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Updated: Jan 31, 2026

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Practice-based comparison of direct and indirect bonding.

S Thomas Deahl1, Norman Salome, John P Hatch

  • 1Institute for Natural Resources and Biomed General Corporation, Concord, Calif, USA. deahl@uthscsa.edu

American Journal of Orthodontics and Dentofacial Orthopedics : Official Publication of the American Association of Orthodontists, Its Constituent Societies, and the American Board of Orthodontics
|December 11, 2007
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Summary

Direct and indirect bracket bonding show similar success rates in private orthodontic practices. This study found no significant differences in bond failures, treatment duration, or appointment frequency between the two methods.

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Area of Science:

  • Orthodontics
  • Dental Materials Science

Background:

  • Direct and indirect bracket bonding are common orthodontic techniques.
  • Assessing their comparative clinical outcomes is crucial for practice management.

Purpose of the Study:

  • To compare bond failure rates between direct and indirect bracket bonding.
  • To evaluate differences in treatment time and number of appointments for both techniques.

Main Methods:

  • A practice-based study involving 11 orthodontic offices and 1,368 patients.
  • Data collected on bond failures, treatment duration, and visit frequency from 29,963 brackets.
  • Comparison between direct bonding (772 patients) and indirect bonding (596 patients).

Main Results:

  • Per-patient debond prevalence was comparable: 1.17% for direct vs. 1.21% for indirect bonding (P = .225).
  • Mean treatment time was similar: 750 days (direct) vs. 745 days (indirect) (P = .691).
  • Mean number of visits was also similar: 22.0 (direct) vs. 22.2 (indirect) (P = .653).

Conclusions:

  • No significant difference in bond failure rates between direct and indirect bonding techniques.
  • Treatment duration and the number of appointments required did not differ between the two methods.
  • Findings support the interchangeability of direct and indirect bonding in clinical orthodontic settings.