Hoofdlijnen voor ergonomische werkwijze ............................................................................................. 63
3
, INLEIDING
Bachelor in de mondzorg is voor België een nieuw en complementair lid van mondzorgteam. Internationaal is het teamlid al langer
bekend als mondhygiënist. Zij zal naast tandarts, tandartsassistent en tandtechnicus instaan voor goede mondzorg van patiënt.
1. Instrumentarium voor mondonderzoek en niet-chirurgische parodontale therapie
2. Materialen binnen de preventieve zorg
3. Materialen binnen de restauratieve zorg
4. Afdrukmaterialen
5. Polijstmaterialen
6. Specifieke materialen
7. Principes van ergonomisch werken
1 INSTRUMENTARIUM VOOR MONDONDERZOEK EN NIET-CHIRURGISCHE
PARODONTALE THERAPIE
1.1 TERMINOLOGIE
Voor mondonderzoek, verstoren van biofilm en verwijderen van tandsteen en plaquevorming bestaan er heel wat instrumentaria.
Scalen Instrumentatie waarbij tandplaque en tandsteen mechanisch wordt verwijderd van
tandoppervlak. Dit kan zowel supra- als subgingivaal.
Rootplanen Glad maken van cement van worteloppervlak na subgingivale curettage of scaling, dit als
onderdeel van parodontale behandeling. Zacht cement wordt verwijderd en worteloppervlak
wordt hard en glad gemaakt.
Engelstalige literatuur spreekt ook van ‘Root Surface Debridement’ (RSD) waarbij tandsteen en
tandplaque worden verwijderd zonder verwijderen van wortelcement. Dit gebeurt met lichte,
niet chirurgische instrumentatie (bv. ultrasonisch).
SRP = scalen en Dieptereiniging, niet-chirurgisch
rootplanen
Polijsten Glad maken van de met instrumenten bewerkte tandoppervlakken met roterend
instrumentarium en polijstpasta.
Gingivitis Tandvleesontsteking
Parodontitis Als tandvleesontsteking onbehandeld blijft en er botafbraak optreedt
Waarom SRP: dieptereiniging om al het tandsteen/bacteriën subgingivaal te verwijderen om botafbraak te stoppen en te stabiliseren.
Bot dat weg is, is weg.
1.2 TYPES VAN INSTRUMENTEN
1.2.1 HANDINSTRUMENTEN
Handinstrumenten
• Instrumenten gebruikt voor mondonderzoek
• Instrumenten gebruikt voor uitvoeren van gebitsreiniging
1.2.1.1 INSTRUMENTEN VOOR MONDONDERZOEK
Voor mondonderzoek worden volgende basisinstrumenten gebruikt :
1. mondspiegel
2. haaksonde
3. pocketsonde
4. SPDI/CPITN pocketsonde
5. furcatiesonde
1. 2. 3. 4. 5.
1) MONDSPIEGEL
Bestaat uit 3 delen:
• handvat
• schacht/hals
• werkeinde
Bij metalen spiegels, kan je handvat losdraaien van werkeinde. Wanneer spiegel niet meer voldoende zicht geeft, kan zo een nieuw
spiegeltje erop geschroefd worden zonder dat handvat verloren is. Er bestaan ook disposable wegwerp mondspiegels uit plastiek.
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