Accuracy of bracket position using thermoplastic and 3D-printed indirect bonding trays

Abstract

Aim: The positional accuracy of bracket placement planned through tooth setup vs actual placement was evaluated by means of conventional thermoplastic indirect bonding trays and customized 3D-printed indirect bonding trays.

Materials and methods: A total of 280 bracket positions placed on the crowns of 10 dental plaster models were evaluated. The manual setup method and a thermoplastic indirect bonding tray were used for the manual group. For the CAD/CAM group, the bracket was positioned using a digital setup and a corresponding 3D-printed tray. The positional accuracy of the bracket placement on the duplicated gypsum model using the trays was evaluated by means of 3D software. Six errors of bracket position (height, depth, mesiodistal, torque, rotation, and tip errors), including linear and angular errors, were measured. Differences in variables were compared across subgroups using the independent t test or the Mann-Whitney U test.

Results: Only the height error differed significantly (P < 0.05) between groups (manual: 0.2 mm; CAD/CAM: 0.12 mm). For both incisors and molars, the manual group showed significantly greater height errors than the CAD/CAM group (P < 0.05). The analysis of variance of the position error to the whole bracket showed statistically significant differences between tooth positions, linear measurements, and angular measurements (P < 0.05).

Conclusion: A 3D-printed indirect bonding tray showed accuracy similar to that of conventional methods for bracket placement, with slightly greater bracket height accuracy. Further studies should strive to improve accuracy in terms of tooth positions.