Clinical Acceptability of Digital Indirect Bonding Compared to Direct Bonding by Varying Orthodontic Experience: Pilot Study

Abstract

This pilot study was a two-factor, in-vitro pilot study comparing the clinical acceptability of orthodontic bracket placement between digital indirect and direct bonding techniques and between participants with three levels of varying orthodontic experience (dental students, orthodontic residents, experienced orthodontists) using one intervention model. The percentage of clinically acceptable bracket positions within a ±0.5mm range of a reference model was measured and calculated. To determine associations between the bonding techniques and orthodontic experience, two-sample t-test and one-way ANOVA test (α = 0.05) were performed respectively. The tooth type where clinically unacceptable brackets were located was also identified. The results of this study suggest that, regardless of orthodontic experience, the percentage of clinically acceptable brackets placed was significantly higher when performed using the digital indirect bonding technique (74% vs. 39%, p=0.01). This trend was confirmed in each orthodontic experience group. When using the indirect bonding technique, orthodontic residents had the lowest percentage of acceptable brackets placed (52% vs. 81%,), while participants with no orthodontic experience had the highest percentage of acceptable brackets placed. Furthermore, all study participants had clinically unacceptable brackets placed on every maxillary second molars and all dental students and orthodontic residents had clinically unacceptable brackets placed on every maxillary first molars when using the direct bonding technique. Overall, this pilot study suggests that using the digital indirect bonding technique instead of the direct bonding technique can improve the clinical acceptability of brackets that are placed by experienced orthodontists, orthodontic residents, and staff.