An Accurate, Efficient Orthodontic Bracket Placement Method: Digital Flash-Free Bonding

Objectives: Despite numerous studies demonstrating superior efficacy, the traditional indirect bonding method of orthodontic appliances is less adopted among practitioners compared to the traditional direct bonding method. This difference is largely due to the number of steps required in the indirect method and the variability in each step that can lead to bond failure. The efficacy is only achieved when the variables within the protocol are controlled. Digital Flash-Free Bonding integrates the accuracy elements of indirect bonding, digital oral scanning, simulation software, 3D printers and bonding agents precoated to the bracket that don’t produce excess adhesive and so are flash-free.
Methods: Designed to remove much of the variability, this protocol is a new paradigm in bonding: the process involves the virtual placement of brackets in software instead of the application of brackets to models or teeth. After the patient’s teeth are scanned, the image is uploaded to treatment planning software that hosts 3D images of the brackets to be placed, providing digital measurement capability. Once the brackets are in the ideal position, a bonding tray is produced via 3D printer with wells for the brackets, and the brackets are loaded. Eliminating the indirect step of first bonding the brackets to a model, the printed bonding tray is placed on the teeth and the brackets are light cured in place. The flash-free technology removes any need to grind off cured flash.
Results: The placement visibility afforded in traditional indirect bonding is achieved in much fewer steps and allows digital measurement not available in direct bonding, reducing the variability that can lead to longer chair time and greater bond failures.
Conclusions: This process leverages the precision available in scanning, software, 3D printing, and the elimination of the flash removal step, integrating their advantages into one protocol.