A Comparative Evaluation Of Accuracy Of Bracket Placement Using Direct And Indirect Bonding Technique

Abstract

Introduction: Orthodontics has advanced significantly from ancient practices, with modern techniques like Edward Angle’s edgewise appliance and Lawrence Andrews’ straight wire method emphasizing precise bracket placement. Direct and indirect bonding are key for accurate positioning, each with distinct advantages and limitations.

Objectives: This study compares bracket positioning accuracy between direct and indirect bonding, evaluating vertical, horizontal, and angular variations to determine which technique offers superior precision.

Method: Forty orthodontic patients at Inderprastha Dental College were randomly assigned to direct or indirect bonding groups. Following oral prophylaxis, brackets were bonded per MBT guidelines. Standardized images were captured using a Canon camera. Data were analysed via SPSS 26, employing descriptive statistics and the Kruskal–Wallis test (p < 0.05).

Results: Both techniques showed minimal, statistically insignificant deviations (p > 0.05). Direct bonding exhibited consistent angular, horizontal, and vertical placement, while indirect bonding demonstrated uniformity with negligible errors, confirming both as reliable.

Discussion: Direct bonding had greater angular deviations due to visibility and manual positioning challenges, whereas indirect bonding’s transfer trays improved consistency. Mesiodistal deviations were minor, possibly due to 2D image measurements. While no significant difference was found, indirect bonding had a narrower error range, aligning with prior studies highlighting difficulties in aligning brackets along the tooth’s long axis. Both methods require refinement to enhance precision further.