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Usefulness of an artificial intelligence-assisted indirect bonding method for optimizing orthodontic bracket

Petra C Bachour, Robert T Klabunde, Thorsten Grünheid

The Angle Orthodontist

|September 27, 2025

Summary

Artificial intelligence (AI)-assisted digital indirect bonding (IDB) shows accuracy comparable to traditional IDB in linear bracket positioning. While AI-enhanced digital methods improve bracket tip accuracy, clinicians can adopt them without compromising overall positioning.

Keywords:

3D technologies Accuracy Artificial intelligence Digital workflow Indirect bonding

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Area of Science:

Orthodontics
Dental Technology
Artificial Intelligence in Medicine

Background:

Indirect bonding (IDB) is a crucial orthodontic technique for precise bracket placement.
Traditional IDB methods have limitations in accuracy, particularly concerning bracket angulation.
Artificial intelligence (AI) offers potential for enhancing digital workflows in orthodontics.

Purpose of the Study:

To compare the bracket positioning accuracy between traditional and AI-assisted digital indirect bonding (IDB) methods.
To evaluate the effectiveness of AI in optimizing orthodontic bracket positioning.
To assess the clinical utility of AI-assisted digital IDB for orthodontists.

Main Methods:

Twenty-five clinicians performed bracket positioning using both traditional and AI-assisted digital IDB.
Bracket positioning accuracy was quantified via digital superimposition and compared to an optimal setup.
Statistical analysis, including one-tailed t-tests, evaluated differences against predefined accuracy limits (0.5 mm linear, 2° tip).

Main Results:

Both methods achieved mean linear bracket positioning differences below the 0.5 mm limit (0.28 mm mesial-distal, 0.32 mm occlusal-gingival).
Tip angulation differences averaged 3.4°, exceeding the 2° limit, with the digital method showing higher accuracy.
Statistically significant differences were observed for tip positioning compared to the optimal setup for both methods, but not for linear dimensions.

Conclusions:

Traditional and AI-assisted digital IDB methods offer comparable accuracy in linear bracket positioning.
AI shows promise for enhancing bracket angulation accuracy in digital IDB workflows.
Clinicians using traditional IDB can transition to AI-assisted digital IDB without compromising bracket positioning accuracy.