Ortodonti Bölümü Yayın Koleksiyonu

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https://hdl.handle.net/20.500.12428/33341

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Shear bond strength of 3-dimensional-printed orthodontic brackets
(Mosby-Elsevier, 2025) Duran, Gökhan Serhat; Topsakal, Kübra Gülnur; Akgün, Yusufcan; Karadaş Bakırhan, Nurgül; Görgülü, Serkan
Introduction This in vitro study aimed to evaluate the shear bond strength (SBS) and adhesive remnant index (ARI) of 3-dimensional-printed orthodontic brackets with 3 different base designs and to examine the surface morphologic differences of remaining adhesives using scanning electron microscopy (SEM). Methods Sixty maxillary premolar teeth (n = 20 per group) were randomly allocated into 3 bracket base design groups: (1) custom, (2) macroretentive, and (3) standard. After digital scanning of the teeth, the brackets were printed using a MAX UV DLP 3D printer (Asiga, Sydney, Australia). Each bracket was bonded using Transbond XT composite and light-cured for 10 seconds with a light-emitting diode curing unit (Valo; Ultradent, South Jordan, Utah). Subsequently, SBS testing was performed using a universal testing machine at a 1 mm/min crosshead speed, and fracture loads were recorded in megapascals (MPa). After debonding, ARI scores were evaluated under a digital microscope by a blinded investigator and reevaluated after 2 weeks for reliability. In addition, bracket bases and tooth surfaces were examined under a high-resolution SEM (30 kV, 20 mm working distance). Results The highest SBS values were observed in the custom base design group (group A, 8.05 ± 4.69 MPa), followed by the macroretentive group (group B, 6.31 ± 3.80 MPa) and the standard group (group C, 5.91 ± 6.09 MPa). The differences between groups A and C were statistically significant (P = 0.017). ARI scores revealed that in groups A and B, most adhesive remained on the tooth (ARI score 2 predominated), whereas group C demonstrated a more variable ARI distribution. In addition, according to the SEM results, most adhesives have remained on the teeth in all groups. Conclusions Custom mesh designs in 3D-printed orthodontic brackets significantly enhance bond strength and adhesive retention, making them a promising option for clinical use. Future studies should investigate their performance under conditions that simulate the oral environment to validate their clinical applicability.
Impact of Biodentine Placement on Fracture Resistance and its Influence on Discoloration with Different Scaffolds
(Elsevier Science Inc, 2025) Sarıyılmaz, Evren; Sarıyılmaz, Öznur; Çarıkçıoğlu, Burak; Uslu, Gülşah; Alan, Raif
Introduction This study aimed to investigate the fracture resistance of teeth that underwent ex vivo regenerative endodontic treatment using Biodentine placed either above or below the cemento-enamel junction (CEJ). Additionally, it examined the impact of different placement approaches, in combination with various scaffold materials (blood, platelet-rich fibrin [PRF], injectable PRF [i-PRF]), on tooth discoloration over time. Methods Thirty-nine human maxillary incisors were divided into three groups. The control group consisted of intact teeth. In the two experimental groups, regenerative endodontic procedures were simulated, and Biodentine was placed above or below the CEJ. Fracture resistance was evaluated after thermal and mechanical aging using a chewing simulator. In the discoloration test, 96 human maxillary incisor teeth were selected. Roots were sectioned 10 mm apical to the CEJ and canal enlargement was performed Gates-Glidden burs. Teeth were grouped according to the placement level of Biodentine (above or below CEJ) and the type of scaffold materials used (blood, PRF, i-PRF, distilled water). Discoloration was assessed by using a spectrophotometer at baseline, 1 week, 1 month, and 6 months. Data were analyzed using one-way analysis of variance followed by Tukey post hoc tests independent t -tests were used to evaluate the effect of placement location on color change. Results The fracture resistance of intact teeth was significantly higher than that of the group in which Biodentine was placed below the CEJ. Blood and blood-derived products resulted in greater discoloration compared to distilled water, whereas PRF induced less discoloration than blood. Furthermore, the placement of Biodentine above the CEJ led to significantly less discoloration at specific time points compared to its placement below the CEJ. Conclusions Positioning Biodentine above the CEJ may offer clinical advantages by potentially improving structural integrity while minimizing aesthetic concerns. When PRF is used as the scaffold material and Biodentine is placed coronally, tooth discoloration is minimized.
Post-curing protocols and dimensional accuracy of 3D-printed resin materials
(Taylor & Francis Ltd, 2025) Aksoy, Merve; Topsakal, Kübra Gülnur; Sükut, Yağızalp; Duran, Gökhan Serhat
Purpose The study aims to evaluate the influence of various post-curing times and temperatures on the dimensional accuracy of 3D-printed resin space maintainers. Materials and Methods Using biocompatible printing resins, the study designed band samples of space maintainers, which were 3D printed with the SLA printer. Samples were grouped based on thickness (0.5 mm and 1.0 mm) and post-cured under different conditions of temperature and time (60 degrees C-30 minutes, 60 degrees C-90 minutes, 60 degrees C-120 minutes, 60 degrees C-60 minutes, 40 degrees C-60 minutes, 80 degrees C-60 minutes). The accuracy of the band part of the printed maintainers was analysed using the total and 4 comparison points' arithmetic mean of the surface deviation on the band's surface. Results The study revealed that the post-curing conditions notably influenced the dimensional accuracy of the printed samples. Post-curing temperature and duration variations produced significant differences in dimensional stability between the groups. Particularly, a post-curing period of 60 degrees C for 60 minutes was identified as optimal for achieving better dimensional accuracy, especially for samples with 1.0 mm thickness. Conclusions Different post-curing parameters significantly affect the dimensional accuracy of 3D-printed resin space maintainers. The 1.0 mm band thickness and a 60 degrees C and 60 minutes post-curing protocol optimize the accuracy of the maintainers.
Orthodontic Biomechanical Reasoning with Multimodal Language Models: Performance and Clinical Utility
(Mdpi, 2025) Arısan, Arda; Genç, Celal; Duran, Gökhan Serhat
Background: Multimodal large language models (LLMs) are increasingly being explored as clinical support tools, yet their capacity for orthodontic biomechanical reasoning has not been systematically evaluated. This retrospective study assessed their ability to analyze treatment mechanics and explored their potential role in supporting orthodontic decision-making. Methods: Five publicly available models (GPT-o3, Claude 3.7 Sonnet, Gemini 2.5 Pro, GPT-4.0, and Grok) analyzed 56 standardized intraoral photographs illustrating a diverse range of active orthodontic force systems commonly encountered in clinical practice. Three experienced orthodontists independently scored the outputs across four domains-observation, interpretation, biomechanics, and confidence-using a 5-point scale. Inter-rater agreement and consistency were assessed, and statistical comparisons were made between models. Results: GPT-o3 achieved the highest composite score (3.34/5.00; 66.8%), significantly outperforming all other models. The performance ranking was followed by Claude (57.8%), Gemini (52.6%), GPT-4.0 (48.8%), and Grok (38.8%). Inter-rater reliability among the expert evaluators was excellent, with ICC values ranging from 0.786 (Confidence Evaluation) to 0.802 (Observation). Model self-reported confidence showed poor calibration against expert-rated output quality. Conclusions: Multimodal LLMs show emerging potential for assisting orthodontic biomechanical assessment. With expert-guided validation, these models may contribute meaningfully to clinical decision support across diverse biomechanical scenarios encountered in routine orthodontic care.
Assessment of Mandibular Trabecular Bone Structure in Hypodivergent Growth Patterns Using Fractal Analysis
(Mdpi, 2025) Boztaş Demir, Gizem; Doğrugören, Rüveyda; Topsakal, Kübra Gülnur; Duran, Gökhan Serhat; Görgülü, Serkan
The objective of this study is to evaluate the trabecular structure in hypodivergent individuals using fractal analysis, with a particular focus on specific mandibular regions. This study aims to assess the impact of hypodivergent growth patterns on bone microarchitecture. This research involved a methodological approach using panoramic radiographs to assess trabecular structure at specific regions of the mandible using fractal analyses. The dimensions of the fractals were calculated with the use of the box-counting technique by the software Image J (v1.53c; Bethesda, MD, USA, National Institutes of Health), while the statistical evaluations were carried out with the Jamovi Software (The Jamovi Project, version 2.3.21.0). The study found significant differences in fractal dimension values between hypodivergent individuals and the control group, particularly in the condyle and angulus regions, indicating a less complex trabecular structure in hypodivergent individuals. This study concludes that individuals with a hypodivergent growth pattern exhibit alterations in trabecular bone structure within the mandibular condyle and angulus regions, characterized by reduced complexity. These findings suggest that increased occlusal forces and mechanical stress associated with this growth pattern may contribute to changes in trabecular architecture. Understanding these variations is essential for orthodontic and maxillofacial diagnosis, treatment planning, and biomechanical considerations, particularly in cases requiring vertical dimension management or anchorage control.
Camera-Based Monocular Depth Estimation in Orthodontics: Vision Transformer vs. CNN Model Performance
(Mdpi, 2025) Arısan, Arda; Duran, Gökhan Serhat
Background: Monocular Depth Estimation (MDE) is a computer vision approach that predicts spatial depth information from a single two-dimensional image. In orthodontics, where facial soft-tissue evaluation is integral to diagnosis and treatment planning, such methods offer new possibilities for obtaining sagittal profile information from standard frontal photographs. This study aimed to determine whether MDE can extract clinically meaningful information for facial profile assessment. Methods: Standardized frontal photographs and lateral cephalometric radiographs from 82 adult patients (48 Class I, 28 Class II, 6 Class III) were retrospectively analyzed. Three clinically relevant soft-tissue landmarks-Upper Lip Anterior (ULA), Lower Lip Anterior (LLA), and Soft Tissue Pogonion (Pog ')-were annotated on frontal photographs, while true vertical line (TVL) analysis from cephalograms served as the reference standard. For each case, anteroposterior (AP) relationships among the three landmarks were represented as ordinal rankings based on predicted depth values, and accuracy was defined as complete agreement between model-derived and reference rankings. Depth maps were generated using one vision transformer model (DPT-Large) and two CNN-based models (DepthAnything-v2 and ZoeDepth). Model performance was evaluated using accuracy, 95% confidence intervals, and effect size measures. Results: The transformer-based DPT-Large achieved clinically acceptable accuracy in 92.7% of cases (76/82; 95% CI: 84.8-97.3), significantly outperforming the CNN-based models DepthAnything-v2 (9.8%) and ZoeDepth (4.9%), both of which performed below the theoretical chance level (16.7%). Conclusions: Vision transformer-based Monocular Depth Estimation demonstrates the potential for clinically meaningful soft-tissue profiling from frontal photographs, suggesting that depth information derived from two-dimensional images may serve as a supportive tool for facial profile evaluation. These findings provide a foundation for future studies exploring the integration of depth-based analysis into digital orthodontic diagnostics.
Assessment of deep learning technique for fully automated mandibular segmentation
(Mosby-Elsevier, 2025) Yurdakurban, Ebru; Süküt, Yağızalp; Duran, Gökhan Serhat
Introduction: This study aimed to assess the precision of an open-source, clinician-trained, and user-friendly convolutional neural network-based model for automatically segmenting the mandible. Methods: A total of 55 cone-beam computed tomography scans that met the inclusion criteria were collected and divided into test and training groups. The MONAI (Medical Open Network for Artificial Intelligence) Label active learning tool extension was used to train the automatic model. To assess the model's performance, 15 cone-beam computed tomography scans from the test group were inputted into the model. The ground truth was obtained from manual segmentation data. Metrics including the Dice similarity coefficient, Hausdorff 95%, precision, recall, and segmentation times were calculated. In addition, surface deviations and volumetric differences between the automated and manual segmentation results were analyzed. Results: The automated model showed a high level of similarity to the manual segmentation results, with a mean Dice similarity coefficient of 0.926 +/- 0.014. The Hausdorff distance was 1.358 +/- 0.466 mm, whereas the mean recall and precision values were 0.941 +/- 0.028 and 0.941 +/- 0.022, respectively. There were no statistically significant differences in the arithmetic mean of the surface deviation for the entire mandible and 11 different anatomic regions. In terms of volumetric comparisons, the difference between the 2 groups was 1.62 mm3, which was not statistically significant. Conclusions: The automated model was found to be suitable for clinical use, demonstrating a high degree of agreement with the reference manual method. Clinicians can use open-source software to develop custom automated segmentation models tailored to their specific needs. (Am J Orthod Dentofacial Orthop 2025;167:242-9)
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 Serhat
Objective: 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.
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 Serhat
Objective > 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.
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, Serkan
Objectives 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.
New horizons in dentistry and orthodontics with 4D printing technologies 4D printing and orthodontics
(Sciendo, 2025) Bakkal, Burcu; Topsakal, Kübra Gülnur; Duran, Gökhan Serhat
Objective 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.
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, Serkan
Introduction: 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 Orthodontists
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, Serkan
Introduction 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.
Accuracy of 3D Printer Technologies Using Digital Dental Models
(Galenos Publ House, 2024) Gökmen, Şule; Görgülü, Serkan; Topsakal, Kübra Gülnur; Duran, Gökhan Serhat
Objective: 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.
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, Serkan
Objective 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.
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, Serkan
Objective 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.
Students' Perceptions About the Instructors' Competence in Technology-supported Courses at Dental Faculty: A Cross-sectional Study
(Aydın Adnan Menderes University, 2023) Çetin Genç, Çiğdem; Deniz, Yeşim; Genç, Celal; Değirmenci, Alpin; Tosun, İlgi
Objective: The pandemic has highlighted the importance of technology-supported courses throughout the world. Evaluating the perceptions of students attending these courses is important to provide high-quality education. Materials and Methods: This study was carried out on 1st, 2nd, and 3rd-grade dentistry students. The Student Perceptions Scale Regarding the Knowledge of Instructors in Technology - Supported Classrooms was applied to 207 dentistry students. This scale consists of four sub-dimensions: subject matter knowledge (SMK), technological knowledge (TK), knowledge of students' understanding (KSU), and technological pedagogical content knowledge (TPCK). Results: SMK, KSU, and TPCK sub-dimension scores did not significantly differ by gender (p>0.05). However, the mean TK score of females (3.55 +/- 0.47) was found to be significantly higher than that of males (3.28 +/- 0.59) (p=0.001). There was no statistically significant difference among the SMK, TK, KSU, and TPCK sub-dimension mean scores by age (p>0.05). There was a statistically significant difference in the mean scores of the SMK and KSU sub-dimensions by grade (p-values are p<0.001 and p=0.015 respectively). The mean TK and TPCK sub-dimension scores yielded no significant difference by grade (p-values are p=0.368 and p=0.050 respectively). Conclusion: Measuring the quality of technology-assisted teaching and the instructor's TPCK from the student's perspective and determining student perceptions will provide accurate data on the long-term quality of education.
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, Serkan
Introduction: 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.
Evaluation of craniofacial anthropometry of children with β-thalassemia major in the eastern Anatolia: a case–control study
(Springer Heidelberg, 2023) Çetin Genç, Çigdem; Genç, Celal; Demir Yenigürbüz, Fatma
Objective The present study aims to compare β-thalassemia major patients and healthy individuals in terms of anthropometric characteristics and changes in craniofacial profile. Subjects and method Craniofacial anthropometric measurements were performed on a total of 422 subjects (199 β-thalassemia major patients and 223 healthy individuals) by using a millimetric caliper and tape measure on 19 anthropometric parameters (8 horizontal, 10 vertical, and 1 head circumference) in cranial, facial, nasal, orolabial, and orbital zones. Results The difference between the orbital, nasal, and orolabial zone parameters of healthy subjects and β-thalassemia major patients was found to be statistically significant (p < 0.05). There was no statistically significant difference between the groups in terms of head circumference in the cranial zone and total facial height in facial zone (n-gn) values (p˃0.05). In intragroup comparison between females and males with β-thalassemia, statistically significant differences were found in forehead width (ft-ft), forehead height (tr-gl), right eye width (R ex-ex), and upper lip height (sn-stm) (p < 0.05). Conclusion Understanding the craniofacial profile changes in β-thalassemia major patients and increasing our knowledge about the relationship between the course and severity of disease and the level of these changes would contribute to the advancements in diagnoses to be made in facial and jaw zones of these patients and in the treatment plans. Clinical relevance We believe that the analysis and results of the craniofacial anthropometric data obtained in the study will contribute to the diagnosis and treatment processes of patients with β-thalassemia major in areas of expertise such as craniofacial surgery, orthodontics, and hemato-oncology.
Accuracy of deep learning-based upper airway segmentation
(Elsevier, 2025) Süküt, Yağızalp; Yurdakurban, Ebru; Duran, Gökhan Serhat
Introduction: In orthodontic treatments, accurately assessing the upper airway volume and morphology is essential for proper diagnosis and planning. Cone beam computed tomography (CBCT) is used for assessing upper airway volume through manual, semi-automatic, and automatic airway segmentation methods. This study evaluates upper airway segmentation accuracy by comparing the results of an automatic model and a semi-automatic method against the gold standard manual method. Materials and methods: An automatic segmentation model was trained using the MONAI Label framework to segment the upper airway from CBCT images. An open-source program, ITK-SNAP, was used for semi-automatic segmentation. The accuracy of both methods was evaluated against manual segmentations. Evaluation metrics included Dice Similarity Coefficient (DSC), Precision, Recall, 95% Hausdorff Distance (HD), and volumetric differences. Results: The automatic segmentation group averaged a DSC score of 0.915+0.041, while the semi-automatic group scored 0.940+0.021, indicating clinically acceptable accuracy for both methods. Analysis of the 95% HD revealed that semi-automatic segmentation (0.997+0.585) was more accurate and closer to manual segmentation than automatic segmentation (1.447+0.674). Volumetric comparisons revealed no statistically significant differences between automatic and manual segmentation for total, oropharyngeal, and velopharyngeal airway volumes. Similarly, no significant differences were noted between the semi-automatic and manual methods across these regions. Conclusion: It has been observed that both automatic and semi-automatic methods, which utilise opensource software, align effectively with manual segmentation. Implementing these methods can aid in decision-making by allowing faster and easier upper airway segmentation with comparable accuracy in orthodontic practice. (c) 2024 Elsevier Masson SAS. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

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