COST AND CLINICAL IMPACT OF DIGITAL VS. CONVENTIONAL INDIRECT BONDING IN EXTRACTION ORTHODONTIC TREATMENT OF CLASS I MALOCCLUSION
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Abstract
Background:Orthodontic treatment advancements aim to improve clinical outcomes, efficiency, and patient
satisfaction. Indirect bonding techniques, both conventional (CIB) and digital (DIB), are innovations that enhance
bracket placement accuracy, reduce chairside time, and potentially minimize the number of visits. However, while
digital methods offer increased precision and efficiency, they incur higher laboratory costs and require advanced
technology.
Methods:This prospective, randomized controlled trial included 28 patients with Class I malocclusion requiring
orthodontic extraction. Participants were randomized into CIB or DIB groups. Brackets in the CIB group were
manually positioned on plaster models and transferred using vacuum-formed trays, while the DIB group used digitally
scanned models with 3D-printed transfer trays. Treatment outcomes were assessed using the Objective Grading
System (OGS). Cost, treatment time, number of visits, and bracket failure rates were also evaluated.
Results:Both techniques yielded comparable OGS scores (CIB median: 14; DIB median: 12; P=1.000), indicating
similar treatment quality. Laboratory costs were significantly higher for DIB ($100.54) than CIB ($16.30; P<0.001).
However, the DIB group demonstrated significant advantages, including shorter treatment times (20 months vs. 24
months; P=0.021) and fewer visits (23 vs. 27; P=0.003). Initial bracket failure rates were lower in the DIB group (2
vs. 4; P=0.018).
Conclusion:Both techniques provide similar treatment quality, but DIB represents a promising advancement in
orthodontics, balancing initial costs with improved clinical efficiency and patient satisfaction. Further research with
larger, diverse populations is necessary to validate these findings and assess long-term cost-effectiveness