Practice-based comparison of direct and indirect bonding

Introduction: The purpose of this study was to compare bond-failure prevalences, numbers of appointments, and treatment times between direct and indirect bracket bonding for patients treated in private orthodontic practices. Methods: A convenience sample was collected from 11 orthodontic offices; 5 orthodontists (772 patients) used a direct bonding technique, and 6 (596 patients) used an indirect technique. Altogether, they examined 29,963 brackets in 1,368 patients. Bond failures were recorded by tooth number and by patient during 10 consecutive practice days. In addition, the orthodontists reported the treatment time and number of visits for each of their 10 most recently completed comprehensive patients. Results: The per-patient debond prevalences were 1.17% ± 3.62% for direct bonding and 1.21% ± 3.81% for indirect bonding (P = .225). Direct-bonded patients required a mean (± SD) treatment time of 750 ± 220 days and 22.0 ± 7.3 visits; indirect bonding required a mean treatment time of 745 ± 256 days and 22.2 ± 7.3 visits (P = .691 and P = .653, respectively). Conclusions: This practice-based study showed no difference in the failure rates between direct and indirect bonding. Furthermore, total treatment times and numbers of appointments did not differ between the 2 techniques.