Conf. Dr Krisztina Martha
Assoc. Prof. Dr. Krisztina Mártha is a senior specialist in Orthodontics and Dentofacial Orthopedics, specialist in General Dentistry and vice-dean of the Faculty of Dentistry UMPh of Tîrgu Mureş . She recieved her PhD degree in 2008 at the Faculty of Dental Medicine, University of Medicine and Pharmacy of Tîrgu Mureş, the topic of the PhD thesis was “Clinical, immunohistochemical and microbiological evaluation of muco-gingival tissues after fixed orthodontic therapy”. She is author and coauthor of six monographs of orthodontics and pediatric dentistry diagnostic and treatment procedures. She is coordinator and member in numerous research teams, author and coauthor of more than 180 scientific papers cited more than 100 times in Google Academics. Her main interests are periodontal behaviour during fixed orthodontic therapy, genetic background of non-syndromic hypodontia, enamel behaviour and white spot lesions after debonding.
PERIODONTAL RESPONSE TO FIXED ORTHODONTIC TREATMENT – CAN IT BE CONSIDERED A IATROGENIC DAMAGE?
In most of the cases, the benefits of an orthodontic treatrment can and should outweigh the risks and complications of it. One of the most common unwanted effect of fixed orthodontic therapy is the dental plaque accumulation, which has been established as a potential risk factor for the development of periodontal diseases and the progression of these diseases depends on the balance between microbial biofilms and immune and inflammatory host responses. This changes the subgingival ecosystem thereby causing an increase in periodontal pathogen levels and orthodontic tooth movement causes reorientation and remodelling of supporting periodontal tissues.
In most of the cases, especially when oral hygiene is not well maintained, transient gingival inflammation occurs after placement of fixed appliances. Gingival hyperplasia can develop around orthodontic bands leading to pseudo pocket formation and spontaneous resolve of this condition can be expected after few days of debonding.
The gingival hyperplasia which occurs quite often can also be explained with mechanical irritation of labially placed attachments. Our clinical observations show a more severe form of this inflammations in the posterior part of the dental arch.
The topic of our three years research project was the clinical and microbiological study of periodontal behaviour during fixed orthodontic therapy. Our results emphasise the importance of plaque control, that good oral hygiene must be stressed to the patient before starting the fixed appliance treatment and adequate patient compliance must be ensured throughout treatment to prevent these undesirable side effects.