Digital Bonding vs. Direct Bonding for Orthodontic Brackets

Enrolling by invitation at 5 trial locations

Overseen By Helen Han

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Solventum Orthodontics Corporation

Disqualifiers: Pregnancy, Breastfeeding, Advanced periodontal disease, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 18-24 months

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores a new method for attaching braces, known as digital bonding, to determine its efficiency compared to the traditional method of placing each bracket directly on the teeth. Participants will receive their brackets using either a digital bonding tray or the usual direct placement method. The trial targets individuals who need braces on both the top and bottom teeth, have mild to moderate crowding, and specific bite conditions. Participants must have all their permanent teeth, including the second molars, and fit the expected treatment timeline of 18 to 24 months. As an unphased trial, this study allows participants to contribute to innovative orthodontic research that could enhance future treatment methods.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that these bonding methods are safe for orthodontic treatment?

Research has shown that digital bonding is generally safe and well-tolerated. Some studies suggest that using digital bonding, especially with pre-coated brackets, can reduce the chance of brackets coming loose by about 60% compared to other methods. This results in fewer unexpected trips to the orthodontist to fix brackets that have popped off.

Digital bonding is also known for its precision, which can lead to better treatment results and fewer risks. No significant reports of problems specific to digital bonding exist, indicating it is a reliable way to place braces.

In contrast, direct bonding, which involves placing brackets directly on the teeth, has been used for a long time and is generally safe. As the traditional method, it benefits from extensive experience. However, it may not be as precise as digital bonding, potentially requiring more adjustments during treatment.

Overall, both digital and direct bonding methods are safe, but digital bonding may offer advantages like fewer loose brackets and more accurate placement. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the orthodontic bonding techniques being tested because they could revolutionize how braces are applied. Digital Bonding uses a digital bonding tray to place brackets on teeth, offering potentially more precise placement and reducing the time spent in the orthodontist's chair. This contrasts with the standard Direct Bonding method, where brackets are placed manually, which can be more time-consuming and less accurate. The hope is that Digital Bonding will improve the accuracy and efficiency of orthodontic treatments, making the process smoother for both patients and orthodontists.

What evidence suggests that this trial's treatments could be effective for orthodontic bracket bonding?

This trial will compare Digital Bonding with Direct Bonding for orthodontic brackets. Research has shown that digital methods for placing orthodontic brackets can be more accurate than manual placement. Studies have found that digital techniques result in smaller placement errors, aligning brackets more closely with the treatment plan. This accuracy reduces risks and leads to more predictable results. Digital bonding also provides a detailed view of each tooth and bracket, enhancing precision. These advantages suggest that digital bonding could offer a more efficient and effective method for placing orthodontic brackets. ^{5 6 7 8 9}

Who Is on the Research Team?

Lori Leitheiser

Principal Investigator

Solventum Orthodontics Corporation

Are You a Good Fit for This Trial?

This trial is for individuals aged 12 or older who need comprehensive orthodontic treatment with brackets on both arches, have mild to moderate teeth crowding, and a specific range of overbite. They must not be pregnant or breastfeeding, have advanced gum disease, non-movable teeth like implants, or severe enamel abnormalities.

Inclusion Criteria

The Subject's intra-oral scan must have been taken within 90 days of bracket placement

The Subject is anticipated to complete treatment within 18 to 24 months

Subject has an overbite measuring between -1 mm (open bite) and 5 mm (deep bite)

Exclusion Criteria

Subject is pregnant or breast feeding

Subject is, in the opinion of the investigator, unsuitable for enrollment in the study for reasons other than those specified in the above exclusion criteria

I have severe gum disease.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either digital bonding or direct bonding treatment for bracket placement

18-24 months

Initial bonding visit, multiple adjustment visits

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Digital Bonding
• Direct Bonding

Trial Overview

The study is testing if using digital bonding trays to place orthodontic brackets is more efficient than the traditional direct method. Participants are randomly assigned to one of these two methods in this forward-looking multi-site trial.

How Is the Trial Designed?

Group I: Treatment Group Experimental Treatment 1 Intervention

Digital Bonding Tray. Brackets will be bonded to each subject's teeth with a digital bonding tray.

Group II: Control Group Active Control 1 Intervention

Direct bonding method. Brackets will be bonded to each subject's teeth by direct placement.

Digital Bonding is already approved in United States, European Union, Canada for the following indications:

Approved in United States as 3M Digital Bonding for:

• Orthodontic treatment for malocclusions
• Dental alignment

Approved in European Union as 3M Digital Bonding for:

• Orthodontic treatment for malocclusions
• Dental alignment

Approved in Canada as 3M Digital Bonding for:

• Orthodontic treatment for malocclusions
• Dental alignment

Who Is Running the Clinical Trial?

Solventum Orthodontics Corporation

Lead Sponsor

Trials

2

Recruited

230+

3M

Lead Sponsor

Trials

160

Recruited

31,600+

Dr. John Banovetz

3M

Chief Medical Officer since 2017

PhD in Inorganic Chemistry from Stanford University, Bachelor's degree in Chemistry from Hamline University

William 'Bill' Brown

3M

Chief Executive Officer

Bachelor's and Master's degrees in Mechanical Engineering from Villanova University, MBA from The Wharton School, University of Pennsylvania

Published Research Related to This Trial

In a study involving 19 sets of Class II malocclusion models, both direct and indirect bonding techniques for bracket placement were found to be inaccurate compared to ideal placements.

Indirect bonding generally resulted in better bracket height accuracy, while direct bonding performed better in angulation for specific teeth, indicating that while neither method achieved perfect placement, indirect bonding may have advantages in certain aspects.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison of the accuracy of bracket placement between direct and indirect bonding techniques. Koo, BC., Chung, CH., Vanarsdall, RL.[2022]

Using a 3D printing pen to create transfer trays from polylactic acid (PLA) for indirect orthodontic bonding significantly reduces chairside time compared to direct bonding methods.

The PLA transfer trays provide precise bracket positioning and allow for effective light curing, leading to improved bond reliability and efficiency in the orthodontic bonding process.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

3D Printing Pen: A Novel Adjunct for Indirect Bonding. Kulkarni, NB., Goyal, SM., Shah, VD.[2021]

Virtual bonding of orthodontic attachments is more accurate than direct bonding, particularly in vertical and horizontal dimensions, based on a study involving 1120 artificial teeth across four groups of clinicians with varying experience.

Experienced clinicians showed greater accuracy in virtual bonding compared to postgraduate students, especially in the angular dimension, highlighting the importance of clinical experience in achieving precise orthodontic outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Influence of clinical experience on accuracy of virtual orthodontic attachment bonding in comparison with the direct procedure. De Oliveira, NS., Rossouw, E., Lages, EMB., et al.[2021]

Recent advancements in adhesives for indirect bonding of orthodontic brackets have significantly improved clinical success rates for orthodontists.

The article reviews various techniques and procedures that highlight the advantages of indirect bonding over direct bonding, suggesting it is a worthwhile method for dental practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Indirect bonding of brackets: don't wait another day! Pellan, P.[2021]

Direct bonding of brackets to tooth enamel is a common orthodontic practice, but it can lead to negative side effects, particularly in the presence of pre-existing white spots on the enamel.

Careful application of the etching agent during the bonding process can minimize the risk of enamel damage, highlighting the importance of technique in orthodontic procedures.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Effects of acid etchants in orthodontics]. Hummel, GI., van Koldam, FA., Dibbets, JM.[2006]

In a study involving 54 extracted premolars, both indirect bonding with a new adhesive resin and direct bonding with a light-activated adhesive achieved mean shear bond strengths well above the clinical success threshold, indicating effective bonding methods.

There was no significant difference in shear bond strength between the two bonding techniques, suggesting that either method can be reliably used for orthodontic bracket placement without compromising effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Shear bond strength comparison between direct and indirect bonded orthodontic brackets. Yi, GK., Dunn, WJ., Taloumis, LJ.[2022]

A systematic review of 8 randomized controlled trials involving 247 orthodontic patients found no significant differences in bracket placement accuracy, oral hygiene status, or bond failure rates between direct and indirect bonding techniques.

Indirect bonding may save chairside time during procedures but requires more total working time compared to direct bonding, indicating a potential trade-off in efficiency.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness, efficiency and adverse effects of using direct or indirect bonding technique in orthodontic patients: a systematic review and meta-analysis. Li, Y., Mei, L., Wei, J., et al.[2020]

The study compared two orthodontic bonding methods using 48 incisor and 48 premolar extracted human teeth, focusing on the effectiveness of a highly filled bis-GMA adhesive.

Results showed differences in tensile and shear bond strengths between the direct and indirect bonding methods, providing insights into which technique may offer better attachment for orthodontic brackets.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Bond strength comparison: a simplified indirect technique versus direct placement of brackets. Milne, JW., Andreasen, GF., Jakobsen, JR.[2019]

Indirect bonding of orthodontic brackets allows for more accurate placement compared to direct bonding, as it can be done on study casts rather than directly in the mouth.

A new simplified bonding method addresses common issues with indirect bonding, such as adhesion consistency and excess composite, while retaining the advantages of direct bonding techniques.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The direct way of indirect bonding--the combined effect. Gayake, PV., Chitko, SS., Sutrave, N., et al.[2021]

In a systematic review of 7 randomized clinical trials involving orthodontic bracket bonding techniques, the direct bonding method showed a significantly lower failure rate compared to the indirect method over a long-term follow-up of 12-15 months.

During the initial 0-6 month period, both bonding techniques had similar adhesion failure rates, indicating that the advantages of direct bonding become more apparent over time.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Orthodontic bracket bonding techniques and adhesion failures: A systematic review and meta-analysis. Dos Santos, AL., Wambier, LM., Wambier, DS., et al.[2022]

Both second- and third-generation LED light-curing units (LCUs) provided strong bond strengths for dental brackets, exceeding acceptable clinical levels, with no significant differences in effectiveness between the two generations.

While the bonding effects were similar, the second-generation LCUs had shorter curing times compared to the third-generation units, suggesting a potential advantage in efficiency.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison of the bonding strengths of second- and third-generation light-emitting diode light-curing units. Lee, HM., Kim, SC., Kang, KH., et al.[2020]

Citations

1.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC11438723/

Direct versus fully digital indirect bracket bonding

IDB bracket positioning leads to significant smaller translation and orientation deviations from digital IDB planning, than DBB bracket positioning.

2.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC7771293/

Comparative Study between the Overall Production Time of ...

The purpose of this study was to compare the production time for indirect digitally and laboratory-produced orthodontic bonding trays. Orthodontic study ...

3.

sciencedirect.com

sciencedirect.com/science/article/abs/pii/S1761722725000713

Effectiveness and efficiency of indirect bonding techniques

Digital indirect bonding software enables clinicians to closely examine individual teeth and brackets, enhancing precision [16]. Automated measurements and ...

4.

multimedia.3m.com

multimedia.3m.com/mws/media/1599561O/innova-volxxv-no2-70-2013-7082-5-solid.pdf

Digital Flash-Free Bonding: An Evolutionary Step in ...

Accurate bracket placement and successful bonding are among the most critical elements of efficient orthodontic treatment. Brackets in the desired position lead ...

5.

bmcoralhealth.biomedcentral.com

bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-025-05777-x

Accuracy of digital indirect bonding technology for customized ...

This technique offers numerous benefits, such as highly predictable outcomes, precise bracket data expression, and fewer orthodontic risks [3].

6.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC11450403/

Comprehensive clinical evaluation of indirect and direct ...

Additionally, several cross-sectional and retrospective studies have shown high failure rates for brackets placed indirectly during treatment [ ...

7.

clinicaltrials.gov

clinicaltrials.gov/study/NCT04395625

Computer-aided Indirect Bonding Versus Traditional Direct ...

Six to twelve months after bonding as well as at the end of treatment, bracket position accuracy will be evaluated on digital models produced by intraoral ...

8.

pubmed.ncbi.nlm.nih.gov

pubmed.ncbi.nlm.nih.gov/39340567/

Direct versus fully digital indirect bracket bonding: a split- ...

Objectives: The primary aim is to assess differences in accuracy of orthodontic bracket positioning between fully digital indirect bracket ...

9.

solventum.com

solventum.com/en-us/home/oral-care/clarity-solutions/clarity-digital-bonding/

Clarity Digital Bonding

Combined with brackets pre-coated with APC™ Flash-Free Adhesive, which have shown an average 60% lower bond failure rate*, this streamlined approach helps you ...