Influence of the design of 3D-printed indirect bonding trays and experience of the clinician on the accuracy of bracket placement.

Abstract

The aim was to investigate the influence of three different three-dimensional (3D)-printed bonding tray designs and professional experience on accuracy of indirect bracket placement. Virtual bracket placement was performed on ascanned dental model using OnyxCeph software (Image Instruments, Chemnitz, Germany). Three different designs for indirect bonding trays (open, semi-open, and closed design) were created and produced using a3D printer. To analyze the influence of professional experience, one of the three tray designs was produced twice. In this case, bracket placement was performed by an inexperienced dentist. Bracket positions were scanned after the indirect bonding procedure. Linear and angular transfer errors were measured. Significant differences between the target and actual situation were analyzed using the Kruskal-Wallis and χ2 test. All bonding tray designs resulted in comparable results. The results of the unexperienced dentist showed significantly higher deviations than those for the experienced orthodontist in the torque direction. However, the mean values were comparable. The open tray design exceeded the clinically acceptable limits of 0.25 mm and 1° more often. The inexperienced dentist exceeded these limits significantly more often than the experienced orthodontist in the vertical and torque direction. The immediate bracket loss rate showed no significant differences between the different tray designs. Significantly more bracket losses were observed for the inexperienced dentist during the procedure compared to the experienced orthodontist. The bonding tray design and professional experience had an influence on the exceedance of clinically relevant limits of positioning accuracy and on the bracket loss rate.