Objective:To evaluate the diagnostic concordance between panoramic radiographs and cone-beam computed tomography (CBCT) and to determine their comparative diagnostic performance in relation to the treatment decision of impacted maxillary canines. Methods:Radiographic records of 51 impacted maxillary canines in 44 patients (37 unilateral and 7 bilateral cases) were analyzed. Panoramic radiographic evaluations included sector classification, the α angle, and the d distance. The KPG index was used in CBCT assessments to determine impaction severity. Results:All imaging parameters showed high intra- and interrater reliability (intraclass correlation coefficients ≥0.927; κ≥0.658; p<0.001). Significant associations were found between the panoramic radiographic parameters (sector, α angle, and d distance) and the CBCT-based KPG index, and between sector classification and buccopalatal position (p<0.05). Regarding treatment decisions, higher parameter values were significantly associated with the choice of surgical extraction (p<0.05). Receiver operating characteristic analysis demonstrated acceptable to excellent discriminatory ability for panoramic radiograph-based and CBCT-based parameters [area under the curve (AUC): 0.715 to 0.843], with no differences among the AUC values (p>0.05). A d distance ≥12.3 mm and an α angle ≥46.1° were identified as thresholds associated with the decision for surgical extraction. Conclusion:Panoramic radiographic parameters demonstrated diagnostic concordance with CBCT, and their performance was comparable to CBCT-based assessment for treatment decisions. The identified 2D thresholds may serve as an effective first-line screening tool for identifying complex cases likely to require surgical extraction, signaling a level of severity at which the superior anatomical detail of CBCT is warranted for precise surgical planning.
Objective:To make accurate orthodontic extraction decisions, various clinical and cephalometric variables must be evaluated. This study aims to evaluate ChatGPT-5.0's performance in distinguishing orthodontic extraction decisions and to compare it with five supervised machine learning (ML) algorithms. Methods:Of 550 retrospectively evaluated orthodontic records, 30 were reserved for calibration, leaving 520 for the main analysis. The reference standard was the consensus treatment decision of three expert orthodontists with more than 5 years of clinical experience. Overall, 23 variables were analyzed, including 13 clinical parameters, 7 cephalometric measurements, and photographs. ChatGPT-5.0's performance was evaluated using a 5-fold cross-validation design. It was compared with XGBoost, random forest, support vector machine (SVM), logistic regression, and multi-layer perceptron (MLP). Performance metrics included accuracy, sensitivity, specificity, precision, F1-score, and balanced accuracy, with 95% confidence intervals calculated. Statistical analyses utilized Cochran's Q test and the McNemar test with Holm-Bonferroni correction. Results:Of the 520 main cases, 223 (42.88%) were extraction treatments and 297 (57.12%) were non-extraction treatments. XGBoost achieved the highest accuracy (78.08%), followed closely by ChatGPT-5.0 (75.77%). The overall performance difference among models was significant (p≤0.001). In pairwise comparisons, ChatGPT's accuracy was significantly higher than those of random forest, SVM, logistic regression, and MLP, but was found to be similar to XGBoost. ChatGPT-5.0 showed the highest sensitivity (76.68%), whereas XGBoost showed the highest specificity (82.15%). Conclusion:ChatGPT-5.0 demonstrated performance comparable to, and in some cases superior to, traditional ML models for orthodontic extraction decisions. While XGBoost yielded the highest overall classification accuracy, ChatGPT-5.0's high sensitivity in detecting extraction cases was noteworthy.
Objective: This randomized clinical trial assessed the effects of polishing enamel with fluoride prophy paste before enamel pretreatment with orthophosphoric acid on bracket bond outcomes. Methods: The study included 49 patients with a mean age of 24.6 years. Participants were randomly allocated to two groups in an approximate 1:1 ratio: 25 participants in the fluoride group (Group 1) and 24 in the non-fluoride group (Group 2). All patients’ tooth surfaces were polished with prophy paste, etched, and fitted with brackets. Patients were followed up for 6 months. Outcome measures included bracket bond survival and the number of bond failures, along with questionnaire items collected from all subjects, such as history of fluoride varnish and mouthwash use, age, and sex. Survival time analysis was used to characterize bond failure outcomes. Results: A total of 951 brackets were tested; the overall bond failure rate was 2.7%. Group 2 (non-fluoride polishing) had a bond failure rate of 4.0%, while Group 1 (fluoride polishing) had a significantly lower failure rate of 1.5%. These failure rates were much lower than those reported previously. Survival analysis, accounting for patient-level variability through random effects, revealed that age and fluoride prophy paste were significant risk factors. The hazard ratio for bond failure associated with the use of fluoride-containing prophy paste was 0.26. Conclusion: Polishing with fluoride-containing prophy paste did not affect the bracket-bond failure rate when it was followed by phosphoric acid etching.
Objective: To compare the effects of functional orthopedic treatment and mandibular advancement induced by orthognathic surgery on hyoid bone position in individuals with skeletal Class II malocclusion, relative to an untreated control group. Methods: Fifty-six individuals were divided into functional (n=20), surgical (n=16), and control groups (n=20). Lateral cephalometric images obtained at pretreatment (T0) and posttreatment (T1) were analyzed using WebCeph software. The linear (aC2-H, aC3-H, aC4-H, S-H, N-H, ANS-PNS-H) and angular (SNA, SNB, ANB, Go-H-S, H-S-N, H-PNS-ANS) describing hyoid bone position were measured. Data normality was assessed with the Shapiro-Wilk test, followed by one-way ANOVA or Kruskal-Wallis test, as appropriate. Intragroup changes were evaluated using paired tests, and post-hoc analyses were performed using Tukey honestly significant difference or Dunn-Bonferroni methods. Measurement reliability was confirmed (intraclass correlation coefficients >0.90). Results: At T0, the orthognathic surgery group showed significantly higher aC2-H, aC3-H, aC4-H, S-H, N-H, and ANS-PNS-H measurements compared to the other groups (p<0.05), while angular variables did not differ significantly. At T1, intergroup differences in hyoid position were no longer significant (p>0.05). Intragroup analysis revealed significant increases in aC2-H, aC4-H, S-H, and N-H in the functional treatment group, whereas significant decreases in N-H, H-S-N, and H-PNS-ANS were observed in the orthognathic surgery group. Changes in the control group were minimal. Conclusion: Functional treatment resulted in anterior-inferior displacement of the hyoid bone, whereas orthognathic surgery predominantly induced superior displacement without significant anteroposterior change. Both treatment modalities improved mandibular skeletal relationships, while hyoid position remained largely stable in untreated individuals.
Objective: This study aimed to evaluate the in vitro cytotoxic effects of 25 pre-orthodontic trainer appliances on human gingival fibroblasts (HgnFs) using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and morphological analysis. Methods: Twenty-five pre-orthodontic trainer appliances were sterilized and incubated in Dulbecco’s Modified Eagle Medium for 1 month to obtain conditioned eluates, in accordance with the principles of ISO 10993-5. The eluates were filtered and applied to cultured HgnFs for 48 h. Cell viability was assessed using the MTT assay, and morphological changes were evaluated using an inverted light microscope. Statistical analysis was performed at the appliance level using the Kruskal-Wallis test, followed by Dunn’s post-hoc test (p<0.05). Results: Statistically significant differences in cell viability were observed among the 25 appliance groups [Kruskal-Wallis H (25)=47.58, p=0.004].The K3 Blue (A8) appliance demonstrated significantly lower viability than J2 (A12) and several other appliance models. Importantly, none of the tested appliances exhibited a statistically significant reduction in cell viability compared to the negative control group. All appliances maintained viability values above the ISO 10993-5 cytotoxicity threshold under the experimental conditions. Conclusion: Within the limitations of this in vitro study, most pre-orthodontic trainer appliances demonstrated acceptable cytocompatibility with HgnFs. Appliance-specific differences were observed, highlighting the importance of individual appliance evaluation rather than broad material-based generalisations. Further studies incorporating long-term exposure models and in vivo validation are necessary.
Objective: Research into the etiology of maxillary canine impaction (MCI) has focused primarily on the transverse dimensions of the maxilla in the premolar and molar regions. The aim of this study was to evaluate and compare premaxillary width, height, depth, and volume -assessed using cone-beam computed tomography (CBCT)- among individuals with palatal MCI, buccal MCI, and normally erupted maxillary canines. Methods: This retrospective study utilized CBCT records of patients with MCI. A total of 45 subjects were divided into three groups of 15 subjects each. Group I (palatal canine impaction), Group II (buccal canine impaction), and Group III (control group of normally erupted canines). Premaxillary width, height, depth, and volume were measured in axial, coronal, and sagittal planes using Horos software. All measurements were performed by a single calibrated examiner. One-way ANOVA with Tukey post-hoc analysis was applied; statistical significance was set at p<0.05. Results: Premaxillary height, depth, and volume were significantly greater in both palatal canine impaction (Group I) and buccal canine impaction (Group II) groups compared to controls (Group III). The increase was greatest in Group I, and this difference among the three groups was statistically significant (p=0.04 for height, 0.0005 for depth, and 0.04 for volume). Premaxillary width did not differ significantly among groups (p=0.38). Post-hoc analysis revealed that premaxillary depth was significantly greater in both palatal and buccal impaction groups than in controls (p=0.021 and 0.002, respectively), while premaxillary volume was significantly greater in the palatal than in the buccal canine impaction group (p=0.03). Conclusion: The findings of this study suggest that three-dimensional premaxillary morphology, as assessed by CBCT -particularly increased depth and volume- may be associated with MCI, with a more pronounced effect in palatal impaction. Premaxillary width did not demonstrate a significant association. These results indicate that localized anterior maxillary skeletal characteristics, rather than transverse maxillary deficiency alone, may influence the eruptive pathway of maxillary canines. These findings represent associations and do not establish causality. Prospective studies with larger sample sizes are warranted to validate these findings and to explore their clinical implications for early orthodontic intervention.
Objective: This study analyzed the publication characteristics, citation patterns, and research trends of the Turkish Journal of Orthodontics (TJO) since its Web of Science (WoS) indexing in 2017. Methods: A retrospective bibliometric analysis was conducted using data from the WoS Core Collection (2018-24) on April, 2025. Network analysis was performed using CiteSpace 6.3.R1 and VOSviewer 1.6.18. Descriptive statistics were used to analyze publication trends, authorship patterns, geographical distribution, and citation performance. Results: A total of 244 publications were analyzed, comprising 192 (78.7%) original articles, 27 (11.1%) reviews, eight (3.3%) systematic reviews, and 17 (7.0%) case reports. The journal achieved an h-index of 15, with 1408 total citations and an average of 5.77 citations per article. Türkiye contributed the most publications (58.2%), followed by India (16.8%), the USA (6.6%), and Iran (5.3%). International collaboration involved 39 countries, and the most-cited article received 32 citations. The gender distribution of authorship was closely balanced: 52.2% female and 47.8% male. 94.7% of publications were multi-authored, with an average of 3.5 authors per article. Keyword analysis revealed thematic clusters dominated by clear aligners, malocclusion, cone-beam computed tomography, and dental materials. Conclusion: TJO shows consistent growth in publication volume, expansion of international collaboration, and increases in citation impact since WoS indexing. The journal successfully captures emerging trends in clear aligners and rapid maxillary expansion while maintaining coverage of fundamental orthodontic topics. A strategic editorial evolution toward systematic reviews indicates a commitment to evidence-based practice. This bibliometric overview offers a data-driven foundation for future editorial decision-making and monitoring the journal’s evolving role within orthodontic research.
Objective: The aim of this study was to evaluate the association between unilateral maxillary impacted canines (UMIC) and condylar morphology by comparing ipsilateral and contralateral condyles within affected individuals using panoramic radiography. Methods: This retrospective cross-sectional study included 364 patients with UMIC (169 with impacted right canines and 195 with impacted left canines). Panoramic radiographs were used to evaluate mandibular condylar morphology. Condyles were classified into four categories (round, angled, flat, and pointed) and additionally dichotomized as round or non-round for binary comparisons. Paired ipsilateral and contralateral comparisons were performed using McNemar’s test for binary outcomes with analyses stratified by age (<20 and ≥20 years). Statistical significance was set at p<0.05. Results: Age-stratified McNemar analyses demonstrated no statistically significant side-related differences in binary condylar morphology (round vs. non-round) between ipsilateral and contralateral sides of the patients (p>0.05). Descriptive evaluations showed that round condylar morphology was less prevalent in patients aged ≥20 years, whereas angled and pointed morphologies were more frequently observed compared to those aged <20 years, on both the ipsilateral and contralateral sides. Conclusion: Based on the present findings, UMIC alone does not appear to be associated with side-specific differences in condylar morphology. Further studies using advanced three-dimensional imaging techniques are needed to better characterize condylar morphology.
Objective: The objective of the study was to compare the accuracy and fit of direct-printed and thermoformed aligners. Methods: The in vitro study included a pre-treatment scan as a reference model. Thirteen successive treatment stages were digitally planned and exported as Standard Tessellation Language (STL) files. Based on the treatment plan, 39 aligners were manufactured for three groups: Group 1, direct-printed aligners with TA-28 resin; Group 2, thermoformed polyurethane (PU) aligners; and Group 3, thermoformed polyethylene terephthalate glycol-modified (PET-G) aligners. All aligners were subsequently scanned, and the resulting STL files were superimposed on the baseline models. The dimensional accuracy and fit of the aligners were evaluated. The groups were compared using the Kruskal-Wallis test, followed by Dunn-Bonferroni post-hoc comparisons, with significance set at p≤0.05. Intra-rater and inter-rater reliability were evaluated via intraclass correlation coefficients. Results: Group 1 exhibited greater dimensional accuracy, as evidenced by the lowest mean deviation compared with Groups 2 and 3 (p<0.001). Pairwise comparisons indicated significant differences between Group 1 and Group 2 and between Group 1 and Group 3 (p<0.001); however, no significant difference was found between Groups 2 and 3 (p=0.489). Landmark-based deviation analysis indicated that Group 1 demonstrated the least deviation across all nine evaluated anatomical landmarks (p<0.001). Group 3 showed slightly greater deviations than Group 2 for most landmarks. Conclusion: Direct-printed aligners fabricated using TA-28 resin exhibited significantly higher dimensional accuracy and a better fit than thermoformed aligners manufactured from PU and PET-G.
Objective: To evaluate the scientific literature on impacted canines using bibliometric and altmetric analyses. Methods: A systematic search of the Web of Science Core Collection was performed using keywords related to impacted canines. Three independent reviewers identified, screened, and evaluated the 100 most-cited articles. Citation data were cross-verified with Scopus and Google Scholar. Extracted information included citation counts, study design, publication year, authors, institutions, journals, and countries. Bibliometric mapping was conducted using VOSviewer, and altmetric indicators were obtained from dimensions. Statistical analysis was performed using Spearman’s rank correlation, with significance set at p<0.05. Results: The 100 most-cited articles received 10,429 citations in the Web of Science, and citation counts were strongly correlated across databases (p<0.001). Most studies were observational (69%), followed by narrative reviews (12%) and interventional studies (10%). Research topics primarily addressed the etiology, radiographic assessments, and associated anomalies. The most cited article in the Web of Science database was Ericson and Kurol’s 1988 study on the interceptive extraction of primary canines. Publications were concentrated in orthodontic specialty journals, with the USA, Italy, and Israel being the leading countries. Conclusion: Analysis of the 100 most-cited articles revealed that influential research on impacted canines is predominantly, focusing on etiology and diagnosis. Areas such as mandibular impactions, periodontal outcomes, and long-term treatment effects remain underexplored.
Objective: To evaluate how vertical-patterns influence dental arch dimensions in class I (CI) and class III (CIII) malocclusions. Methods: Pretreatment patient files, lateral cephalometric parameters, and initial intraoral digital models of adult patients were retrieved from the archive in an academic setting. Skeletal and dental CI and CIII individuals were divided into three subgroups (n=20 for each group) according to frankfort-mandibular plane angle (FMA) values (angle between Frankfurt horizontal and mandibular planes): FMA <22° for low-angle (L), FMA=22-28° for normal-angle (N), and FMA >28° for high-angle (H) vertical patterns. Dental arch parameters were measured on digital models using 3D Slicer software (version 5.6.1; www.slicer.org). One-way analysis of variance, Kruskal-Wallis test, and Spearman correlation analysis were performed. The significance level was set at p<0.05. Results: A significant difference in maxillary intermolar width was found between CI-H and CIII-L groups (p=0.004). A significant difference in the maxillary intermolar angle was found between the CIII-N and CI-N groups and between the CIII-N and CI-L groups (p=0.003). A significant difference in intermolar mandibular width was observed between the CI-H and CI-L groups (p=0.002). Occlusal angle differed significantly between the CI-N and CIII-H groups and between the CI-N and CIII-L groups (p=0.002). No differences were observed in intercanine width, arch length, or arch depth. Conclusion: CIII-L group has a significantly greater intermolar width for both maxillary and mandibular arches. The clinical implications of this result can be particularly important when selecting prefabricated archwires. Therefore, it is recommended that this difference be taken into consideration in diagnosis and treatment planning to achieve effective and stable outcomes.
Objective: This study aimed to investigate the effects of tooth-borne, tooth-bone-borne, and bone-borne rapid maxillary expansion (RME) on the nasomaxillary complex in individuals with maxillary transverse constriction using cone-beam computed tomography (CBCT), and to compare the outcomes of these expansion modalities. Methods: CBCT images from 45 patients (aged 10-17 years) with maxillary transverse constriction who were treated with RME were evaluated. Patients were divided into three groups according to the appliance used: tooth-borne (Hyrax), tooth-bone-borne (hybrid), and bone-borne. CBCT records were obtained at three time points: before treatment, after active expansion, and after a 3-month retention period. Dentoalveolar and skeletal measurements were performed on the CBCT images. Intergroup comparisons were conducted using one-way ANOVA and Kruskal-Wallis tests, while intragroup comparisons were performed using repeated-measures ANOVA and Friedman tests. Results: CBCT evaluation revealed no statistically significant intergroup differences in dental and skeletal measurements. However, all RME groups showed significant increases between time points, most of which were maintained after the retention period. In the mandible, increases in intercanine, interpremolar, and intermolar widths, observed during the active expansion phase, partially relapsed or lost their statistical significance following retention. Conclusion: All RME modalities produced significant skeletal and dental expansion in the maxilla, with the bone-borne appliance showing greater skeletal effects than the hybrid and tooth-borne appliances.
Objective: The aim was to evaluate optimum site for insertion of orthodontic mini-implants at mandibular symphysis in patient with different mandibular growth patterns using cone-beam computed tomography (CBCT). The objectives were to evaluate and measure complete bone width (CBW) and cortical bone width (CtBW) in the symphysis area at various heights [2 mm, 4 mm, 6 mm, 8 mm, 10 mm, and 12 mm from cementoenamel junction (CEJ)] and at various angles (0º, 10º, 20º, 30º, 40º, 50º, and 60º to the occlusal plane), and to assess the effect of mandibular growth patterns (low, average, and high angle) on these measurements. Methods: The study sample included 45 patients aged 16-30 years. Patients were categorized into three groups (n=15) corresponding to the mandibular growth pattern for the assessment of CBW and CtBW. Individual data for each patient were entered into a master table in Microsoft Excel and subjected to statistical analysis using SPSS version 22.0. Analysis of variance was applied to investigate the influence of insertion location, facial type, insertion height and insertion angle on overall bone thickness and CtBW. A p-value <0.05 was considered statistically significant. Intra-observer reliability was assessed using the intraclass correlation coefficient. Results: CBW was notably greater in patients with a low-angle mandibular growth pattern than in patients with other mandibular growth patterns at insertion heights of 8, 10, and 12 mm. CtBW was greater in cases with a low-angle mandibular growth pattern than in cases with other mandibular growth patterns. Similar results were observed for CtBW. Conclusion: The mandibular symphysis in patients with a low-angle growth pattern provides more favorable anatomical conditions for mini-implant placement. The ideal insertion site lies between 6 and 10 mm below the CEJ of the central incisors, with angulation ranging from 0° to 60° relative to the occlusal plane. CBCT assessment should be considered essential in treatment planning to customize implant positioning based on individual growth patterns, thereby enhancing implant stability and success.
External apical root resorption (EARR) is an important concern in orthodontic practice. Despite extensive research, the reported prevalence, occurrence, and grade distribution of EARR remain heterogeneous, ranging from 0% to 100%. This review aimed (i) to analyse the available scientific evidence worldwide to ascertain conclusions regarding EARR prevalence and (ii) to identify and evaluate the most appropriate radiographic technique and complete/comprehensive assessment method for EARR. This review followed the JBI and PRISMA guidelines and included studies of any orthodontic treatment. The studies were analysed based on diagnostic imaging methods, quantification, categorisation, and other variables. Of the 1209 records identified, 81 studies were included. The evidence originated from six continents, predominantly Europe (33 studies), Asia (23 studies), and the Americas (13 studies from North America and 16 from South America). Across the studies, marked variability was observed in both the reported prevalence and the severity of EARR. Studies utilising two-dimensional techniques mainly reported no or only mild resorption in most incisors. Similarly, studies employing three-dimensional techniques found that mild or no resorption was predominant. However, severe EARR was rare in all studies, consistently affecting fewer than 5% of cases. Notably, discrepancies in severity and mean EARR values among studies were largely attributable to variations in techniques and classification systems. This inconsistency emphasises the urgent need for standardised diagnostics and a unified classification. Resolving these issues will provide clearer insights into EARR.
Objective: To evaluate the relationship between incisor retraction and upper and lower lip repositioning in patients with high and normal vertical growth patterns (NVP), and to assess whether vertical growth pattern influences soft tissue changes following extraction treatments. Methods: Pre- and post-treatment lateral cephalograms of 79 patients who underwent extraction of two or four first premolars were analyzed. Patients were divided into a [high vertical pattern (HVP); Frankfort-mandibular plane angle (FMA) >30°, n=49] and a NVP; 22< FMA ≤30°, n=30) group. Horizontal and vertical changes in the lips, labiomental fold, and lip strain were measured, and correlations between these changes and incisor movements were assessed. Results: Upper lip retraction was greater in the HVP group (2.86 mm, p<0.05) than in the NVP group (1.97 mm, not significant). Upper lip height decreased significantly in both groups, with a slightly greater decrease in the NVP group (p<0.001). Upper lip strain decreased in both groups, especially in the HVP group (p<0.001). Incisor retraction was strongly correlated with upper-lip changes in both groups, and with lower-lip and labiomental-fold repositioning in the NVP group. Conclusion: Soft tissue response to incisor retraction varies with vertical growth pattern, with greater upper lip retraction in HVP patients. Vertical growth patterns should be considered for optimal soft tissue outcomes.
Objective:This study aimed to evaluate the micro-implant safest insertion site on the mandibular buccal shelf (MBS) without compromising the integrity of the mandibular canal (MC). Methods:This retrospective investigation included cone-beam computed tomography (CBCT) of 96 Portuguese patients (58 females and 38 males, average age of 25.5±10.2 years). Measurements were taken in four bilateral MBS sites buccal to the mandibular second molar; tangent to the distal surface (7D), distobuccal cusp tip (7CD), buccal groove (7S) and mesiobuccal cusp tip (7CM). The transversal MBS midpoint was also determined, and the maximum angulation from the transversal MBS midpoint was extracted relative to the true vertical plane. Subsequently, the distance from the MBS midpoint to the MC was calculated at this angulation. Descriptive and inferential statistical analyses were performed at p<0.05. Results:Significant correlations were observed among several variables and age, sex and bilateral asymmetry (p<0.05). The MBS transversal width and the distance from the MBS midpoint to the MC progressively increased in the posterior direction while the angulation decreased. Conclusion:The most appropriate micro-implant insertion location compared to the other MBS investigated sites, in the absence of impacted third molars, is adjacent to the distal surface of the second molar. This finding is consistent across all age groups, sexes, and insertion sides. However, due to the demonstrated variability, taking a CBCT scan prior to mini-implant insertion might be considered to minimize the risk of injury to the inferior alveolar nerve.
Objective:To evaluate and compare the effects of low-intensity pulsed ultrasound (LIPUS), low-level laser therapy (LLLT), and their combined effects on sutural bone regeneration during rapid maxillary expansion (RME) of rats. Methods:Twenty-eight Sprague-Dawley rats were randomly assigned to four groups: LLLT group, LIPUS group, combination group, and control group. RME was performed on all groups for 11 days. The Both LLLT and LIPUS groups received their respective therapies (30 J/cm2), while the combination group received both therapies, each at 30 J/cm2. All treated rats received their doses on days 0, 4, and 8 and were sacrificed on day 11. Numbers of osteoblasts, capillaries, and osteoclasts were counted, and suture widths and areas of newly formed bone were measured histomorphometrically. General and cellular immunoreactivity of bone morphogenetic protein-2 (BMP-2), vascular endothelial growth factor (VEGF), and osteopontin (OPN) was evaluated by immunohistochemistry. Results:The number of osteoblasts was significantly higher in the combination group than in the control group (p<0.05). The combination group showed the highest general BMP-2 immunoreactivity and cellular VEGF immunoreactivity among all groups, and exhibited increased cellular OPN immunoreactivity compared with the control group (p<0.05). Both the area of newly formed bone (p<0.05) and suture width (p<0.01) were significantly greater in the LIPUS group than in the LLLT group. Conclusion:LIPUS is a more effective adjuvant therapy than LLLT for increasing sutural bone formation during RME. Combined therapy with LIPUS and LLLT has a synergistic effect and accelerates sutural bone regeneration by enhancing cellular activation more than either LIPUS or LLLT alone.
Objective:The aim of this study was to evaluate the surface hardness, surface roughness, and chemical structure changes of four vacuum-formed retainer (VFR) materials after thermoforming. Methods:Four groups of VFR materials were evaluated: Taglus, Lumex-G, Atmos, and Duran. Each group consisted of 12 samples (n=12) that were thermoformed according to the manufacturer's guidelines. Surface roughness was measured using a high-precision profilometer, and hardness was assessed with a micro-Vickers hardness tester. Chemical structure analysis was conducted using Fourier transform infrared spectroscopy (FTIR), and surface morphology was examined using scanning electron microscopy (SEM). Results:Hardness measurements demonstrated a general decrease across all groups following thermoforming. After thermoforming, surface roughness increased significantly in the Taglus and Lumex-G groups, whereas the Atmos and Duran groups maintained greater surface stability. FTIR demonstrated that all materials retained their chemical stability, and no significant changes in functional groups were detected. SEM results revealed more pronounced surface irregularities in the Taglus and Lumex-G groups. Conclusion:Polyethylene terephthalate glycol copolyester-based materials with high surface homogeneity, such as Atmos and Duran, may be recommended for clinical use due to their superior surface stability and chemical resilience. By contrast, the surface irregularities observed in Taglus and Lumex-G may compromise their long-term clinical performance.
Objective:The aim of this study was to compare the effects of two thermoforming machines on the gap width and thickness of passive aligners with the same nominal thickness from different manufacturers by using nano-computed tomography (CT). Methods:An intraoral scan of a patient with Angle's Class I malocclusion was conducted, and a 3D maxillary arch model was printed. The aligners (n=16) were fabricated using two thermoforming machines: Ministar machine (n=8) and a Plastpress machine (n=8). Each group was subdivided on the basis of aligner material: polyethylene terephthalate glycol (PET-G) (Group A) and thermoplastic polyurethane (TPU) (Group B). Sheets with a nominal thickness of 0.75 mm were used. Nano-CT was performed, and the rendered 3D models were sliced into central incisor, canine, and molar regions to assess gap width and aligner thickness in the buccal, incisal, and palatal regions. Results:Comparing thermoforming machines, PET-G (p=0.010) and TPU (p=0.004) aligners showed significant differences in gap width in the molar region. Similar results were found for aligner thickness (TPU, p=0.05; PET-G, p=0.004). Comparing PET-G and TPU sheets thermoformed via the same machine, significant differences were observed only in the molar region (p=0.004), with no differences in the canine and incisor regions. Adaptation in the anterior region was greater than in that of the posterior region, whereas aligner thickness increased from posterior to anterior. Conclusion:Aligner material type significantly affected gap width and thickness only in the molar region, whereas the specific thermoforming machine did not substantially affect these characteristics.
Objective:To evaluate the positioning of brackets in customized and conventional bonding methods in accordance with Andrews' approach to bracket placement. Methods:Twenty-six patients were enrolled; 11 were treated with the Insignia system and 15 with Kalange's method. Crown length was measured on a digital diagnostic model and the facial axis (FA) point was calculated. After leveling and alignment, a new digital model was created, and the bracket position was measured along the vertical axis. The distance between the bracket position and the FA point was calculated, and the deviation was determined according to Andrews' method. Teeth with significant deviation (TSD), i.e., >0.5 mm, were identified. Frequencies and percentages of TSD were calculated. Results:The TSD percentage was 56.65% in the Insignia group and 69.5% in the modified Kalange group; the difference between groups was significant (p=0.003). The anterior and posterior regions differed significantly within groups: in the Insignia group, this difference was observed in the maxilla (p=0.002), whereas in the modified Kalange group it was observed in both the mandible and maxilla (P < 0.001). In both groups, the anterior TSD percentage was higher than the posterior TSD percentage in both the maxilla and the mandible. The deviation was predominantly occlusal or incisal: Insignia group, 86.9%; modified Kalange group, 97.6%. Conclusion:In the Insignia system and Kalange's method, brackets are positioned more incisally/occlusally relative to Andrews' FA point. In both methods, anterior brackets are positioned more incisally than posterior brackets.
