Comparison of the accuracy of virtual and direct bonding of orthodontic accessories

Abstract

Introduction: Conventional direct and indirect bonding techniques fail to obtain the ideal bracket position. Objective: To compare the accuracy of virtual and conventional direct bonding of orthodontic accessories. Methods: A single virtual configuration (dental mannequin with Class I malocclusion) served as basis for generating the reference model (treated virtually) and the intervention models (10 digital models and 10 solid models, obtained by means of prototyping). A total of 560 teeth were then equally distributed between a group of orthodontists (Group I, direct bonding; and Group II, virtual bonding), working in two different time intervals. The individual positions of the accessories were measured after three-dimensional superimposition with customized software. The Student’s-t test for paired samples, and Chi-square tests were used for statistical analysis, both at the level of significance of 5%. Results: In comparison of the errors in raw values, there were significant differences only in the vertical (p< 0.001) and horizontal dimensions (p< 0.001). Considering the groups of ranges by clinical limits of the deviations, these differences were significant in the three dimensions, vertical (p< 0.001), horizontal (p= 0.044) and angular (p= 0.044). Conclusion: Virtual bonding made it possible to obtain more precise/accurate positioning of the orthodontic accessories. The potential accuracy of this method brings new perspectives to refining the indirect bonding protocols.

Orthodontic digital workflow: devices and clinical applications

“…Digital workflow for indirect bonding in Orthodontics features numerous advantages, including: lack of physical impressions, pouring gypsum cast and decreased laboratory working time. 16 , 17 , 26 …”

“…The advent of digital indirect bonding enables greater precision and standardization in bracket positioning, due to digital measuring tools, improved view and manipulation of virtual models. 16 , 19 Consequently, the digital bonding may reduce treatment duration and contribute to better occlusal relationships. 16 , 17 , 21 …”

“…The digital workflow for bonding fixed orthodontic appliance allows greater precision in the brackets placement 16 and reduces the laboratory time required for conventional indirect bonding. 17 In addition, it eliminates the adhesion impairments in the resin/adhesive interface.…”

Fusion of intra-oral scans in cone-beam computed tomography scans

“…Orthodontic virtual setups can be created and used to assess the accuracy of the treatment. [ 21 ] Digitally created indirect bonding trays can be used for optimal bracket placement and an enhancement of the workflow [ 22 ].…”

CAD/CAM-gestützte Planung und Übertragungsmöglichkeiten von Brackets und Gaumenimplantaten

“…Duarte et al konnten in einer in-vitro-Studie zeigen, dass weder die Berufserfahrung der Kieferorthopäden noch der Grad der Erfahrung mit dem indirekten Kleben mit gedruckten Klebeschablonen einen Einfluss auf die Genauigkeit des Bracket-Klebens im digitalen Workflow hatten[26]. In einer in-vitro-Untersuchung kommen Oliviera et al zu dem Schluss, dass das virtuelle Bonding eine genauere Positionierung der Brackets ermöglichen könnte[27]. Im Rahmen der computergestützten Planung ist weiterhin fraglich, ob die vom Computer berechnete Position genauer ist,▶abb.…”