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Öğe Analysis of the effect of maxillary transverse deficiencies on permanent maxillary first molar rotations using 3D digital models(Bmc, 2025) Ozden, Samet; Cicek, OrhanAimThe aim of this study was to evaluate the permanent maxillary first molar rotation (PMMR) angles in cases of maxillary transverse skeletal deficiency (MTSD) and to compare them with a control group. Materials and methodsIn this study, which included a total of 88 patients (50 females, 38 males, with a mean age of 14.98 +/- 2.14 years), consisting of 66 patients with MTSD and 22 patients in the control group, four groups were divided: Group 1 (MTSD without molar crossbite), Group 2 (MTSD with bilateral molar crossbite), Group 3 (MTSD with unilateral (right-sided) molar crossbite), and Group 4 (Control Group). Skeletal deficiencies were evaluated by measuring the interjugular, jugale right (JR), and jugale left (JL) distances on posteroanterior cephalograms (PACs), while occlusal relationships were assessed using 3-dimensional (3D) intraoral models. PMMR angles were measured using the 3D Slicer software on 3D intraoral models with the Ricketts Molar-Cusp Reference Line and the midsagittal reference plane. Statistical significance was set at p < 0.05. ResultsThe PMMR angles and JR and JL distances of Group 2 were significantly higher, while the interjugular distance was found to be the lowest (p < 0.05). There was no significant difference in the PMMR angles between the Control group and Group 1 (p > 0.05), while the JR and JL distances were significantly smaller in the Control group (p < 0.05). In Group 3, on the crossbite side, both the PMMR and the JR and JL distances were significantly higher than on the non-crossbite side (p < 0.05). A significant positive correlation was found between PMMR angles and JR and JL distances (p < 0.05). ConclusionIt was concluded that (i) mesiopalatal PMMRs are observed in the MTSDs with molar crossbite, (ii) molars with normal molar occlusal relationships have normal PMMR angles even in the presence of MTSDs, and (iii) early detection of MTSD enables timely interventions, preventing treatment delays and improving occlusal outcomes, particularly in developing patients, thereby optimizing long-term orthodontic results. Clinical relevanceConsidering the differences in PMMR angles between MTSD patients with and without molar crossbite, these findings should be taken into account when designing expansion appliances to achieve molar derotation in these patients.Öğe Assessment of the Mandibular Osseous Architecture in Cleft Lip and Palate Using Fractal Dimension Analysis: A Pilot Study(Mdpi, 2024) Ozden, Samet; Cicek, OrhanBackground/Objectives: Although there has been extensive research on the orofacial morphologic effects of cleft lip and palate (CLP), the effects of CLP on mandibular structures remain largely unknown. The aim of this study was to investigate the trabeculation differences in the mandibular osseous architecture of patients with bilateral CLP (BCLP) and left-sided unilateral CLP (UCLP) using fractal dimension (FD) analysis and to compare these findings with healthy controls without CLP. Methods: A total of 63 patients (27 females, 36 males) with a mean age of 9.69 +/- 1.5 years in the pre-peak growth stage were divided into three groups (n = 21 per group): the control group (CG), the BCLP group, and the UCLP group. The FD analysis was conducted on selected regions of interest (ROIs) from the mandibular condyle, angulus, corpus, and coronoid areas in TIFF-formatted panoramic radiographs. Statistical analyses were performed using the paired t-test and ANOVA for parametric data, and the Wilcoxon and Kruskal-Wallis tests for nonparametric data. Statistical significance was set at p < 0.05. Results: The FD values obtained from the ROIs of the right condyle were found to be significantly lower in the BCLP group compared to the CG and UCLP groups (p < 0.05). Conversely, the FD values for the left condyle were significantly higher in the CG group (p < 0.05), while no significant differences were observed between the BCLP and UCLP groups (p > 0.05). The FD value of the left condyle in the UCLP group was found to be significantly lower than that of the right condyle (p < 0.05). In the CG group, the FD values for both the right and left mandibular condyle and corpus were significantly higher than those for the angulus and coronoid regions; in the UCLP group, only the FD values of the right mandibular condyle and corpus were significantly higher than those for the same regions (p < 0.05). Conclusions: The reduced FD values in the mandibular condyle of CLP patients during the pre-peak growth stage suggest a loss of trabeculation and lower metabolic activity, while similarly, reduced FD values in the corpus region contribute to delayed tooth eruption timing, likely due to decreased masticatory forces during the intercuspal position and altered occlusal relationships. Clinical Relevance: In treating CLP patients, particularly with orthopedic face masks, the reduction in metabolic activities in these areas should be considered to achieve the optimal mandibular growth and development, and dental eruptions during the distribution of force from the chin to the corpus and condyle.Öğe Automated deep learning detection of orthodontically induced external apical root resorption in maxillary incisors on panoramic radiographs(Springer, 2026) Ozden, Samet; Kula, Betul; Tankus, MahmutObjectivesThis study aimed to develop and compare two YOLOv12-based deep learning models-object detection and pose estimation-for the automatic classification of orthodontically induced external apical root resorption (OIEARR) using panoramic radiographs.Materials and methodsA total of 624 panoramic radiographs obtained from 312 patients aged 10-18 who underwent at least 12 months of fixed orthodontic treatment were retrospectively analyzed. Each maxillary central and lateral incisor was graded for OIEARR severity on a 4-point scale (Grade 0 to Grade 3) by two experienced orthodontists serving as the ground truth. Two YOLOv12-based models were trained: an object detection (OD) model for regional analysis and a pose estimation (PE) model for anatomical landmark localization. Both models were trained and validated on annotated panoramic images and evaluated using accuracy, precision, recall, specificity, F1-score, confusion matrix, and ROC-AUC.ResultsThe PE model outperformed the OD model across all evaluation metrics, demonstrating superior performance in detecting OIEARR. Specifically, the PE model achieved a weighted F1-score of 0.88, compared to 0.60 for the OD model. It also showed higher accuracy (0.93 vs. 0.78), precision (0.88 vs. 0.64), and recall (0.88 vs. 0.59), confirming its robustness in root resorption classification. Particularly in Grade 1 and Grade 2 resorption categories, the PE model demonstrated markedly superior classification performance (F1 = 0.85 and 0.88, respectively), while maintaining excellent detection in Grade 3 cases (F1 = 0.95). Confusion matrix analysis revealed that most misclassifications occurred between neighboring grades. ROC-AUC values for the PE model were consistently high (0.90-0.99), indicating strong discriminative ability across all resorption stages.ConclusionsThe YOLOv12x PE model offers a reliable and sensitive tool for detecting varying degrees of root resorption on panoramic radiographs. Its fine-grained anatomical localization capabilities provide an advantage for early diagnosis, making it a promising approach for clinical decision support in orthodontics.Öğe Comparison of a novel 3-dimensional-printed attachment transfer method with conventional methods in clear aligner therapy: An in vitro study(Mosby-Elsevier, 2026) Bor, Sabahattin; Ozden, SametIntroduction: This study aimed to compare the accuracy of a novel 3-dimensional (3D)-printed attachment transfer technique with conventional composite-based methods, evaluating the effect of template and thickness. Methods: Three transfer methods were investigated: nonflowable composite resin, flowable composite resin, and 3D-printed attachments with a transfer carrier. In the conventional attachment method, 4 different thermoplastic template sheet thicknesses were used: 0.3, 0.5, 0.75, and 0.8 mm. dardized reference model with 6 digitally planned attachments was used for all groups. Using each method, tachments were transferred to 3D-printed dental models, which were then scanned and superimposed reference model. Root mean square and mean distance values were calculated using CloudCompare software (version 2.14; www.danielgm.net/cc/) for surface deviation analysis. Results: Statistically significant ences were observed among the attachment transfer methods (P <0.001, Kruskal-Wallis test). The printed attachment group exhibited the highest geometric accuracy across all evaluated sites. Pairwise comparisons showed that the 3D-printed group performed significantly better than both composite groups (P <0.001, Dunn's test). Composite viscosity showed no significant effect on transfer accuracy, except for attachments 16 and 23 in mean distance values (P = 0.023-0.031) and attachment 16 mean square values (P = 0.043). Template thickness significantly influenced transfer accuracy, with aligners generally producing lower deviation values, particularly between Tristar (0.3 mm) and Track mm) (P <0.05 to P <0.001). Conclusions: The 3D-printed attachment transfer method demonstrated superior accuracy than conventional composite-based methods. Although the thinnest template exhibited deviations, accuracy varied among the different templates, suggesting that both material thickness composition may influence transfer performance. Composite viscosity did not substantially affect accuracy, as both flowable and nonflowable composite resins produced comparable results in attachment sites.Öğe Deep Learning Based Evaluation of Skeletal Maturation: A Comparative Analysis of Five Hand-Wrist Methods(Wiley, 2025) Tentas, Serhat; Ozden, SametObjectiveThe study aims to evaluate the effectiveness of deep learning algorithms in skeletal age estimation by comparing the diagnostic reliability of five different hand-wrist maturation (HWM) assessment methods.Materials and MethodsA total of 6572 hand-wrist radiographs from orthodontic patients aged 8-16 years were retrospectively analysed. Radiographs were categorised into five groups based on HWM classification methods: (I) Bj & ouml;rk's nine-stage, (II) H & auml;gg and Taranger's five-stage, (III) Chapman's four-stage, (IV) three-stage hook of hamate ossification based and (V) simplified three-stage Bj & ouml;rk's classification based. YOLOv8x-based deep learning models were trained separately for each group. The dataset was split into training, validation and test subsets. Performance was evaluated using accuracy, precision, recall, F1 score and AUC metrics.ResultsThe YOLOv8x-cls model demonstrated high classification performance across all five groups. Group IV and Group II achieved the highest accuracy and F1 scores, with average F1 values of 0.99 and 0.96, respectively. Group III and Group V also showed strong performance (F1 = 0.93 and 0.92). In Group I, slightly lower classification performance was observed in the S-H2 and MP3-Cap stages (F1 = 0.72-0.74), which correspond to the pubertal growth peak, while early and late skeletal maturation stages were classified with high accuracy and F1 scores. ROC curve analysis further supported these findings, with AUC values for MP3-Cap and S-H2 recorded as 0.70 and 0.75, respectively, whereas higher AUC values were achieved in most other stages across all groups.ConclusionDeep learning models proved effective in evaluating skeletal maturation across five different HWM methods. Particularly high performance was observed in anatomically distinct regions such as the MP3, adductor sesamoid and hamate bone, which can be reliably identified by general dentists, enabling earlier referrals and timely orthodontic interventions.Öğe Distalization Methods for Maxillary Molars Utilizing Temporary Anchorage Devices (TADs): A Narrative Review(Mdpi, 2024) Oguz, Firat; Ozden, Samet; Cicek, OrhanClass II malocclusions, characterized by the mesial positioning of the maxillary molars relative to the mandibular molars, are among the most frequently encountered orthodontic issues. One of the widely adopted non-extraction approaches for addressing this malocclusion is maxillary molar distalization, which has been utilized for decades to create space within the dental arch. Historically, extraoral appliances such as headgear were commonly employed. However, with technological advancements, intraoral distalization devices, particularly those incorporating temporary anchorage devices (TADs), have gained prominence due to their compact size, not being visible externally, and improved patient acceptance. These appliances offer significant advantages, including being less invasive compared with extraction-based camouflage treatments, being more readily accepted by patients due to the absence of extraction spaces, and not requiring the complex biomechanical principles involved in extraction-based methods. TADs have revolutionized distalization techniques by providing superior anchorage control, reducing treatment duration, and offering a straightforward, patient-friendly application. The purpose of this comprehensive narrative review is to focus specifically on intraoral distalization techniques utilizing TADs, summarizing their efficacy and outcomes in the management of Class II malocclusions as reported in clinical studies over the past three decades.Öğe Evaluation of bone area in the posterior region for mandibular molar distalization in class I and class III patients(Springer Heidelberg, 2023) Ozden, Samet; Uslu, Filiz; Dedeoglu, NumanObjectivesThe aim of this study was to investigate the bone area in the posterior region, which is important for mandibular molar distalization in skeletal class I and class III individuals with normodivergent and hyperdivergent vertical growth patterns.Materials and methodsIn this retrospective study, cone-beam computed tomography (CBCT) scans of 120 individuals divided into 4 groups as class I normodivergent (group-I), class I hyperdivergent (group-II), class III normodivergent (group-III), and class III hyperdivergent (group-IV). Retromolar area at crown level measurements was performed on CBCT-derived panoramic radiographs and axial sections. Retromolar area at the root level was measured 2 mm, 4 mm, 6 mm, 8 mm, and 10 mm apical to cemento-enamel junction at CBCT axial sections.ResultsRetromolar area decreased towards the root apex in all groups and smallest retromolar area was level of CEJ(10mm) in all groups. At any root level, the distal root of the mandibular second molar tooth was in contact with the mandibular inner or outer lingual cortex; 50% in group-I, 46.7% in group-II, 23% in group-III, and 23% in group-IV.ConclusionsIn normodivergent individuals, the retromolar area length at the root level is observed to be higher in class III than in class I at almost every level. In hyperdivergent individuals, on the other hand, only at CEJ(10mm) level, it is higher in length in class III than in class I. Vertical growth pattern has no effect on the root and crown level retromolar area in class I and class III individuals.Öğe Evaluation of the Effects of Different Orthodontic Wire Material Compositions and Cross-Sectional Forms on In Vitro Streptococcus mutans Adhesion(Bilimsel Tip Yayinevi, 2026) Ozden, Samet; Tanriverdi, Elif Seren; Korkmaz, Merve KilicerIntroduction: The present in vitro study was conducted to evaluate the effects of different orthodontic wire materials and cross-sectional geometries on Streptococcus mutans biofilm formation and bacterial viability. Materials and Methods: The study examined three distinct wire materials: Stainless steel (SS), nickel-titanium (NiTi), and copper containing nickel-titanium (Cu-NiTi). Each material was prepared in two cross-sectional forms: round (0.016 '') and rectangular (0.016 '' & times; 0.022 ''). Twelve samples from each group were incubated with S. mutans ATCC 25175 strain at 37 degrees C and 5% CO2 for 24 hours. The measurement of biofilm biomass was conducted by means of crystal violet staining at OD570. The assessment of bacterial viability was conducted through the quantification of colony-forming units (CFU/mL) following a process of vortex-ultrasonication separation. The subsequent analysis of the data was conducted using two-way analysis of variance (Robust analysis of variance) and Holm-corrected post-hoc tests. The level of statistical significance was set at p< 0.05. Results: The composition of the wire material and the cross-sectional shape of the wire exhibited a significant impact on the accumulation of biofilm and bacterial adhesion (p< 0.001). Rectangular cross-section NiTi wires demonstrated the highest OD570 and CFU values, while Cu-NiTi (both cross-sections) and round cross-section SS wires exhibited the lowest bacterial loads (p< 0.001). A higher degree of biofilm accumulation was observed in rectangular cross-section wires compared to round cross-section wires (p< 0.001). Conclusion: The composition and geometry of the wire material jointly affect bacterial adhesion on orthodontic arch wires. In addition, Cu-NiTi wires demonstrated a reduced tendency for biofilm accumulation, an outcome that can be attributed to the inherent antimicrobial properties of copper. The findings emphasize the significance of material selection and wire design in minimizing microbial colonization during orthodontic treatment.Öğe Finite element analysis of maxillary arch distalization using skeletal anchorage at three different application regions(Nature Portfolio, 2025) Oguz, Firat; Ozden, SametThis study aimed to evaluate total maxillary arch distalization using three different skeletal anchorage systems-Mini Screw-Assisted Kele & scedil; Slider (MKS), infrazygomatic crest (IZC) screw, and maxillary tuberosity (MT) screw-through finite element analysis (FEA). A 3D cranio-maxillary model including dentition, periodontal ligament, and alveolar bone was constructed. For the MKS and IZC groups, forces were applied at three vertical heights (0 mm, 3 mm, and 6 mm apically), while the MT group involved three directional applications: buccal, palatal, and combined bucco-palatal. This design yielded nine distinct simulation scenarios. Tooth movements were assessed along the x (transverse), y (sagittal), and z (vertical) axes, and Von Mises stress distributions were analyzed in surrounding structures. In the MKS group, the first scenario showed the greatest molar crown displacement, while the third had the highest root-level movement. The ninth MT scenario yielded the most palatal crown displacement of incisors, while the sixth IZC scenario showed the greatest root movement. Apical force applications (MKS and IZC at 3-6 mm) allowed controlled displacement suited for Class II Division 2 malocclusions. In contrast, archwire-level and MT scenarios produced patterns favorable for Class II Division 1 cases. Anchorage type and force direction significantly affected distalization outcomes.Öğe Reconstruction of Oronasal Fistulas with Multiple Techniques: A Case Series Including an Orthodontic Appliance-Induced Defect(Springer India, 2026) Ciftci, Sezai; Cetiner, Yunus; Ozden, SametPurpose To assess the effectiveness of various surgical techniques for repairing oronasal fistulas (ONFs) and to present clinical cases utilizing multilayer closure and tongue flap combinations. Materials Four ONF patients underwent different repairs: three-layer closure for an orthodontic appliance-induced fistula, double palatal flap with buccal fat pad for a congenital fistula, anteriorly based tongue flap for a recurrent fistula, and autogenous bone grafting with flap reconstruction for dual fistulas. Results Complete closure was achieved in three patients (75%), with one small asymptomatic residual fistula. No major complications were observed during 6-12 months of follow-up. The appliance-induced fistula appears to be the first reported case linked directly to orthodontic devices. Conclusion ONF repair remains complex, with outcomes influenced by defect size and tissue quality. Local flaps are adequate for small defects, whereas larger or recurrent cases benefit from advanced reconstructive methods. Long-term orthodontic appliance use may increase fistula risk, highlighting the need for close monitoring.Öğe Relationship between maxillary sinus volume and alveolar trabeculation at orthodontic mini-implant sites across vertical skeletal patterns: a cross-sectional CBCT analysis(Bmc, 2025) Ozden, Samet; Cicek, Orhan; Sobi, ElifBackground This study aimed to evaluate the relationship between maxillary sinus volume (MSV) and alveolar bone trabeculation using fractal dimension (FD) analysis across different vertical skeletal patterns, and to assess its potential implications for orthodontic mini-implant (OMI) stability. Methods CBCT images of 84 skeletal Class I individuals (47 females, 37 males; mean age 20.08 +/- 2.25 years) were analyzed and categorized into three vertical skeletal groups (28 normodivergent, 28 hyperdivergent, 28 hypodivergent). MSVs were measured bilaterally using 3D Slicer, and FD analyses were conducted on alveolar bone regions of interest (ROIs) located between the roots of teeth #14-15, #15-16, #16-17, and #24-25, #25-26, #26-27. MSV and FD values were analyzed within and between groups using one-way ANOVA, Kruskal-Wallis test, paired t-tests, Wilcoxon signed-rank tests, and Spearman's correlation test at a significance level of p < 0.05. The effects on OMI stability were then evaluated. Results Both right and left MSVs, as well as FD values in the ROIs between teeth #14-15, #15-16, #24-25, and #25-26, were found to be significantly higher in hypodivergent individuals. The posterior increase in FD values was significant only in the normodivergent group. In hypodivergent individuals, right MSVs were significantly correlated with FD values at the 14-15 ROI, and left MSVs with those at the 24-25 ROI, while no such correlation was found in other vertical patterns. Conclusions In hypodivergent individuals, increased trabecular complexity between the maxillary second premolar and first molar may enhance OMI stability; however, the MSV, which correlates significantly with FD values in this region, necessitates caution due to the potential risk of sinus perforation during insertion.Öğe Three-Dimensional Evaluation of TMJ Morphology in Individuals with Maxillary or Mandibular Impacted Canines: A CBCT-Based Retrospective Study(Mdpi, 2026) Oguz, Firat; Ozden, SametBackground/Objectives: This study aimed to evaluate temporomandibular joint (TMJ) morphology in individuals with impacted maxillary and mandibular canine teeth using cone beam computed tomography (CBCT) and to compare the findings with those of a control group without impacted canines. Methods: A total of 80 individuals were included in this retrospective study. Based on CBCT images, participants were divided into three groups: the impacted maxillary canine group (n = 30), impacted mandibular canine group (n = 20), and control group (n = 30). CBCT images were oriented in the 3D Slicer software according to the Frankfurt Horizontal plane and the midsagittal reference line. Condylar width, length, position, angular parameters, joint spaces, and condylar volume were measured. Appropriate parametric and non-parametric statistical tests were used for intergroup comparisons. Results: The control group exhibited significantly higher values of condylar width, coronal condylar position and angle, certain joint spaces, and condylar volume compared with both impacted maxillary and mandibular canine groups (p < 0.05). In particular, significant differences were observed for condylar width (p <= 0.002) (Control: 19.76 +/- 2.09 mm, Maxillary: 17.92 +/- 2.14 mm, Mandibular: 17.76 +/- 1.64 mm), coronal condylar position (p < 0.001) (Control: 7.50 +/- 1.34 mm, Maxillary: 6.02 +/- 0.89 mm, Mandibular: 6.30 +/- 0.83 mm), coronal condylar angle (p < 0.001) (Control: 25.09 degrees +/- 4.40, Maxillary: 28.80 degrees +/- 3.70, Mandibular: 33.37 degrees +/- 4.10), and condylar volume (p < 0.001) (Control: 1755.87 +/- 357.32 mm(3), Maxillary: 1337.18 +/- 302.65 mm(3), Mandibular: 1252.71 +/- 369.24 mm(3)). No significant differences were found between the impacted maxillary and mandibular canine groups for most parameters (p > 0.05). Right-left side comparisons demonstrated that bilateral symmetry was largely preserved, except for condylar volume (p > 0.05). Conclusions: The presence of impacted canines may influence TMJ morphology, particularly at the level of condylar morphometry and joint spaces. Therefore, considering TMJ morphology in addition to local dental factors when evaluating impacted canines may provide a more comprehensive approach to orthodontic diagnosis and treatment planning.Öğe Treatment of a class III patient with maxillary retrognathia and amelogenesis imperfecta using a surgery-only orthognathic approach(Elsevier, 2025) Ciftci, Sezai; Simsek, Mehmet Sait; Ozden, SametAmelogenesis imperfecta (AI) is a rare disorder characterized by structural irregularities of enamel and may be associated with various oral-craniofacial features. The compromised surface of the teeth creates an unsuitable area for the application of orthodontic appliances. The aim of this study is to present the prosthetic rehabilitation of an 18-year-old male patient diagnosed with amelogenesis imperfecta and skeletal Class III malocclusion due to maxillary retrognathia, following a surgery-only approach (SOA) with virtually planned Le Fort I and bilateral sagittal split ramus osteotomies (BSSRO). (c) 2025 Elsevier Masson SAS. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
