Direct versus fully digital indirect bracket bonding: a split-mouth randomized clinical trial on accuracy.

Area of Science:

• Orthodontics
• Digital Dentistry
• Biomaterials

Background:

• Conventional direct bracket bonding (DBB) is the standard in orthodontics.
• Digital indirect bracket bonding (IDB) offers a potentially more accurate alternative.
• Assessing the comparative accuracy and clinical outcomes of IDB versus DBB is crucial for advancing orthodontic treatment.

Purpose of the Study:

• To compare the accuracy of bracket positioning between digital indirect bracket bonding (IDB) and conventional direct bracket bonding (DBB).
• To evaluate differences in bracket bonding failures, need for repositioning, clinician experience, and patient satisfaction between the two techniques.

Main Methods:

• A prospective split-mouth randomized clinical trial involving 35 patients with a six-month follow-up.
• Quantitative assessment of translational and orientational deviations from planned bracket positions.
• Evaluation of clinician experience and patient satisfaction through surveys.

Main Results:

• Digital indirect bracket bonding (IDB) demonstrated significantly smaller translational (0.34 mm) and orientational (4.80°) deviations compared to direct bracket bonding (DBB).
• IDB exhibited higher rates of immediate (3.9%) and late (5.4%) bonding failures than DBB (0% immediate, 2.5% late).
• Both clinicians and patients reported shorter clinical chair time with IDB compared to DBB.

Conclusions:

• Digital indirect bracket bonding (IDB) provides superior accuracy in orthodontic bracket positioning relative to digital planning compared to direct bracket bonding (DBB).
• Despite increased bonding failures, IDB is preferred by most patients due to significantly reduced clinical chair time.
• This study provides valuable evidence for the application of IDB in clinical orthodontics, highlighting its benefits for patient satisfaction and acknowledging its technical limitations.