Three-dimensional evaluation of the transfer accuracy of a bracket jig fabricated using computer-aided design and manufacturing to the anterior dentition: An in vitro study

Comparison of 1- and 3-piece directly 3-dimensional printed indirect bonding trays: An in vitro study

INTRODUCTION

This study aimed to compare the transfer accuracy of indirect bonding trays of different thicknesses and numbers of pieces.

METHODS

Digital indirect bonding was performed on 56 printed resin models, divided into 4 groups with 14 models in each: 1-mm 1-piece tray (OPT), 2-mm OPT, 1-mm 3-piece tray (TPT), and 2-mm TPT. The trays were designed using Appliance Designer (3Shape A/S, Copenhagen, Denmark). Angular (torque, tip, or angulation) and linear (mesiodistal, buccolingual, occlusogingival, or vertical) differences were compared by using open-source GOM Inspect software (GOM GmbH, Braunschweig, Germany).

RESULTS

In the buccolingual direction, the 1-mm TPT (0.180 ± 0.041 mm) was significantly more accurate than the 1-mm OPT (0.240 ± 0.032 mm). In the vertical direction, significant differences were seen between the 1-mm and 2-mm OPTs (1-mm OPT: 0.220 ± 0.043 mm; 2-mm OPT: 0.428 ± 0.143 mm; P = 0.003) and between the 1-mm and 2-mm TPTs (1-mm TPT: 0.210 ± 0.072 mm; 2-mm TPT: 0.340 ± 0.062 mm; P = 0.004) in the total region. In the tip angle, significant differences were seen between the 1-mm and 2-mm OPTs and between the 1-mm OPT and TPT. In the torque angle, a significant difference was seen between the 1-mm TPT (2.815°±0.350°)and 2-mmTPT (2.368° ± 0.245°; P = 0.017).

CONCLUSIONS

Both the thickness and the splitting of the trays impacted the bracket bonding accuracy. The 1-mm trays were more accurate than the 2-mm trays. Despite a few statistically significant differences between the 1-mm OPT and TPT, the 1-mm OPT was recommended for clinical use, considering the designing and placing of the trays.

Comparison of the accuracy of two techniques for three-dimensional digital indirect bonding of orthodontic brackets: A randomized controlled trial

OBJECTIVE

This study aimed to clinically compare the accuracy of bracket positioning between three-dimensionally (3D) printed indirect bonding trays and vacuum-formed trays made over 3D-printed models.

MATERIAL AND METHODS

Fourteen patients, planned for fixed orthodontic therapy, were randomly divided into two equal groups. For both groups, both dental arches were scanned, to acquire virtual models, brackets were virtually positioned from central incisors to second premolars, and scans for the final bracket positions were performed. In the first group, transfer trays were 3D-printed. In the second group, virtual models were 3D-printed, and vacuum-formed soft sheets were thermoformed on the printed model. Teeth were indirectly bonded and then scanned. Superimposition of the virtual and the final bracket positioning scans was performed to measure linear and angular deviations in brackets positions.

RESULTS

The first group showed significantly less occlusogingival and buccolingual linear errors than the second group. No significant differences in angular deviations were found between both groups. The frequencies of clinically acceptable linear errors within 0.5 mm and angular errors within 2° showed no statistically significant difference between both groups (p> 0.05 for all measurements). The transfer errors in both groups showed linear directional biases toward the mesial, gingival and labial directions. There was no statistically significant difference in the rate of immediate debonding between both groups (10.7% and 7.1% for the first and the second groups, respectively, p=0.295).

CONCLUSIONS

3D-printed indirect bonding trays were more accurate than vacuum-formed trays, in terms of linear deviations. Both types of trays showed similar angular control.

Effect of fence tray matching care on excess adhesive and bracket placement accuracy for orthodontic bonding: an in vitro study

OBJECTIVE

This study aimed to evaluate the effect of fence tray matching care (FTMC) in bracket bonding by measuring excess adhesive, as well as linear and angular deviations, and by comparing it with the half-wrapped tray (HWT).

MATERIALS AND METHODS

An intraoral scanner was used to acquire data on the maxillary dental arch of a patient with periodontitis.Furthermore, 20 maxillary dental arch models were 3D printed. Using 3Shape, PlastyCAD software, and 3D printing technology, 10 FTMC (method I) and HWT (method II) were obtained. By preoperative preparation, intraoperative coordination, and postoperative measurement, the brackets were transferred from the trays to the 3D-printed maxillary dental arch models. Additionally, the bracket's excess adhesive as well as linear and angular deviations were measured, and the differences between the two methods were analyzed.

RESULTS

Excess adhesive was observed in both methods, with FTMC showing less adhesive (P< 0.001), with a statistical difference. Furthermore, HWT's vertical, tip and torque, which was significantly greater than FTMC (P< 0.05), with no statistical difference among other respects. The study data of incisors, canines, and premolars, showed that the premolars had more adhesive residue and were more likely to have linear and angular deviations.

CONCLUSIONS

The FTMC had higher bracket bonding effect in comparison to HWT, and the adhesive residue, linear and angular deviations are smaller. The fence tray offers an intuitive view of the precise bonding of the bracket, and can remove excess adhesive to prevent white spot lesions via care, providing a different bonding method for clinical applications.

Do the Various Indirect Bonding Techniques Provide the Same Accuracy for Orthodontic Bracket Placement? (Randomized Clinical Trial)

Background

For orthodontic treatment to be effective, bracket placement must be precise to make the finishing stage easier, leading to an ideal occlusion with minimal intervention. This study aimed to evaluate the accuracy of manual and digital bracket positioning techniques utilizing computer-aided design and computer-aided manufacturing (CAD/CAM) jigs, 3D-printed indirect bonding trays (IBT), and double-layer vacuum-formed thermoplastic IBT.

Methods

This study was done by scanning the dental arch of 30 orthodontic patients. The virtual setup and bracket positioning were performed with the Insignia™ system for ten patients, and 3D Maestro® software was used for the virtual setup of the remaining 20 patients. At the same time, the bracket positioning of 10 patients was done digitally by the 3D Maestro® software and the remaining 10 patients manually through the Ray Set® device. IBT were fabricated by CAD/CAM system, 3D printer, and vacuum-formed thermoplastic machine. A virtual bracket position was compared to the actual bracket position using the best-fit method of 3D digital superimposition in Geomagic® Control X™ (CX) software to determine how accurate it was in terms of linear and angular accuracy. Statistical analyses using SPSS 26.0 including Bland-Altman plots were used to assess the intra-examiner reproducibility. Shapiro-Wilk test was used to measure normality distribution. Wilcoxon matched-pairs signed rank test was used to analyze the differences between bracket positions within each group.

Results

Although there were obvious positional discrepancies between several readings, they were still within clinically acceptable ranges.

Conclusions

All types of IBT would translate the planned position of the bracket from the digital and manual techniques to the teeth of patients with accepted precision in both linear and angular measurements; in addition, the error rate is about the same for all types of IBT. This trial is registered with NCT05549089.

Accuracy of 3-dimensional-printed customized transfer tray using a flash-free adhesive system in digital indirect bonding: An in vivo study

INTRODUCTION

This paper evaluated the accuracy of a computer-aided design and manufacturing indirect bonding technique using a new customized 3D-printed transfer tray and a flash-free adhesive system for orthodontic bonding.

METHODS

This in vivo study analyzed 106 teeth selected from 9 patients undergoing orthodontic treatment. Quantitative deviation analysis was performed to evaluate the bonding positioning errors, assessing the differences between the virtually planned and the clinically transferred bracket position after indirect bonding procedures by superimposing 3-dimensional dental scans. Estimated marginal means were evaluated for individual brackets and tubes, arch sectors, and overall collected measurements.

RESULTS

A total of 86 brackets and 20 buccal tubes were analyzed. Among individual teeth, mandibular second molars showed the highest positioning errors, whereas maxillary incisors reported the lowest values. Considering arch sectors, the posterior areas showed greater displacements than the anterior areas, as the right side compared to the left side, with a higher error rate reported for the mandibular arch than the maxillary arch. The overall bonding inaccuracy measurement was 0.35 mm, below the clinical acceptability limit of 0.50 mm.

CONCLUSIONS

The accuracy of a 3-dimensional-printed customized transfer tray using a flash-free adhesive system in computer-aided design and manufacturing indirect bonding was generally high, with greater positioning errors for posterior teeth.

Transfer Accuracy of 3D-Printed Customized Devices in Digital Indirect Bonding: A Systematic Review and Meta-Analysis

Aim

To evaluate in vitro and in vivo the accuracy of 3D-printed customized transfer devices during indirect bonding technique (IBT).

Methods

A search for articles published in the English language until April 2022 was carried out using PubMed, Web of Science, Scopus, and Google Scholar databases and by applying a specific search strategy for each database to identify all potentially relevant in vivo or in vitro studies. After the removal of duplicate articles and data extraction according to the participants-intervention-comparison-outcome-study design schema scheme, the methodological quality of the included studies was assessed using the Swedish Council on Technology Assessment in Health Care Criteria for Grading Assessed Studies.

Results

The initial search identified 126 articles, 43 of which were selected by title and abstract. After full-text reading, 15 papers were selected for the qualitative analysis and seven studies for the quantitative analysis. The evidence quality for the selected studies was moderate.

Conclusions

Except for the bucco-lingual direction, the 3D-printed customized devices have a transfer accuracy within the clinically acceptable limits established by the American Board of Orthodontics. Therefore, 3D-printed transfer devices may be considered an accurate method for bonding position during IBT, both in vitro and in vivo. Additional randomized clinical studies in vivo should be suggested.

Clinical Study on Efficiency of Using Traditional Direct Bonding or OrthGuide Computer-Aided Indirect Bonding in Orthodontic Patients

Objective

This study aims to clinically investigate and compare the therapeutic effects and treatment cycle between traditional direct bonding and OrthGuide computer-aided indirect bonding in orthodontic treatment.

Methods

Forty patients treated at the Department of Orthodontics, Beijing Rytime Dental Hospital between July 1, 2016, and December 31, 2019, were included. The patients were divided into a control group (n = 20, traditional direct bonding) and a test group (n = 20, OrthGuide computer-aided indirect bonding). The American Board of Orthodontics (ABO) measurement was performed on patients using Uceph cephalometric analysis software to compare intragroup and intergroup differences, and the treatment cycles of all patients were recorded.

Results

After treatment, U1-NA (mm), ∠U1-SN (°), LL-EP (mm), and UL-EP (mm) in the control group were significantly lower than before treatment, and there was no significant difference in other ABO measurement indexes, while the test group showed no marked difference in all ABO measurements between pre- and posttreatment. Further, intergroup comparison showed no significant difference in ABO measurements in pre- and posttreatment between the two groups. The test group had a shorter treatment cycle than the control group, with an average treatment cycle of 21.20 ± 7.14 months in the control group and 17.17 ± 4.16 months in the test group.

Conclusion

There was no significant difference in the therapeutic effects between the direct and indirect bonding techniques. However, OrthGuide computer-assisted indirect bonding demonstrated a significantly shorter treatment cycle and might be more efficient than traditional direct bonding.

Clinical application of maxillary tissue bone-borne expander and biocreative reverse curve system in the orthodontic retreatment of severe anterior open bite with transverse discrepancy: A case report

Anterior open bite and transverse discrepancy are often accompanied by hyperdivergent skeletal patterns. In addition, degenerative joint disorders and vertical maxillary excess contribute to an unfavorable convex facial profile with a retruded chin. Correction of this complex three-dimensional problem with orthodontic treatment alone is considered challenging owing to anatomical limitations. Moreover, a history of orthodontic treatment with premolar extraction makes retreatment difficult. This case report illustrates the application of a maxillary tissue bone-borne expander and biocreative reverse curve system in a 23-year-old female patient with a severe anterior open bite and transverse discrepancy who underwent orthodontic treatment with four premolar extractions. By setting the treatment target under precise diagnosis and using appropriate appliances, a satisfactory treatment result could be achieved without orthognathic surgery.

Bracket Transfer Accuracy with the Indirect Bonding Technique-A Systematic Review and Meta-Analysis

Purpose: To investigate the bracket transfer accuracy of the indirect bonding technique (IDB). Methods: Systematic search of the literature was conducted in PubMed MEDLINE, Web of Science, Embase, and Scopus through November 2021. Selection Criteria: In vivo and ex vivo studies investigating bracket transfer accuracy by comparing the planned and achieved bracket positions using the IDB technique were considered. Information concerning patients, samples, and applied methodology was collected. Measured mean transfer errors (MTE) for angular and linear directions were extracted. Risk of bias (RoB) in the studies was assessed using a tailored RoB tool. Meta-analysis of ex vivo studies was performed for overall linear and angular bracket transfer accuracy and for subgroup analyses by type of tray, tooth groups, jaw-related, side-related, and by assessment method. Results: A total of 16 studies met the eligibility criteria for this systematic review. The overall linear mean transfer errors (MTE) in mesiodistal, vertical and buccolingual direction were 0.08 mm (95% CI 0.05; 0.10), 0.09 mm (0.06; 0.11), 0.14 mm (0.10; 0.17), respectively. The overall angular mean transfer errors (MTE) regarding angulation, rotation, torque were 1.13° (0.75; 1.52), 0.93° (0.49; 1.37), and 1.11° (0.68; 1.53), respectively. Silicone trays showed the highest accuracy, followed by vacuum-formed trays and 3D printed trays. Subgroup analyses between tooth groups, right and left sides, and upper and lower jaw showed minor differences. Conclusions and implications: The overall accuracy of the indirect bonding technique can be considered clinically acceptable. Future studies should address the validation of the accuracy assessment methods used.