Accurate bracket placement using a computer-aided design and computer-aided manufacturing-guided bonding device: An in vivo study

Introduction: A protocol was introduced to achieve accurate bracket placement in vivo, which consisted of operative procedures for precise control, and a computer-aided design and computer-aided manufacturing-guided bonding device. To evaluate the accuracy of this protocol, a 3-dimensional assessment was performed. Methods: Ten consecutive patients were enrolled. Strictly following the protocol, from December 2017 to March 2018, brackets were placed on the teeth of each patient using the device. To evaluate the accuracy, deviations of positions and orientations for bracket placement were measured. Each patient was followed up after 3 months regarding bracket failures. Results: The guided bonding device was used in all cases, and a total of 205 brackets were successfully bonded and evaluated. Except for 15.12% brackets with torque deviation over 2 degrees, the deviations in mesiodistal, buccolingual, vertical, rotation, and angulation were below the clinical acceptable range (0.5 mm in translation or 2 degrees in orientation) for all brackets. In the 3-month follow-up, there was no bracket failure in any patient. Conclusion: This protocol transferred the planned bracket position from the digital setup to patient's dentition with generally high positional accuracy.