Evaluation of effectiveness and efficiency of fixed orthodontic treatment comparing standard and computer-aided design and manufacturing conventional bracket systems using indirect bonding for both: A retrospective study

Abstract

Background

To compare the effectiveness and efficiency of orthodontic treatment (OT) with standard versus computer-aided design and computer-aided manufacturing (CAD/CAM) indirect bonding of conventional brackets.

Methods

This retrospective study examined two groups: standard indirect bonding group (12 males, 13 females; mean age 12.21 ± 0.52 years), and digital indirect bonding group (11 males, 14 females; mean age 12.76 ± 1.32 years), treated via a CAD/CAM indirect bonding system. Conventional brackets were used in both groups. Pretreatment and post-treatment records were acquired for all subjects. Weighted Peer Assessment Rating (W-PAR) index was used to assess the effectiveness of OT, in conjunction with five angular cephalometric measurements (ANB°, Sn-GoGn°, U1-PP°, IMPA° and FMA°) and comparatively analyzed using generalized mixed-effects models and post hoc test. Treatment efficiency was assessed in terms of the numbers of bracket repositionings, archwire bends, accidental bracket debondings, appointments and treatment months. Comparative analysis of efficiency was performed using the asymptotic Wilcoxon–Mann–Witney test. Statistical significance was set at 5%.

Results

Total W-PAR and W-PAR component scores decreased significantly during treatment for both groups and in a similar way. Cephalometric measures ANB° and IMPA° significantly decreased and increased, respectively. Significantly fewer bracket repositionings, number of appointments and treatment months were recorded in group digital indirect bonding.

Conclusions

Although both methods investigated were effective to achieve good outcomes, CAD/CAM indirect bonding method increased the efficiency of OT, when conventional brackets are used.