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Öğe 3D evaluation of cranial and dentofacial morphological differences between individuals with mouth breathing and nasal breathing(Elsevier, 2024) Topsakal, Kübra Gülnur; Yurdakurban, Ebru; Duran, Gökhan Serhat; Görgülü, SerkanIntroduction: The present study aimed to identify the morphological differences in cranial and dentofacial structures between individuals with mouth-breathing and nasal-breathing. Materials and Methods: The study included 120 individuals, 60 each in the nasal breathing (NB) and mouth breathing (MB) groups. 3D stereophotogrammetry, lateral cephalometric radiographs, and intraoral examination results were recorded by the researchers to determine the morphological differences between the MB group and the NB group. The study utilized cephalometric radiographs for 2D hard tissue measurements and 3D stereophotogrammetric records for linear and angular measurements. Results: Statistically significant differences were found between the NB and MB groups' SNB angles (respectively, 79.3 +/- 3.04, 76.6 +/- 4.24, and p = 0.002). Also, the NB group's SN-GoGn angle was lower than the MB group's (respectively, 31.5 +/- 5.12, 36.0 +/- 5.55, and p = 0.002). Considering the Jarabak ratio, the NB group's Jarabak ratio was higher than the MB group (respectively,65.7 +/- 4.16, 62.6 +/- 4.10, and p = 0.014). In 3D stereophotogrammetry measurements, increased Li-Me' was detected in the MB group than in NB group. Conclusion: Mouth breathing results in significant morphological differences that affect the development of both soft tissues and skeletal structures. Orthodontists utilize these characteristic features observed in mouth-breathing anomalies for early diagnosis and consider referring their patients for medical treatment of mouth breathing. (c) 2024 Elsevier Masson SAS. All rights reserved.Öğe Accuracy of 3D Printer Technologies Using Digital Dental Models(Galenos Publ House, 2024) Gökmen, Şule; Görgülü, Serkan; Topsakal, Kübra Gülnur; Duran, Gökhan SerhatObjective: This study aimed to compare the manufacturing accuracy of different printing techniques - Stereolithography (SLA), Digital Light Processing (DLP), and PolyJet-using digital dental models. Methods: The study included cast models of 30 patients aged between 12 and 20 years. The selected models were scanned using an intraoral scanner, and surface topography format files were obtained. The models were produced from 3D printers with SLA, DLP, and PolyJet technology and scanned with an intraoral scanner. The digital files of the reference and printed models were superimposed with reverse engineering software. Root mean squared (RMS) values and point registration differences were evaluated. Furthermore, digital mesiodistal measurements of the teeth were taken to determine the point registration deviation values. Descriptive statistics were used to evaluate the measurements. ANOVA was used to evaluate differences between normally distributed data. In addition, a box plot was used to show the variability in the measurements, and the Bland-Altman test was used to examine the agreement between the measurements. Results: According to the digital superimposition data of DLP-SLA-PolyJet technologies, PolyJet had the smallest RMS (0.145 +/- 0.10 mm), followed by DLP and SLA (0.161 +/- 0.12 mm and 0.345 +/- 0.23 mm, respectively). In the mesiodistal dimensional measurement evaluations, there was no statistically significant difference (p>0.05) between the averages of the main reference and DLP, PolyJet, and SLA measurements for all teeth. Conclusion: According to the results of this study, all three production technologies are clinically usable at the model production stage. However, SLA was found to be less accurate than DLP and PolyJet.Öğe Effect of post-curing parameters and material thickness on the color stability of 3D-printed dental resins: An in vitro study(Elsevier Masson Sas Editeur, 2025) Topsakal, Kübra Gülnur; Aksoy, Merve; Sukut, Yağızalp; Duran, Gökhan SerhatObjective > To assess the effect of variations in post-curing temperatures and times on the colour stability of 3D-printed resins used in orthodontics and paediatric dentistry applications and the effect of material thickness on colour properties was also examined. Methods > The two different disk samples (15.00 x 1.0 mm, n = 90; 15.00 x 2.00, n = 90; diameter and height, respectively) were designed and printed from biocompatible resin with SLA technology. These samples were subjected to various post-curing temperatures and times (60 degrees C and 30 min, 60 degrees C and 90 min, 60 degrees C and 120 min, 60 degrees C and 60 min, 40 degrees C and 60 min, 80 degrees C and 60 min). The values of L, a, and b of the 3D-printed resin samples were evaluated under D65 illumination conditions in the centre of the samples using a spectrophotometer. The same researcher recorded the average values after the measurements were performed three times for each sample. Results > The results indicated significant differences in colour stability (L, a, b values) among samples subjected to different post-curing conditions. Variations in post-curing time and temperature significantly affected the colour of the resins. The study found that certain post-curing conditions could lead to acceptable colour values that are similar to natural teeth. Conclusions > The study concluded that the time and temperature of post-curing significantly affected the colour properties of 3D-printed clear resins used in orthodontic applications. It suggests that a 30-minute post-curing time can yield acceptable colour values, highlighting the importance of selecting appropriate post-curing conditions based on clinical requirements. Additionally, an increase in material thickness was found to correlate with increased yellowness in the samples. Clinical significance > The changes in post-curing temperature and time may impact colour properties. Clinicians should consider this situation when manufacturing with 3D printing.Öğe Evaluating the accuracy between hollow and solid dental aligner models: a comparative study of printing technologies(Sciendo, 2024) Yurdakurban, Ebru; Topsakal, Kübra Gülnur; Duran, Gökhan Serhat; Görgülü, SerkanObjective To evaluate the accuracy between hollow and solid dental models produced using a StereoLithography Apparatus (SLA), Digital Light Processing (DLP), and PolyJet 3D printing technologies.Materials and methods Hollow (of 1 mm, 2 mm, 3 mm shell thicknesses) and solid maxillary models were produced using SLA, DLP, and PolyJet printers. To determine the accuracy of the tested models and deviations from the reference models, 3D digital superimposition was performed. For a detailed analysis, the dental arch was subdivided into five regions which yielded root mean square (RMS) values post-registration. Six different RMS values were generated, one for the total dental arch and one for each of the five individual regions. One-Way ANOVA analysis was applied for intergroup comparisons, and post hoc comparisons were conducted using the Tukey test. The significance of the deviation of RMS values from zero was evaluated through the one-sample t test.Results The PolyJet printer produced models with the least deviation for the total arch, while the SLA printer showed the greatest deviation. The DLP printer produced models with the least deviation for the hollow designs in the anterior region, while the SLA printer produced models with the least deviation of the solid design. The PolyJet printer showed the least deviation for both hollow and solid designs of 2 mm and 3 mm shell thicknesses in the molar regions. Except for the 1 mm shell thickness hollow design on the right side, the PolyJet printer showed the highest accuracy in the premolar-canine regions.Conclusion Accuracy varies in the posterior and anterior regions of the dental arch as a result of different shell thicknesses produced by 3D printing technologies. The clinician should select a design that is appropriate for the intended 3D printing technology based on use and required accuracy.Öğe Evaluating the Impact of Different Education Methods on Cleft Lip and Palate Anatomy Training(Sage Publications Inc, 2024) Dalgalı, Perihan; Topsakal, Kübra Gülnur; Mısır, Selcen Eser; Ergüven, Sara Samur; Duran, Gökhan Serhat; Görgülü, SerkanObjective To compare the effects of different educational methods on short and long-term learning outcomes and to investigate the satisfaction and perception of cleft lip and palate (CLP) education among dental students.Design The theoretical exam on CLP to determine their baseline level of knowledge was taken by the participants(T0). After the exam, the students were randomly divided into three groups and all students attended a lecture-based traditional education on CLP. Students in the first group (n = 40) received no additional teaching (Group A). Students in the second group (n = 38) received model teaching with 3D-printed models (Group B). The third group (n = 39) was trained in e-learning-supported education (Group C). The theoretical exam was repeated immediately after the education (T1/short-term learning), one week later (T2/early long-term learning), and one month later (T3/late long-term learning), and the effect of the education methods on information level was assessed. In addition, a post-training satisfaction questionnaire was administered to participants of Group B and Group C.Results Both 3D model-based and e-learning-supported approaches significantly improved immediate knowledge of CLP. However, no significant differences were found in knowledge retention over time between the all methods. A majority of students favored the incorporation of both methods in orthodontic education.Conclusions While both 3D models and e-learning effectively enhance short-term CLP knowledge among dental students, their long-term educational impacts are comparable. However, student preferences indicated that the use of 3D-printed models and e-learning strategies may be useful augmentations to traditional lecture education.Öğe Evaluation of composite materials with different viscosities on the accuracy of in-office aligner attachments(Elsevier Inc., 2025) Yıldız Erkuş, Kübra; Topsakal, Kübra Gülnur; Duran, Gökhan Serhat; Görgülü, SerkanIntroduction: To evaluate the accuracy of two different composites with low and high viscosity in different attachment designs, in-office clear aligner therapy was used. Methods: The study consisted of two main groups: the flowable composite group (n = 60) and the nanofilled composite group (n = 60), and in each group, five attachments (rectangular, beveled, ellipsoid, pentagon, and concave) (n = 12, per group) were used. The typodont model was scanned with an intraoral scanner to obtain a stereolithography file. The stereolithography data was transferred to the software, and attachments were placed on the teeth. A total of five models with attachments and 60 models without attachments were obtained with digital light processing technology. Attachments were applied to test models using two different types of composites with guide plates. Models with attachments applied were scanned with an intraoral scanner, and the attachments on the models were separated through the software. As a result of the comparison, the root mean square and the depth, width, and height linear dimensional measurements of the attachments were obtained. The 1-way analysis of variance test was used to compare attachment shapes, and the Tukey test was used in post-hoc comparisons. Results: According to the 3-dimensional digital comparison data, there is a statistically significant difference between flowable composite and nanofilled composite groups in root mean square values and width, height, and depth measurements (P = 0.034, P <0.001, P = 0.007, and P = 0.001, respectively). Conclusions: Although the flowable composite used in this study provides more accurate results compared with the nanofilled composite, both composite types have clinically applicable accuracy. © 2024 American Association of OrthodontistsÖğe Evaluation of dentists' malpractice fears and defensive dentistry attitudes: a scale development(Bmc, 2025) Eser Mısır, Selcen; Uğrak, Ugur; Topsakal, Kübra Gülnur; Dalgalı, Perihan; Duran, Gökhan Serhat; Görgülü, SerkanObjectives To develop and design the Defensive Dentistry Attitude Scale (DDAS) to evaluate the relationship between defensive dentistry and fear of malpractice among dentists in T & uuml;rkiye. Methods The Defensive Dentistry Assessment Scale (DDAS) questions were determined based on expert opinions and a literature review. Based on these results, a questionnaire including the 13-item DDAS and the malpractice fear scale was sent to 3513 dentists in T & uuml;rkiye by email between 3.11.2023 and 10.1.2024. A total of 369 dentists returned. The questionnaire consisted of 26 questions with two VAS scales related to the frequency of complications and detailed anamnesis. During the development of DDAS, the Content Validity Index (CVI), Exploratory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA) were utilized. The Mann-Whitney U and Kruskal-Wallis tests were employed for group comparisons. In examining the relationships between variables, path analysis within the structural equation modeling (SEM) framework was conducted. Results The DDAS developed in the study was a valid and reliable measure with two dimensions and eight items. DDAS (Median = 29) and malpractice fear scores (Median = 21) were high in dentists. Malpractice fear scores of dentists aged 29-35 years (Median = 21) were found to be statistically significantly higher than those of dentists aged 36 years and older (p < 0.05). The levels of malpractice fears (Median = 22) and defensive dentistry attitudes (Median = 31) of dentists with 6-10 years of experience were statistically significantly higher than those of dentists with 11 years of experience and over (respectively (Median = 20), (Median = 28), p < 0.05). A statistically significant and high-level positive correlation was found between dentists' fear of malpractice and their tendency to adopt defensive dentistry practices (beta = 0.56, p < 0.001). Conclusions According to the results of this study, the DDAS was found to be a valid and reliable measure of negative and positive defensive dentistry. Specifically, a significant and strong positive correlation was identified between dentists' fear of malpractice and their engagement in defensive dentistry practices. This finding indicates that the tendency to adopt defensive dental behaviors increases as malpractice fear increases.Öğe Evaluation of the reliability of palatal rugae as a reference area in digital superimposition after slow maxillary expansion treatment(Elsevier Inc., 2025) Gökmen, Şule; Topsakal, Kübra Gülnur; Duran, Gökhan Serhat; Görgülü, SerkanIntroduction This study aimed to evaluate the stability of palatal rugae patterns after slow maxillary expansion (SME) treatment and the reliability of the rugae region as a reference region in digital superimposition. Methods The SME group comprised 21 subjects with Angle Class I or Class II dental malocclusion with unilateral or bilateral crossbite and constricted maxilla and were selected before the pubertal peak. Intraoral scans were captured via the intraoral scanner iTero Element software (version 1.13; Align Technology, San Jose, Calif) before treatment and after completion of 12 rotations of the screw in the expansion appliance. Patients rotated the screw once a week by the established protocol. The digital data of the impressions were analyzed using GOM Inspect 3D analysis software (version 2018; GOM GmbH, Braunschweig, Germany). Dimensional changes in rugae after SME were measured with MeshLab software (version 2022.02, the Visual Computing Lab of CNR-ISTI, Italy). For the statistical analysis, the Shapiro-Wilk test was used to assess normality, whereas the Kruskal-Wallis and Mann-Whitney U tests were applied for group comparisons. Results According to digital superimposition data, the root mean square value of the rugae region in the SME group was found to be 0.195 ± 0.086 mm. The greatest dimensional change was found in the third rugae (1.70 ± 0.42 mm, P <0.001). Post-hoc pairwise comparisons revealed a statistically significant difference between the dimensional changes of the first and third rugae (P <0.05). No statistically significant difference was found as a result of pairwise comparisons of the right and left rugae points (P = 0.083 and P = 0.200, respectively). Conclusions The observed transverse dimensional changes in the rugae, particularly in the third rugae, indicate that caution should be exercised in using the rugae region as a reference in superpositions after SME treatment.Öğe Innovative use of the snowplow technique in orthodontics: Evaluation of its effect on the accuracy and manipulation time in clear aligner attachment reproduction(Elsevier Sci Ltd, 2025) Demir, Gizem Boztaş; Görgülü, Serkan; Topsakal, Kübra Gülnur; Duran, Gökhan SerhatObjective: In this study, we evaluated the effectiveness of the snowplow technique, commonly used in restorative dentistry, in clear aligner therapy, focusing on manipulation time and the accuracy of attachment-shape transfer from the 3D-designed model (i.e., attachment-reproduction accuracy). Methods: Rectangular, ellipsoidal, and customized attachments were placed on the first premolar teeth, and different attachment-reproduction methods were evaluated. The study groups included high-viscosity (HV) and low-viscosity (LV) composites, as well as two variations of the snowplow techniques (S1 and S2). The manipulation time was recorded, and a highly detailed 3D comparison methodology (sigma, arithmetic mean, and deviation label) was used to assess attachment-reproduction accuracy. Results: Manipulation time differed significantly across all groups, with the LV group exhibiting the shortest time, followed by the S1 group (p < .001). For surface deviation, the S1 group demonstrated the lowest sigma values, particularly for rectangular attachment designs (p < .001). Conclusions: Using the LV composite allowed the shortest application time, while the S1 technique required less manipulation time than did the HV composite. The S1 technique also achieved superior attachment accuracy, making it an effective technique for reproducing attachments with intricate surface details. Clinical Significance: The improved accuracy facilitated by the S1 technique may positively influence clinical outcomes by enhancing successful execution of planned tooth movements, thereby potentially improving the overall efficacy of clear aligner therapy.Öğe New horizons in dentistry and orthodontics with 4D printing technologies 4D printing and orthodontics(Sciendo, 2025) Bakkal, Burcu; Topsakal, Kübra Gülnur; Duran, Gökhan SerhatObjective This study aims to explain the mechanisms of the four-dimensional (4D) printing technique and its potential applications in dental and orthodontic practice.General Information Rapid advances in science and technology have led to significant developments in production systems. Described as additive manufacturing or rapid prototyping, a positive innovation has been the introduction of three-dimensional (3D) printers in the 1980s. The technology quickly became popular because it allowed complex structures to be produced using less material compared to traditional manufacturing methods. Objects are designed in three dimensions using dedicated computer programs and 3D printed using materials such as composites, resins, metals, and polymers. Orthodontics has also benefitted from 3D printing in the fields of clear aligner treatment, indirect bonding using bracket transfer trays, dental modelling, and the production of guides for mini-screw and implant placement, as well as the manufacture of removable appliances. As 3D printers continued to evolve and new 'smart' materials were specifically developed, 4D printing techniques emerged. 4D printing allows objects, produced by 3D printers to change shape in response to stimuli, usually in the form of heat and light, thereby enabling the performance of specific functions. The objects can also self-assemble into larger structures without external intervention. The applications of 4D printing are expanding across a wide range of clinical fields.Conclusion 4D printing is an evolving technology that requires further research. However, if integrated into dentistry, it holds great potential as an efficient printing method, similar to its applications in other fields.
