三种间接粘接方法转移托槽的准确性比较

目的:比较间接粘接技术中使用不同转移托盘转移托槽的准确性。方法:选择2019年7月至2021年1月空军军医大学口腔医院正畸科就诊的患者28例,分为A、B、C三组,分别使用3D打印托盘、双层压膜塑料托盘、双层硅橡胶托盘粘接托槽。A组口内扫描获取工作模型,使用软件定位托槽,再导出数字化模型,作为该组托槽转移前的数字化模型。B组和C组在工作石膏模型上定位托槽,使用口内扫描仪扫描,获取B组和C组托槽转移前的数字化模型。A、B、C组制作相应的转移托盘,将托槽粘接至患者口内后对患者口内扫描,获取三组托槽实际粘接的数字化模型。使用Geomagic软件测量转移前后的数字化模型,获取使用不同托盘时,托槽粘接的实际位置距离预设在近远中方向、龈 方向、颊舌方向上的线距误差,超过0.5 mm的托槽转移线距误差定义为严重误差。 结果:近远中向上B组与A组间、C组与A组间严重误差发生率的差异存在统计学意义( P<0.05)。龈 向上3组组间的严重误差发生率差异均存在统计学意义( P<0.05)。颊舌向上3组组间的严重误差发生率差异无统计学意义。 结论:(1)3D打印托盘转移托槽时严重误差的发生率显著高于双层硅橡胶托盘与双层压膜塑料托盘。(2)双层硅橡胶托盘粘接托槽时严重误差的发生率最低。     

三种间接粘接方法转移托槽的准确性比较

目的:比较间接粘接技术中使用不同转移托盘转移托槽的准确性。方法:选择2019年7月至2021年1月空军军医大学口腔医院正畸科就诊的患者28例,分为A、B、C三组,分别使用3D打印托盘、双层压膜塑料托盘、双层硅橡胶托盘粘接托槽。A组口内扫描获取工作模型,使用软件定位托槽,再导出数字化模型,作为该组托槽转移前的数字化模型。B组和C组在工作石膏模型上定位托槽,使用口内扫描仪扫描,获取B组和C组托槽转移前的数字化模型。A、B、C组制作相应的转移托盘,将托槽粘接至患者口内后对患者口内扫描,获取三组托槽实际粘接的数字化模型。使用Geomagic软件测量转移前后的数字化模型,获取使用不同托盘时,托槽粘接的实际位置距离预设在近远中方向、龈 方向、颊舌方向上的线距误差,超过0.5 mm的托槽转移线距误差定义为严重误差。 结果:近远中向上B组与A组间、C组与A组间严重误差发生率的差异存在统计学意义( P<0.05)。龈 向上3组组间的严重误差发生率差异均存在统计学意义( P<0.05)。颊舌向上3组组间的严重误差发生率差异无统计学意义。 结论:(1)3D打印托盘转移托槽时严重误差的发生率显著高于双层硅橡胶托盘与双层压膜塑料托盘。(2)双层硅橡胶托盘粘接托槽时严重误差的发生率最低。     

Transfer accuracy of vinyl polysiloxane trays for indirect bonding

Objective:To elicit the magnitude, directional bias, and frequency of bracket positioning errors caused by the transfer of brackets from a dental cast to the patient’s dentition in a clinical setting.Materials and Methods:A total of 136 brackets were evaluated. The brackets were placed on dental casts and scanned using cone beam computed tomography (CBCT) to capture 3-D positioning data. The brackets were then transferred to the patient’s dentition with an indirect bonding method using vinyl polysiloxane (VPS) trays and later scanned using CBCT to capture the final bracket positioning on the teeth. Virtual models were constructed from the two sets of scan data and digitally superimposed utilizing best-fit, surface-based registration. Individual bracket positioning differences were quantified using customized software. One-tailed t tests were used to determine whether bracket positioning was within limits of 0.5 mm in the mesiodistal, buccolingual, and vertical dimensions, and 2° for torque, tip, and rotation.Results:Individual bracket positioning differences were not statistically significant, indicating, in general, final bracket positions within the selected limits. Transfer accuracy was lowest for torque (80.15%) and highest for mesiodistal and buccolingual bracket placement (both 98.53%). There was a modest directional bias toward the buccal and gingival.Conclusion:Indirect bonding using VPS trays transfers the planned bracket position from the dental cast to the patient’s dentition with generally high positional accuracy.     

Measurement and comparison of bracket transfer accuracy of five indirect bonding techniques

Objective:To measure and compare bracket transfer accuracy of five indirect bonding (IDB) techniques.Materials and Methods:Five IDB techniques were studied: double polyvinyl siloxane (double-PVS), double vacuum-form (double-VF), polyvinyl siloxane vacuum-form (PVS-VF), polyvinyl siloxane putty (PVS-putty), and single vacuum-form (single-VF). Brackets were bonded on 25 identical stone working models. IDB trays were fabricated over working models (n  =  5 per technique) to transfer brackets to another 25 identical stone patient models. The mesiodistal (M-D), occlusogingival (O-G), and faciolingual (F-L) positions of each bracket were measured on the working and patient models using digital photography (M-D, O-G) and calipers (F-L). Paired t-tests were used to compare bracket positions between working and patient models, and analysis of variance was used to compare bracket transfer accuracy among the five techniques.Results:Between the working and patient models, double-VF had the most teeth with significant differences (n  =  6) and PVS-VF the fewest (n  =  1; P < .05). With one exception, all significant differences were ≤0.26 mm and most (65%) were ≤0.13 mm. When the techniques were compared, bracket transfer accuracy was similar for double-PVS, PVS-putty, and PVS-VF, whereas double-VF and single-VF showed significantly less accuracy in the O-G direction.Conclusions:Although overall differences in bracket position were relatively small, silicone-based trays had consistently high accuracy in transferring brackets, whereas methods that exclusively used vacuum-formed trays were less consistent.     

Application of silicon hybrid transfer trays to an indirect bonding system through bracket positions referred by 3D digital software

Recently many indirect bonding systems have been developed. However, the necessary laboratory work can be quite complicated. Therefore we developed a method of systematic positioning, and a simple and easy method using a silicone tray.We measured accurate bracket positioning height (BPH-line) and referred to Kalange's method using virtual setup models. We used two characteristically different chemical bonded silicon materials as the tray as part of our indirect bonding method.We found this system to be very useful, simple to apply, and accurate.     

间接粘结中托槽转移精确度的比较

目的 比较间接粘结技术中使用两种不同转移托盘及不同牙列拥挤度时的托槽转移精确度.方法 收集30名患者的上颌或下颌硬石膏模型,各取2付,在之后的托槽转移步骤中根据用单层膜片和双层膜片制作间接粘结的转移托盘,分为A、B两组;根据其牙列拥挤度、1为轻度及以下拥挤,2为中度拥挤,再分为A1、A2、B1、B2组,每组中各有15付模型.模型上粘结托槽后经CBCT扫描并重建数字化三维模型,分别用单层膜片(A1、A2组)和双层膜片(B1、B2组)制作间接粘结的转移托盘,将转移托盘重新放回初始模型完成托槽粘结,再次经过CBCT扫描并重建数字化三维模型,通过Geomagic软件比对前后的数字模型,比较托槽位置在转移过程中的变化程度.结果 托槽转移前后的最大距离及平均距离各组之间无统计学差异(P＞0.05),B组平均距离的标准差大于A组,且差异有统计学意义(P＜0.05).B2组平均距离的标准差大于A1、A2、B1组,差异有统计学意义(P＜0.05).结论 使用单层膜片和双层膜片的间接粘结技术托槽转移精确度无显著差异,单层膜片的稳定性更佳;牙列拥挤度增大会使托槽转移的稳定性下降.     

Bracket transfer accuracy with two different three-dimensional printed transfer trays vs silicone transfer trays

ObjectivesTo compare the transfer accuracy of two different three-dimensional printed trays (Dreve FotoDent ITB [Dreve Dentamid, Unna, Germany] and NextDent Ortho ITB [NextDent, Soesterberg, the Netherlands]) to polyvinyl siloxane (PVS) trays for indirect bonding.Materials and MethodsA total of 10 dental models were constructed for each investigated material. Virtual bracket placement was performed on a scanned dental model using OnyxCeph (OnyxCeph 3D Lab, Chemnitz, Germany). Three-dimensional printed transfer trays using a digital light processing system three-dimensional printer and silicone transfer trays were produced. Bracket positions were scanned after the indirect bonding procedure. Linear and angular transfer errors were measured. Significant differences between mean transfer errors and frequency of clinically acceptable errors (<0.25 mm/1°) were analyzed using the Kruskal–Wallis and χ² tests, respectively.ResultsAll trays showed comparable accuracy of bracket placement. NextDent exhibited a significantly higher frequency of rotational error within the limit of 1° (P = .01) compared with the PVS tray. Although PVS showed significant differences between the tooth groups in all linear dimensions, Dreve exhibited a significant difference in the buccolingual direction only. All groups showed a similar distribution of directional bias.ConclusionsThree-dimensional printed trays achieved comparable results with the PVS trays in terms of bracket positioning accuracy. NextDent appears to be inferior compared with PVS regarding the frequency of clinically acceptable errors, whereas Dreve was found to be equal. The influence of tooth groups on the accuracy of bracket positioning may be reduced by using an appropriate three-dimensional printed transfer tray (Dreve).     

Effect of adhesion boosters on indirect bracket bonding

Objective:To determine the influence of two adhesion boosters on shear bond strength and on the bond failure location of indirectly bonded brackets.Materials and Methods:Sixty bovine incisors were randomly divided into three groups (n  =  20), and their buccal faces were etched using 37% phosphoric acid. In group 1 (control), brackets were indirectly bonded using only Sondhi adhesive. In groups 2 and 3, the adhesion boosters Enhance Adhesion Booster and Assure Universal Bonding Resin, respectively, were applied before bonding with Sondhi. Maximum bond strength was measured with a universal testing machine, and the location of bond failure was evaluated using the Adhesive Remnant Index (ARI). One-way analysis of variance followed by the Tukey test (P < .05) was used to compare the shear bond strength among groups, and the differences in ARI scores were evaluated using the Kruskal-Wallis test (P < .05). The Pearson correlation coefficient was calculated to determine whether there was any correlation between bond strength and ARI scores.Results:The mean shear bond strength in group 3 was significantly higher (P < .01) than in the other groups. Evaluation of the locations of bond failure revealed differences (P < .05) among the three groups. There was a moderate correlation between bond strength and ARI scores within group 3 (r  =  0.5860, P < .01).Conclusion:In vitro shear bond strength was acceptable in all groups. The use of the Assure adhesion booster significantly increased both the shear bond strength of indirectly bonded brackets and the amount of adhesive that remained on the enamel after bracket debonding.     

托槽在数字化牙颌模型上位置与间接粘结转移后实际位置的一致性研究

目的 本研究比较托槽在数字化牙颌模型上的位置与转移至初始石膏模型上的位置的差异,以期为数字化托槽间接粘结位置的一致性提供实验依据.方法 选取在含牙根的数字化牙颌模型上进行托槽定位的15个数字化模型,通过间接粘结转移托盘将托槽转移至初始石膏模型上,用OrthoRx软件工具测量每个托槽在数字化牙颌模型上的位置与初始石膏模型上位置的线距差.结果 所有牙位托槽在数字化牙颌模型上的位置与初始石膏模型上位置的线距差值均小于检验值0.20 mm,与检验值差异有统计学意义(P<0.05).结论 托槽在数字化牙颌模型上的位置与初始石膏模型上位置具有一致性.     

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

ObjectivesTo evaluate the transfer accuracy of 3D-printed indirect bonding trays constructed using a fully digital workflow in vivo.Materials and MethodsTwenty-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 2° for torque, tip, and rotation.ResultsMean 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 2.55°, 2.01°, and 2.47° for torque, tip, and rotation, respectively, with frequencies within the 2°-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.ConclusionsIndirect 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.     

A clinical comparison of bracket bond failures in association with direct and indirect bonding

Abstract

Objective: To compare bond failure rates between direct and indirect techniques for bonding orthodontic brackets.

Design: A two-centre single blinded prospective randomized controlled clinical trial.

Materials and methods: This study was undertaken at the Birmingham Dental Hospital and Good Hope Hospital, Sutton Coldfield. Thirty-three subjects meeting the inclusion criteria were selected from orthodontic waiting lists and assigned to either of two study groups according to a split-mouth study design. The number and site of bracket failures between tooth types was recorded over 1 year. Statistical analysis was carried out using chi-square tests.

Results: Brackets were lost from 14 of the 553 teeth bonded, giving an overall bond failure rate of 2.5%. There were no significant differences in bond failures between direct and indirect bonding or in the tooth types of the failures.

Conclusions: There was no significant difference in the bond failure rates between direct and indirect bonding.     

两种不同类型粘接剂和临床四手操作在正畸托槽粘结过程中的应用效果评价

目的：评价两种不同类型粘接剂和临床四手操作在正畸托槽粘结过程中的应用效果。方法：将正畸门诊40例需粘接托槽患者随机均分为四组,A组10例,四手操作粘接托槽184个,使用光固化粘接剂。B组10例,非四手操作粘接托槽180个,使用光固化粘接剂。C组10例,四手操作粘接托槽188个,使用化学固化粘接剂。D组10例,非四手操作粘接托槽192个,使用化学固化粘接剂。分别记录四组患者粘接托槽所需时间和1周以后托槽脱落情况,进行统计分析。结果：粘接单个托槽平均所需时间A组2．65min,B组3．52rain,C组1．95min,D组2．18min,A组与B组、C组与D组、A组与C、B组与D组分别有明显的统计学差异（P〈O．05）。1月后复诊四组的托槽脱落分别为5个、7个、4个、8个,托槽脱落率分别为：2．72％、3．89％、2．13％、4．16％,四组间没有明显的统计学差异（P〉0．05）。结论：在粘接托槽过程中,使用化学固化粘接剂和通过四手操作均可以明显缩短医生临床操作时间,并对粘接效果没有明显影响,工作效率显著提高。     

Comparison of the accuracy of bracket placement between direct and indirect bonding techniques.

An in vitro study was conducted to evaluate the accuracy of bracket placement for direct and indirect bonding techniques. Nineteen sets of duplicated Class II malocclusion models were divided into three groups: (1) one set for ideal bracket placement, (2) nine sets for direct bonding on mannequins, and (3) nine sets for indirect bonding. Both direct and indirect bonding were performed on all teeth except molars by nine faculty members from the Department of Orthodontics, University of Pennsylvania. The position of each bonded bracket from these two bonding groups was compared with that of the same tooth from the ideal group and to each other in terms of bracket height, mesiodistal position, and angulation. Our results indicated that both direct and indirect bonding techniques failed to execute ideal bracket placement. On individual teeth, there was no statistically significant difference in the accuracy of bracket placement between these two bonding techniques except for upper right second premolar and lower left central incisor, where indirect bonding yielded better results in bracket height (P < .05), and for lower left central incisor where indirect bonding was better in mesiodistal position (P < .05), and for upper right lateral incisor where direct bonding was closer to the ideal in angulation (P < .05). Overall, indirect bonding showed better bracket placement in bracket height (P < .05), whereas, no statistically significant difference was found between them regarding the angulation and mesiodistal position.     

A randomized clinical trial comparing the accuracy of direct versus indirect bracket placement

Abstract

Objective: To determine the accuracy of direct or indirect bracket placement.

Design: A prospective, randomized comparison of 2 different methods of bracket placement.

Setting: Queens Hospital, Burton upon Trent, UK between February and May 2001.

Materials and method: Twenty-six consecutive patients requiring upper and lower MBT? pre-adjusted Edgewise appliances had their labial segments bonded directly or indirectly according to a split mouth system of allocation. Before and after bond-up all brackets were photographed and measured from tracings to determine positional differences from the ideal.

Results: Using ANOVA (General Linear Model), vertical errors were found to be greater than those in the horizontal plane, which in turn were greater than angular errors (p<0.05). Errors were greater in the maxillary arch than in the mandibular arch. There was no significant difference between the mean errors produced by the two methods of bracket placement.

Conclusions: Mean bracket placement errors were similar with both techniques.     

三种粘结剂在唇侧间接粘结技术中的临床应用

目的 观察比较三种粘结剂对正畸托槽间接粘结效果的影响.方法 选择需要正畸治疗患者60例,共计1200个托槽.随机分为三组,SondhiTM快速间接粘结剂组(A组)20例400个托槽、TransbondTM Supreme LV粘结剂组(B组)20例400个托槽和GC Fuji ORTHO LC粘结剂组(C组)20例400个托槽.分别采用相同方法进行托槽间接粘结,并对三组的托槽脱落率进行统计分析.结果 SondhiTM快速间接粘结剂组(A组)的脱落率为3.05％,TransbondTM Supreme LV粘结剂组(B组)脱落率为2.67％,而GC Fuji ORTHO LC粘结剂组(C组)脱落率为2.33％.三者差异无统计学意义.结论 在唇侧间接粘结技术中,应用三种粘结剂粘结托槽均可取得良好的粘结效果,但GC Fuji ORTHO LC粘结剂的脱落率最低.     

间接粘结技术的研究进展

正畸托槽的精确定位和足够的粘结强度,是正畸治疗获得成功的必要条件。近年来,随着正畸材料和技术的发展,托槽间接粘结技术受到越来越多的关注,该文对托槽间接粘结技术的托槽粘结精确度、粘结强度的研究和发展前景做出综述。     

间接粘接技术细节与难点:如何整体提高正畸临床的工作效率

托槽粘接是固定正畸矫治的关键技术之一,托槽粘接的准确性直接影响到正畸矫治的精确度以及矫治效率.间接粘接是一种通过在模型上粘接托槽,制作转移托盘将托槽转移到口内的一种托槽定位和粘接技术,具有粘接精确性高、减少临床椅旁操作时间、提高医生工作效率的优势,目前已广泛应用于固定矫治托槽的粘接.本文简要阐述了间接粘接的技术流程、特点以及临床实际操作中的细节要素与难点.