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Effectiveness, efficiency and adverse effects of using direct or indirect bonding technique in orthodontic patients: a systematic review and meta-analysis.

ABSTRACT: BACKGROUND:The direct and indirect bonding techniques are commonly used in orthodontic treatment. The differences of the two techniques deserve evidence-based study. MATERIALS AND METHODS:Randomized controlled trials (RCTs), wherein direct and indirect bonding techniques were used in orthodontic patients were considered. The MEDLINE, EMBASE, CENTRAL and Web of Science databases were searched to identify relevant articles published up to December 2018. Grey literature was also searched. Two authors performed data extraction independently and in duplicate using the data collection form. The included trials were assessed using the Cochrane risk of bias assessment tool. RESULTS:Of the 1557 studies screened, 42 full articles were scrutinized and assessed for eligibility. Eight RCTs (247 participants) were finally included for the analyses. The qualitative synthesis showed that no significant difference existed in the accuracy of bracket placement and oral hygiene status between the two bonding techniques. The indirect bonding was found to involve less chairside time but more total working time compared with the direct bonding. The meta-analysis on bond failure rate demonstrated no significant difference between the direct and indirect bonding (RR?=?1.13, 95% CI?=?0.78-1.64, I2 =?22%, P?=?0.50). Consistent results were obtained in the subgroup analyses and sensitivity analyses. CONCLUSION:Weak evidence suggested that the direct and indirect bonding techniques had no significant difference in bracket placement accuracy, oral hygiene status and bond failure rate, for bonding orthodontic brackets. The indirect bonding might require less chairside time but more total working time in comparison with the direct bonding technique. High-quality well-designed randomized controlled trials are needed before a conclusive recommendation could be made.

SUBMITTER: Li Y

PROVIDER: S-EPMC6615229 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Effectiveness, efficiency and adverse effects of using direct or indirect bonding technique in orthodontic patients: a systematic review and meta-analysis.

Li Yanxi Y Mei Li L Wei Jieya J Yan Xinyu X Zhang Xu X Zheng Wei W Li Yu Y

BMC oral health 20190708 1

<h4>Background</h4>The direct and indirect bonding techniques are commonly used in orthodontic treatment. The differences of the two techniques deserve evidence-based study.<h4>Materials and methods</h4>Randomized controlled trials (RCTs), wherein direct and indirect bonding techniques were used in orthodontic patients were considered. The MEDLINE, EMBASE, CENTRAL and Web of Science databases were searched to identify relevant articles published up to December 2018. Grey literature was also sear ...[more]

PMID: 31286897

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Project description:BackgroundFor 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.MethodsThis 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.ResultsAlthough there were obvious positional discrepancies between several readings, they were still within clinically acceptable ranges.ConclusionsAll 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.

Dataset Information

Effectiveness, efficiency and adverse effects of using direct or indirect bonding technique in orthodontic patients: a systematic review and meta-analysis.

Publications

Effectiveness, efficiency and adverse effects of using direct or indirect bonding technique in orthodontic patients: a systematic review and meta-analysis.

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