PURPOSE:To determine the influence of different bleaching methods on the shear bond strength (SBS) of orthodontic brackets bonded to resin-infiltrated (Icon, DMG) extracted human enamel. METHODS AND MATERIALS:64 extracted wisdom teeth were randomized into four groups (n = 16): 1. (-)control (no treatment), 2. (+)control (RI), 3. RI followed by 25% H2O2 (IOB) and 4. RI followed by 10% carbamide peroxide bleaching (HB). After a standardized demineralization protocol, RI and bleaching were performed according to the manufacturer's instructions prior to storage for 14 days. Brackets (Mini Diamond Twin, Ormco) were bonded buccally and lingually (Transbond XT, 3M). SBS values (MPa, traverse speed 0.5 mm/min, Zwick Roell) and the Adhesive Remnant Index (ARI) were determined on the buccal side. Following 5000 thermal cycles (5-55°C; RC 20 CS Lauda), SBS and ARI values for the lingual brackets were determined analogously. Data were analyzed with mixed ANOVA and Kruskal-Wallis and Wilcoxon tests at a 0.05 significance level. RESULTS:Differences in SBS were observed among groups (F(3, 64) = 8.01, P 0.001). HB exhibited the lowest SBS values (14.99 ± 6.42 MPa; 10.84 ± 3.61 MPa), differing significantly from the negative control (P = 0.041; P = 0.002 after thermocycling). No significant differences were noted between IOB and HB. Thermocycling reduced SBS values across all groups (F(3, 64) = 25.83, P 0.001). CONCLUSION:RI followed by bleaching negatively impacts bracket bonding strength, with a significant reduction observed after home bleaching, while in-office bleaching showed no such effect.

Abstract Background Children born with cleft lip and palate (CLP) require intensive interdisciplinary care from birth onward. Intraoral scanners (IOS) have emerged as a promising alternative for neonatal maxillary data acquisition. This study evaluated the precision and trueness of five commonly used IOS using a standardized landmark-based methodology complemented by full-surface deviation analysis, applied to neonatal maxillary models with increasing morphological complexity. Methods Three neonatal plaster casts were digitized: An edentulous maxilla without cleft, a unilateral and a bilateral cleft maxilla. Ten pyramidal landmarks defining five transversal distances were constructed along the alveolar ridge. These resulting digital master models (DMM) were 3D-printed (Formlabs Form 2, 25 μm) and their dimensional fidelity independently verified by digital caliper (± 0.01 mm). Each printed model was scanned ten times by the same operator using Primescan, CS3600, Trios 3, iTero Element 2 and Medit i500. Linear trueness and precision were quantified in Rhinoceros 3D. Full-surface trueness was assessed in Geomagic Control 3D using a standardized alignment protocol. Statistical analysis was performed using the Kruskal–Wallis test and Mann–Whitney U post-hoc tests ( p < 0.05). Results Trueness varied between IOS and depended on the combination of device and cleft morphology. Mean signed linear deviations were minimal in the non-cleft model (all scanners within ± 0.03 mm) and reached − 0.147 mm for Medit in the bilateral cleft model, where Primescan and Trios remained essentially unbiased in the non-cleft and bilateral cleft models. Between-scanner differences were significant in both cleft models ( p < 0.001). Intra-scanner reliability, an aspect of precision, ranged from ICC 0.832 to 1.000. Full-surface trueness differed significantly between scanners in all three models ( p < 0.01). Mean RMS deviations remained below 0.07 mm for four of the five devices in every model, whereas iTero reached 0.224 mm in the bilateral cleft model. Compared with the non-cleft model, in-tolerance percentages decreased in both cleft models, most markedly in posterior and undercut regions. Conclusion Under in-vitro conditions, all IOS digitized neonatal maxillary anatomy with high technical accuracy. Trueness and precision depended on the combination of device and cleft morphology rather than on morphological complexity alone, but all IOS captured the relevant morphological features. Clinical feasibility in neonates was not assessed and remains to be established in in-vivo studies. Clinical trial number Not applicable.

BACKGROUND:Robin sequence (RS) is characterized by upper airway obstruction leading to life-threatening desaturations in neonates. Procedural sedation in this population presents unique challenges due to anatomical airway anomalies, young patient age, and associated comorbidities. The pre-epiglottic baton-plate (PEBP) procedure is a non-invasive, endoscopically guided intervention that alleviates obstruction, facilitates oral feeding, and promotes mandibular growth. Sedation for PEBP adjustment requires the maintenance of spontaneous respiration while ensuring patient comfort and procedural tolerance. AIMS:To compare process characteristics and observed adverse events before and after an institutional change in the sedation regimen and staffing model for endoscopic PEBP adjustment in neonates with RS. METHODS:This retrospective single-center cohort study included 18 infants undergoing endoscopic PEBP adjustment between December 2012 and June 2025. Cohort I (n = 8) received individualized sedation, most commonly propofol with remifentanil, with variable personnel present. Cohort II (n = 10) received sevoflurane induction followed by ketamine and dexmedetomidine for maintenance, with predefined interdisciplinary staffing including two senior anesthesiologists. Demographic data, sedation regimens, sedation-related adverse events, and airway interventions were compared between groups. RESULTS:All 18 procedures were completed successfully. A total of five sedation-related adverse events occurred, four in Cohort I and one in Cohort II. All events were managed effectively with routine measures. No patient required conversion to general anesthesia or invasive airway management. Procedural duration was significantly shorter in Cohort II. Baseline, lowest intraoperative, and first postoperative oxygen saturation did not differ significantly. CONCLUSIONS:Standardization of sedation protocols and procedural workflows was associated with shorter procedure times and fewer observed adverse events; however, the small sample size (n = 8 and n = 10) precludes conclusions regarding safety or causality. In rare, high-risk neonatal procedures, structured and interprofessional approaches may help reduce variability and support reproducible care.

In orthodontic education, the integration of digital teaching methods is crucial to meet the complex demands of the discipline. This study evaluates the performance of the web-based e-learning application Orthotrainer, designed for orthodontic case planning. It is hypothesised that case evaluations through this digital approach are comparable to traditional analogue measurement methods. The aim is to contribute to the standardisation of orthodontic learning content in North Rhine-Westphalia and promote innovative teaching strategies. A total of 61 dental students were randomly assigned to either an analogue (group A) or a digital (group D) cohort. The students were tasked with performing orthodontic case planning, which included model analysis and X-ray analysis, specifically OPG and LCR analysis. As part of a crossover design, both groups completed both a digital and an analogue treatment case. The quality and usability of the digital application were evaluated, and the results of the learning modes were quantitatively compared. In the model analyses the tooth-width measurements were almost identical between analogue and digital methods, with only minimal differences observed. Analogue techniques demonstrated slightly higher accuracy in arch-width determinations, while the digital approach exhibited superiority over analogue measurements in classifying canine Angle relationships. Conversely, analogue gauge measurements maintained their superiority in molar classification In the radiographic assessment, the Orthotrainer demonstrated its superiority, with its lateral cephalometric radiograph landmarking (LCR) success rate exhibiting a significant increase in comparison to conventional methods (LCR: 55.74

Background/Objectives: To evaluate the role of temporomandibular disorder (TMD)-related diagnostics in orthodontic treatment routines and investigate what consequences are drawn from symptoms concerning orthodontic treatment planning and therapy. Methods: All officially listed orthodontists in Germany were surveyed about their professional background, TMD-related specialization, and concrete clinical procedures. Anonymized responses were systematized, manually checked, and statistically analyzed. Differences in reported TMD-related procedures depending on orthodontists’ professional experience and specialization were determined using Fisher’s exact tests. Results: A total of 2359 questionnaires were sent out, of which 630 could be evaluated. The majority of the orthodontists surveyed stated that they perform either a brief TMD screening or a complete functional analysis. In total, 21.1% of the respondents base their examination on the patient’s medical history. A second complete functional analysis is performed by 33% of the responding orthodontists during the course of orthodontic therapy, and by 56.6% only in the case of an initial pathological finding. For 60.1% of the respondents, pre-therapeutically diagnosed, non-painful temporomandibular joint clicking has an influence on orthodontic treatment planning. Only 4.3% of respondents take no further action prior to orthodontic therapy in the case of TMD symptoms. There is an indication that professional experience has no influence on the procedure, whereas a specialization in the field of TMDs does. Conclusions: A discrepancy between the current state of research and standard procedures in German orthodontic practices may lead to an overly detailed examination. However, this has no health disadvantages for the patient.

PURPOSE:In advanced stages of spinal muscular atrophy (SMA), established motor scores are unable to distinguish between the different degrees of remaining motor function. Bulbar muscles are affected at a later stage. The aim of the present study was to test whether oral function tests are able to better discriminate motor function than established scores and to replicate known associations between disease-related altered craniofacial anatomy and oral dysfunction in SMA. METHODS:A total of 43 adult individuals with SMA (mean age 39.7 ± 12; 25 men, 18 women) were included in this prospective, cross-sectional study. Oral function was measured using a piezoelectric sensor system and an Iowa Oral Performance Instrument (IOPI) device. Data from oral function tests and established motor scores were analyzed with regard to a possible floor or ceiling effect. It was tested to what extent SMA patients with different malocclusions presented with variable scores. RESULTS:Patients differed in ambulatory and treatment status (15 ambulatory vs. 28 nonambulatory; 35 treated vs. 8 nontreated) and orthodontic findings (22 with a class II molar relationship and increased overjet, 35 with posterior crossbite). In contrast to the oral function tests, some of the established motor scores showed a clear floor effect. Statistically significant associations were identified between reduced oral function values and an enlarged overjet, a class II molar relationship, and a posterior crossbite. This should be taken into account in neuromuscular evaluations. CONCLUSION:In severely affected patients, oral function tests appear to be superior to established motor scores and fill a diagnostic gap in research and clinical practice.

In advanced stages of spinal muscular atrophy (SMA), established motor scores are unable to distinguish between the different degrees of remaining motor function. Bulbar muscles are affected at a later stage. The aim of the present study was to test whether oral function tests are able to better discriminate motor function than established scores and to replicate known associations between disease-related altered craniofacial anatomy and oral dysfunction in SMA. A total of 43 adult individuals with SMA (mean age 39.7 ± 12; 25 men, 18 women) were included in this prospective, cross-sectional study. Oral function was measured using a piezoelectric sensor system and an Iowa Oral Performance Instrument (IOPI) device. Data from oral function tests and established motor scores were analyzed with regard to a possible floor or ceiling effect. It was tested to what extent SMA patients with different malocclusions presented with variable scores. Patients differed in ambulatory and treatment status (15 ambulatory vs. 28 nonambulatory; 35 treated vs. 8 nontreated) and orthodontic findings (22 with a class II molar relationship and increased overjet, 35 with posterior crossbite). In contrast to the oral function tests, some of the established motor scores showed a clear floor effect. Statistically significant associations were identified between reduced oral function values and an enlarged overjet, a class II molar relationship, and a posterior crossbite. This should be taken into account in neuromuscular evaluations. In severely affected patients, oral function tests appear to be superior to established motor scores and fill a diagnostic gap in research and clinical practice.

In light of the growing interest in orthodontic care and its effectiveness in Germany, part 2 of this multicenter cohort study evaluated patient-reported outcomes such as oral health-related quality of life (OHRQoL), oral hygiene habits, oral health beliefs, and potential influencing factors. Of 586 patients screened from seven German study centers, data from 343 patients were analyzed for this part of the study. At the end of their orthodontic treatment, study participants filled out a questionnaire of either the German long version of the Oral Health Impact Profile (OHIP-G 49) or the German short version of the Child Oral Health Impact Profile (COHIP-19), depending on their age, as well as questions about their oral hygiene behavior and beliefs. Patient-, treatment- and occlusion-related factors were analyzed to account for potential influencing factors with regard to patients’ OHRQoL after orthodontic treatment. In all, 222 study participants filled out the OHIP-based and 121 the COHIP-based questionnaire. The mean OHIP-G 49 score was 12.68 and the mean OHIP-G 14 score was 3.09; the mean COHIP-19 score was 6.52 (inverted score 69.48). For OHIP-G 49 scores, a nonsignificant trend towards a higher score for male patients (14.45 vs 11.54; p = 0.061) was detected, while this trend was inverse for the COHIP-19 scores, i.e., female patients reported more impairment (total score 6.99 vs. 5.84; p = 0.099). Analyses suggested a trend towards better OHRQoL for patients who classified for the Peer Assessment Rating (PAR) Index improvement rate group ‘greatly improved’ as well as for nonsmokers. Oral hygiene habits and beliefs after orthodontic treatment were estimated to be good. In this German cohort, OHRQoL proved to be good and was rather unimpaired after orthodontic treatment. Furthermore, self-reported oral hygiene behavior and oral health beliefs represented good health awareness.

Abstract Background Oral function tests have been shown to reliably detect impaired bulbar function in adults with spinal muscular atrophy (SMA). Although not routinely recorded, it is known that persons with SMA are affected to varying degrees. Detecting differences in bite and tongue force, endurance, and maximum mouth opening has become particularly promising since the introduction of causal therapy for SMA. This study aimed to compare oral function among adult persons with SMA with different SMA types, walking abilities, and treatment status to a healthy control group. Methods Data from oral function tests conducted on 58 persons with SMA and 45 healthy individuals were analyzed. Differences in oral function between SMA subgroups were pairwise tested and compared to the healthy control group using Wilcoxon rank sum tests. Results In an overall comparison, three out of five oral function tests revealed lower values for the SMA group compared to the control group. Subgroup analyses indicated lower scores for most oral function tests in non-ambulatory, untreated patients with SMA type 2 compared to controls. Ambulatory, treated patients with SMA type 3 achieved strength and endurance values comparable to those of healthy individuals. Conclusions The impairment of oral function varies across persons with SMA. Routine measurement of oral function is warranted to determine individual bulbar involvement stages. Further evaluation should be scheduled if indicators such as restricted maximum mouth opening arise. Trial registration DRKS, DRKS00015842. Registered 30 July 2019, https://drks.de/register/de/trial/DRKS00015842/preview.

To identify predictors for long-term relapse of orthodontic therapy in patients with cleft lip and palate (CLP). Patients with uni- and bilateral non-syndromal CLP were followed up at least two years after completion of their orthodontic therapy. Plaster casts of the start of treatment (T1), after completion of treatment (T2), and at follow-up (T3) were measured using the modified Huddart Bodenham Index. Characteristics of multidisciplinary therapy were taken from the patient files. Potentially influencing factors of relapse were investigated using logistic regression analyses and Spearman correlations. In total 58.07

BACKGROUND:Impairment of bulbar function in adult individuals with spinal muscular atrophy (SMA) usually is not assessed by established motor scores. Measurements of oral function including quantitative muscle and endurance tests are able to detect subtle changes. The aim of this study was to systematically evaluate the measurement of maximum bite force and endurance, maximum tongue pressure and endurance, as well as maximum mouth opening in adult individuals with SMA types 2 and 3.METHODS:Data from oral function tests in 43 individuals were analyzed. Differences in oral function between individuals with different SMA types and numbers of SMN2 copies were tested. Spearman´s rho correlations among oral function measures themselves as well as with established clinical outcome scales were analyzed.RESULTS:The absolute maximum measures of oral function (maximum bite force, maximum tongue pressure, maximum mouth opening) were able to discriminate between individuals with different SMA types, individuals with a different number of SMN2 copies and with different walking abilities. The pairwise correlations of the absolute maximum measures of oral function were fair to moderate in size; the same was true for their correlations with the established motor scores. All correlations assessing endurance measures of oral function were weaker and statistically insignificant.CONCLUSIONS:Among the oral function tests maximum tongue pressure and maximum mouth opening are particulary promising as clinical and sensitive outcome measures for clinical trials. Oral function tests may supplement existing motor scores, in particular concerning specific questions about bulbar function or in severely affected non-ambulatory individuals where mild (treatment-related) changes would otherwise remain undetected. Trial registration DRKS, DRKS00015842. Registered 30 July 2019, https://drks.de/search/de/trial/DRKS00015842.

Objective:In order to better and more objectively assess and compare the aesthetics of the lip, we offer an inovative, digital measurement method.Patients and method:Patients were divided into 2 groups:a) patients with unilateral CLP andb) patients with bilateral CLP.Based on standardised photos from 3 different directions, lip symmetry and aesthetics were assessed. A new digital measurement system was used, which was integrated into a proven clinical programme. Different symmetry indices were compared with a non-cleft control group. In addition, the function was investigated and a standardised questionnaire was used.Results:In total, 92 patients with operated CLP could be recruitetd and showed significant residual asymmetry compared to the control group with 49 patients. The results were more symmetrical in group b) than in group a). In contrast, scar width and scar aesthetics as well as orofacial function were better in group a). The preoperative cleft width showed a positive correlation with the postoperative scar width and scar aesthetics. Socioeconomic factors were not related to surgical outcome. Satisfaction of affected children and parents correlated with objectively assessed scar aesthetics and function. There was no correlation between satisfaction and symmetry or cleft width or scar width.Conclusion:The presented measurement system can be used excellently and effectively in clinical routine, especially for the inexperienced examiner, for fast and yet detailed, objective recording of findings. The measurement results can be analyzed comparatively and interpreted predictively for diagnostics, planning and therapy.

Purpose Studies from the 1970s and 1980s, but also recent investigations on social media suggest that wearing a fixed orthodontic appliance can be a cause of bullying and social exclusion. With the greater uptake of orthodontic treatment in recent decades, it can be assumed that fixed braces are increasingly perceived as normal or even socially desirable. This study investigated how wearing visible fixed braces affects adolescents’ social position in their peer networks using cross-sectional survey data. Methods A total of 3002 students in the seventh grade (ages 12/13) at 39 secondary schools were asked about their social relationships in school. These directed network data were used to compare different indegrees (friendship, popularity and victimisation) of students with and without fixed braces. Statistical analyses were performed using ordinary least squares multiple regression models with school cohort fixed effects. Results In all, 19% of the surveyed students indicated that they wear visible fixed braces. Girls with fixed braces were slightly more likely to be nominated for friendship and popularity and slightly less likely to be nominated for victimisation than girls without fixed braces ( p < 0.05). These associations also remained stable when controlling for socioeconomic differences. Among boys, all observed associations were statistically insignificant. Conclusion We found no evidence that wearing fixed braces in adolescence is socially sanctioned by peers. Rather, female students with fixed braces even tend to hold a slightly more favourable position in their peer networks than girls without braces do. These analyses exemplify how network-analytic approaches can be successfully applied in interdisciplinary research at the intersection of sociology, epidemiology and medicine.

This article describes the management of patients with cleft lip and palate and Robin Sequence from prenatal diagnosis to the end of growth. Orthodontic treatment management of patients with oro- and craniofacial malformations is complex, time-consuming and needs an interdisciplinary coordination. A network of specialized centers offers the best possible interdisciplinary expertise in rare diseases. The goals and organization of these specialized centers will be explained in the following. A central aim is to be available as a low-threshold contact and to support resident orthodontists in treatment planning, timing and trouble-shooting. A basic knowledge of the most common cranio- and orofacial anomalies and know ledge of early treatment steps such as the early therapy with a palatal plate (with or without extended spur) are important for orthodontic practitioners. This is the only way to ensure safe, effective therapy and stable esthetic and functional rehabilitation. Functional impairments, as well as skeletal and dental anomalies, require anticipatory orthodontic planning in this patient group. Any surgical procedures that may be necessary must be considered in the treatment sequence, and treatment decisions should always be made with the goal of making the treatment as effective as possible.

BackgroundNonsyndromic cleft lip with/without cleft palate (nsCL/P) is a congenital malformation of multifactorial etiology. Research has identified >40 genome-wide significant risk loci, which explain less than 40% of nsCL/P heritability. Studies show that some of the hidden heritability is explained by rare penetrant variants. MethodsTo identify new candidate genes, we searched for highly penetrant de novo variants (DNVs) in 50 nsCL/P patient/parent-trios with a low polygenic risk for the phenotype (discovery).We prioritized DNV-carrying candidate genes from the discovery for resequencing in independent cohorts of 1010 nsCL/P patients of diverse ethnicities and 1574 population-matched controls (replication). Segregation analyses and rare variant association in the replication cohort, in combination with additional data (genome-wide association data, expression, protein-protein-interactions), were used for final prioritization. ConclusionIn the discovery step, 60 DNVs were identified in 60 genes, including a variant in the established nsCL/P risk gene CDH1. Re-sequencing of 32 prioritized genes led to the identification of 373 rare, likely pathogenic variants. Finally, MDN1 and PAXIP1 were prioritized as top candidates. Our findings demonstrate that DNV detection, including polygenic risk score analysis, is a powerful tool for identifying nsCL/P candidate genes, which can also be applied to other multifactorial congenital malformations.

Aims For any orthodontic-orthognathic treatment, it is crucial that patients are provided with enough and proper information in order to make evidence-based decisions- not only prior to treatment start, but also throughout the course of therapy. Thus, the objectives of this qualitative study were to identify information needs of patients undergoing combined orthodontic-orthognathic treatment. Additionally, professionals’ perspectives were evaluated. Methods A qualitative research approach was chosen in order to determine crucial aspects of information needs before and throughout treatment. With respect to a purposive sampling strategy and thematic saturation, we conducted ten semi-structured interviews with patients who had finished their orthodontic-orthognathic surgery treatments (five women, five men; being 21 to 34 years old). The indications for the combination treatment were severe skeletal Class IIs to Class IIIs with various vertical and transverse discrepancies. In addition, a multidisciplinary focus-group with six professionals from the maxillofacial surgery and orthodontic department (three women, three men; being 30 to 38 years old) helped to reflect about the experts’ point of views. After transcription, data was categorized and analyzed by Mayring’s content analysis. Results We identified three key themes. During this analysis, we focused on theme (1) ‘information transfer’ with its corresponding categories ‘information needs’ – depending on different treatment stages –, ‘source of information’ and ‘doctor-patient-communication’. The affected patients ranked individualized patient information and empathetic doctor-patient-communication high. This was mostly in line with the professionals’ point of view. Verbal communication was seen as being the best way to communicate throughout treatment. The role of the internet as a source of information was seen diversely. Conclusion This qualitative study highlights the need for individualized patient information and reveals both met and unmet information needs by patients. Although evidence-based written information is highly necessary for orthognathic patients and their families alike, it cannot replace an empathetic way of direct verbal doctor-patient-communication. It seems crucial to give specific individualized information at different treatment stages, starting at a thoroughly interdisciplinary screening at the very beginning.

ZusammenfassungIn diesem Artikel wird beispielhaft die Betreuung von Patientinnen und Patienten mit Lippen-Kiefer-Gaumen-Spalten und Robin Sequenz von der pränatalen Diagnostik bis zum Wachstumsabschluss beschrieben. Das kieferorthopädische Behandlungsmanagement bei Betroffenen mit oro- und kraniofazialen Fehlbildungen ist komplex, zeitintensiv und erfordert eine interdisziplinäre Koordination. Vernetzte Zentrumsstrukturen bieten eine bestmögliche interdisziplinäre Expertise bei diesen seltenen Erkrankungen. Ziel und Aufbau dieser spezialisierten Zentren sollen hier erläutert werden. Unter anderem sollten sie niederschwellig als Ansprechpartner zur Verfügung stehen und niedergelassene Kieferorthopädinnen und Kieferorthopäden in Therapieplanung, Timing und Trouble-Shooting unterstützen. Das Grundverständnis der häufigsten oro- und kraniofazialen Anomalien und die Kenntnis über frühe Behandlungsschritte wie der Versorgung mit einer Gaumenplatte oder Spornplatte sind für kieferorthopädisch Behandelnde wichtig. Denn nur so kann eine sichere, effektive Therapie und eine stabile ästhetische und funktionelle Rehabilitation gewährleistet werden. Funktionelle Beeinträchtigungen sowie skelettale und dentale Anomalien erfordern bei dieser Patientengruppe eine vorausschauende kieferorthopädische Planung. Eventuell notwendige chirurgische Eingriffe müssen im Ablauf mit bedacht und Therapieentscheidungen immer mit dem Ziel getroffen werden, die Behandlung möglichst effektiv zu gestalten.

Purpose To better understand the side effects of fixed lingual retainers by means of an in vitro study in a two-tooth model determining the three-dimensional (3D) force–moment components acting at adjacent teeth combined with different composite–wire interfaces. Methods Triple-stranded round retainer wires were embedded in cured disks of flowable composite. At one side the composite–wire interface was untreated and checked to be absolutely fix. At the other side the composite–wire interface was configured as either an isolated compound with (1) petroleum jelly coating, or an adhered compound with (2) no manipulation, (3) ethanol degreasing or (4) ethanol degreasing and rectangular bending of the wire ends. The 3D force–moment components were registered, while the intertooth distance was increased in steps of 0.01 mm leading to increasing tension of the wire. Measurements were repeated after artificially aging the specimens. Results Retainer wire specimens with adhered compound (2, 3, 4) showed negative vestibulo-oral moments ranging maximally each between −0.3 and −0.9 Nmm in opposite direction to positive moments of 1.9 Nmm for specimens with isolated compound 1. Significant tipping moments occurred in the group with isolated compound at lower forces than in those groups with adhered compound. Similar effects were observed after artificial aging. Conclusion Side effects emerge under specific circumstances: an altered adhesive compound combined with the presence of oral forces. Compounds with lost adhesion at the composite–wire interface showed rotational moments in the direction of the wire windings even during low tensile forces similar to those that may occur in clinical settings. Opposite rotational moments leading to unwinding of the wire may occur in cases with adhered compounds at higher tensile forces. Utilization of round triple-stranded retainer wires without bent ends are of higher risk to induce inadvertent side effects.