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For the total sample, the linear transfer errors were 0.10 ± 0.08 mm, 0.10 ± 0.07 mm, and 0.18 ± 0.14 mm for the mesiodistal, buccolingual, and occlusogingival dimensions, respectively. The means and standard deviations of the linear and angular bracket-position differences are shown in Table 3 and Figure 5. Such brackets were discarded from analysis due to what is referred to as a scan error. In some cases, the quality of the postbonding scan prohibited the identification of the landmark datums.
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An X-Y-Z coordinate system was automatically created based on these datums. To assign the position of each bracket in space, four consistent datums were identified on the surface of each bracket in the upper left, lower left, upper right, and lower right corners of the bracket base ( Figure 4).
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An iterative closest point matching algorithm was used to achieve surface feature-based, best-fit superimposition.
ADOBE BRACKETS PRINT REGISTRATION
Initial registration was completed using a six-point match based on the buccal cusp tips of the premolars and canines. To ensure that superimposition was based only on tooth-surface features, soft tissue and brackets were eliminated from the postbonding models ( Figure 3).
ADOBE BRACKETS PRINT SOFTWARE
The digital setup and postbonding model for each patient were digitally superimposed using best-fit methods using VisionX Compare software (VisionX, Edina, MN). The resulting digital model, referred to as the postbonding model, was exported in STL format and used for comparison to the digital setup. Any immediate bond failures were recorded, and an intraoral scan was taken using the iTero Element scanner to capture the final position of the brackets on the teeth ( Figure 2). After tray removal, excess adhesive was removed from around the brackets with a carbide bur on a slow-speed handpiece. The adhesive was then light-cured for 40 seconds per tooth. Each tray was seated using light finger pressure on the occlusal surface.
ADOBE BRACKETS PRINT PLUS
Assure Plus primer (Reliance Orthodontic Products, Itasca, IL) was applied to the tooth surfaces and Transbond XT light-curing adhesive (3M) to the bracket bases. The teeth were pumiced, etched using 37% phosphoric acid for 20 seconds, rinsed, and dried. The average time from scan acquisition to bonding was 2 weeks. MATERIALS AND METHODSĪ total of 410 brackets were bonded to incisors, canines, and premolars of both dental arches by a single operator. For this reason, the present study aimed to measure the transfer accuracy of a fully digital indirect bonding method for orthodontic brackets using 3D-printed trays in vivo. While traditional indirect bonding methods have been found to transfer brackets reliably to their intended positions on the dentition in vivo, 7 little is known regarding the transfer accuracy of digital methods during clinical application. 4, 5 Obviously, inaccuracies in bracket transfer would negate such advantages. Digital indirect bonding promises all the advantages of traditional indirect bonding in addition to a completely digital workflow, computer-aided bracket positioning and outcome prediction, standardization of tray fabrication, and fewer manufacturing steps. Brackets can then be placed in the trays and used for bonding. A transfer tray or jig can be designed virtually and directly 3D-printed with no physical transfer model as an intermediary. 4– 6 In digital indirect bonding, software is used to digitally position brackets on virtual models of the teeth. 2, 3 More recently, facilitated by advances in intraoral scanning, 3D printing, and virtual treatment planning, digital methods for indirect bonding have been developed.
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In traditional indirect bonding methods, brackets are manually placed on a stone or resin model of the patient's dentition, and trays are created in a laboratory setting using silicone-based and/or vacuum-formed materials. Since its introduction in 1972, 1 the indirect bonding method has seen many variations and improvements in practice.