Transfer accuracy of 3D-printed trays for indirect bonding of orthodontic brackets: A clinical study

Objectives: To evaluate the transfer accuracy of 3D-printed indirect bonding trays constructed using a fully digital workflow in vivo. Materials and Methods: Twenty-three consecutive patients had their incisors, canines, and premolars bonded using fully digitally designed and 3D-printed transfer trays. Intraoral scans were taken to capture final bracket positioning on teeth after bonding. Digital models of postbonding scans were superimposed on those of corresponding virtual bracket setups, and bracket positioning differences were quantified. A total of 363 brackets were evaluated. One-tailed t-tests were used to determine whether bracket positioning differences were within the limit of 0.5 mm in mesiodistal, buccolingual, and occlusogingival dimensions, and within 28 for torque, tip, and rotation. Results: Mean bracket positioning differences were 0.10 mm, 0.10 mm, and 0.18 mm for mesiodistal, buccolingual, and occlusogingival measurements, respectively, with frequencies of bracket positioning within the 0.5-mm limit ranging from 96.4% to 100%. Mean differences were significantly within the acceptable limit for all linear dimensions. Mean differences were 2.558, 2.018, and 2.478 for torque, tip, and rotation, respectively, with frequencies within the 28-limit ranging from 46.0% to 57.0%. Mean differences for all angular dimensions were outside the acceptable limit; however, this may have been due to limitations of scan data. Conclusions: Indirect bonding using 3D-printed trays transfers planned bracket position from the digital setup to the patient's dentition with a high positional accuracy in mesiodistal, buccolingual, and occlusogingival dimensions. Questions remain regarding the transfer accuracy for torque, tip, and rotation.