ORTHODONTIC BRACKET PLACEMENT: DIRECT AND INDIRECT BONDING TECHNIQUES. A SYSTEMATIC REVIEW

Since the introduction of the straight wire technique in orthodontics, precise bracket (BRK) placement has become essential to avoid unwanted tooth movements. Two main techniques are used: direct bracket bonding (DBB) and indirect bracket bonding (IBB). DBB involves placing braces individually on teeth, while IBB uses a plaster cast to position braces in removable trays for single-session application. IBB improves accuracy, reduces chairside time, and addresses issues like poor hygiene and high bond failure rates. Advances in adhesion technology have significantly changed orthodontic practices since the 1960s. Early adhesives had limitations, but innovations in the 1970s and 1980s, including chemically cured composites and heat-cured resins, improved bonding efficiency. Digital technologies like CAD/CAM and 3D scanners further refined BRK placement, enabling virtual bracket positioning and custom transfer trays. Studies show that DBB and IBB achieve similar results in terms of bond strength and effectiveness. Recent research highlights that while IBB offers advantages such as reduced clinical time and lower enamel demineralization, it requires more total time due to laboratory phases. Both techniques demonstrate comparable bond failure rates and placement accuracy, though digital advancements promise to enhance these methods, improving orthodontic treatment precision and efficiency.