Filiz Uslu

Background: Pain is among the most frequently reported adverse effects of fixed orthodontic appliances. Self-ligating systems are promoted as offering reduced friction and more favorable early tooth movement, and the Damon Ultima system is additionally claimed to improve torque expression through a modified slot, but clinical evidence remains limited. Because each bracket system is used with its own archwire sequence, this study compared complete treatment systems rather than bracket design alone. Methods: Retrospective analysis of prospectively collected, routinely recorded clinical data from 44 consecutive patients (22 per group) treated with non-extraction fixed appliances between September 2023 and December 2024. The appliance system was selected by the patient and family rather than allocated at random. Pain was recorded at six time points from baseline to day 7 on a standardized departmental form using a 0–10 cm visual analog scale. Cephalometric and digital model analyses were performed at T0 (before treatment) and T1 (after the 20-week leveling-alignment phase). Mann-Whitney U tests, Friedman tests with Durbin-Conover post hoc comparisons, and independent samples t-tests were used, with Bonferroni, Benjamini-Hochberg, and Holm adjustments within three predefined families of tests. Results: Both groups showed a similar pain trajectory, peaking between 6 h and 2 days and declining by day 7. No baseline cephalometric or digital model variable differed between the groups. Only posterior biting at 2 h reached nominal significance ( p = 0.038; rank-biserial r = 0.368, 95% CI 0.041 to 0.624), which did not survive adjustment (Bonferroni-adjusted p = 0.676). Mandibular incisors proclined, overbite decreased and transverse arch dimensions increased significantly within both groups, except maxillary mesiopalatal intermolar width in the conventional group. No between-group comparison of T1-T0 change was significant (smallest unadjusted p = 0.113 and 0.120 in the cephalometric and digital model families); no effect size exceeded d = 0.49. Conclusions: No difference between the Damon Ultima and conventional MBT systems in early pain perception or dentoalveolar change survived adjustment for multiple comparisons. The study was not powered as an equivalence trial, however, so small-to-moderate differences cannot be excluded, and these data provide no evidence of an early clinical advantage for the newer system.

Objectives: This study aimed to evaluate impacted mandibular canines and adjacent dentoalveolar structures using cone beam computed tomography. Methods: Measurements were made on CBCT images of 54 impacted mandibular canines. Parameters such as the position of the canine teeth, follicle diameter, their relationship with the mental foramen and the incisive mandibular canal, resorption in the adjacent teeth, interpremolar and intermolar width, arch symmetry, and mesiodistal width of the canine teeth were investigated. Results: The resorption rate in adjacent permanent teeth was recorded as 14.8%. No statistically significant difference was found between the follicle size of the canine tooth and the resorption in the adjacent teeth (p > 0.05). Cortical bone perforation was found in 83.3% of individuals with impacted mandibular canines. Teeth in contact with the mental foramen and incisive mandibular canal were found in 11.1% and 6.5%, respectively. There was no statistically significant difference in the interpremolar and intermolar width on the impacted and non-impacted sides (p > 0.05). However, a significant difference was observed in the mesiodistal width of the canines and arch length on the impacted and non-impacted sides (p < 0.05). Conclusions: No correlation was found between root resorption in adjacent teeth and follicle size. Cortical bone perforations were observed in most impacted canines, and some were in contact with the mental foramen and the incisive mandibular canal. Although transversal arch widths were similar on the impacted and non-impacted sides, differences in arch length and mesiodistal widths may affect arch symmetry and should be considered in treatment planning.

Background: Adhesive systems are important for achieving reliable and durable bracket bonding in orthodontic treatments. The purpose of this study is to compare the outcomes of a new one-step orthodontic bonding system that combines the primer and adhesive solutions. Methods: In this study, four groups were formed, each consisting of 20 first premolar teeth. Acid etching was applied to all teeth for 30 s, except in Group II. Group I included teeth where a single layer of primer was applied using the Transbond XT system before bracket bonding. Group II consisted of teeth bonded with brackets after using a self-etching primer with the Transbond XT system. Group III used GC Ortho Connect, a single-step adhesive that incorporates the primer within the adhesive itself. Group IV, a single layer of primer was applied before bonding with GC Ortho Connect. Shear bond strength (SBS) was assessed using one-way ANOVA and the Tukey-HSD test, while Adhesive Remnant Index (ARI) scores were analyzed using the Chi-square test at a significance level of p < 0.05. Results: SBS measurements were recorded as 13.28 ± 2.15 MPa for Group I, 11.06 ± 2.26 MPa for Group II, 10.37 ± 1.92 MPa for Group III, and 16.02 ± 2.17 MPa for Group IV. Statistical analysis using the Tukey test revealed significant differences in SBS values between Groups II and IV, as well as Groups III and IV (p < 0.05). All groups showed clinically acceptable bond strength, with Group IV demonstrating superior adhesion. Additionally, the chi-square test indicated a statistically significant variation in the ARI scores across all four groups (p < 0.05). Conclusions: The adhesive performance of the one-step GC Ortho Connect system is clinically comparable to Transbond XT. However, primer application is necessary to achieve optimal bond strength.

Background: This study aimed to evaluate the long-term stability of maxillary molar distalization in the treatment of Class II malocclusion. Methods: This study included 40 patients (31 males and 9 females) who received fixed orthodontic treatment after maxillary molar distalization. Orthodontic models and lateral cephalograms were evaluated at three time points: pre-treatment (T1), after orthodontic treatment (T2), and long-term follow-up (T3). The mean ages of the patients’ ages at T1, T2, and T3 were 13.02, 15.97, and 22.05 years, respectively. The statistical analysis included paired t-tests and Wilcoxon signed-rank tests. The statistical significance was set at p < 0.05. Results: The statistical analysis indicated no gender-related differences. A significant distalization of maxillary first molars was observed at T2 compared to T1 (p < 0.001). Despite a minor relapse, a statistically significant distalization was observed in T3-T1 (p < 0.001). The vertical skeletal angles, which increased during the treatment period, decreased at T3-T2. The molar relationship was almost maintained after long-term follow-up (p < 0.001). Conclusions: The maxillary molar distalization achieved in the Class II treatment was maintained in the long term. The vertical skeletal measurements decreased to their initial values in the long term. The Class I molar relationship did not change during the completion of the growth. This study hypothesized that the maxillary molar distalization achieved during fixed orthodontic treatment can be maintained in the long term without significant relapse.

Objectives The 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 methods In 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. Results Retromolar 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. Conclusions In 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. Clinical relevance CBCT provides more useful information than panoramic radiographs for patients who are scheduled for large mandibular molar distalization.

Objectives The 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 Methods In this study, cone-beam computed tomography 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 space at crown level measurements were performed on CBCT-derived panoramic radiographs and axial sections. Retromolar space at the root level was measured 2mm, 4mm, 6mm, 8mm and 10mm apical to cemento-enamel junction at CBCT axial sections. Results Retromolar space decreased towards the root apex in all groups and smallest retromolar space 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, 7% in Group-III and 7% in Group-IV. Conclusions In 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 CEJ₁₀ 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 space in Class I and Class III individuals. Clinical Relevance CBCT provides more useful information than panoramic radiographs for patients who are scheduled for large mandibular molar distalization