Accuracy of 3-dimensional-printed customized transfer tray using a flash-free adhesive system in digital indirect bonding: An in vivo study

Introduction: This paper evaluated the accuracy of a computer-aided design and manufacturing indirect bonding technique using a new customized 3D-printed transfer tray and a flash-free adhesive system for orthodontic bonding. Methods: This in vivo study analyzed 106 teeth selected from 9 patients undergoing orthodontic treatment. Quantitative deviation analysis was performed to evaluate the bonding positioning errors, assessing the differences between the virtually planned and the clinically transferred bracket position after indirect bonding procedures by superimposing 3-dimensional dental scans. Estimated marginal means were evaluated for individual brackets and tubes, arch sectors, and overall collected measurements. Results: A total of 86 brackets and 20 buccal tubes were analyzed. Among individual teeth, mandibular second molars showed the highest positioning errors, whereas maxillary incisors reported the lowest values. Considering arch sectors, the posterior areas showed greater displacements than the anterior areas, as the right side compared to the left side, with a higher error rate reported for the mandibular arch than the maxillary arch. The overall bonding inaccuracy measurement was 0.35 mm, below the clinical acceptability limit of 0.50 mm. Conclusions: The accuracy of a 3-dimensional-printed customized transfer tray using a flash-free adhesive system in computer-aided design and manufacturing indirect bonding was generally high, with greater positioning errors for posterior teeth.