Introduction: Conventional direct and indirect bonding techniques fail to obtain the ideal bracket position. Objective: To compare the accuracy of virtual and conventional direct bonding of orthodontic accessories. Methods: A single virtual configuration (dental mannequin with Class I malocclusion) served as basis for generating the reference model (treated virtually) and the intervention models (10 digital models and 10 solid models, obtained by means of prototyping). A total of 560 teeth were then equally distributed between a group of orthodontists (Group I, direct bonding; and Group II, virtual bonding), working in two different time intervals. The individual positions of the accessories were measured after three-dimensional superimposition with customized software. The Student’s-t test for paired samples, and Chi-square tests were used for statistical analysis, both at the level of significance of 5%. Results: In comparison of the errors in raw values, there were significant differences only in the vertical (p< 0.001) and horizontal dimensions (p< 0.001). Considering the groups of ranges by clinical limits of the deviations, these differences were significant in the three dimensions, vertical (p< 0.001), horizontal (p= 0.044) and angular (p= 0.044). Conclusion: Virtual bonding made it possible to obtain more precise/accurate positioning of the orthodontic accessories. The potential accuracy of this method brings new perspectives to refining the indirect bonding protocols.

The treatment of choice in cases of avulsed permanent teeth is the immediate reimplantation. However, this conduct does not always work favorably, either by failures in the initial approach or by inappropriate interventions. In this sense, the aim of this study is to present an alternative prosthetic rehabilitation with the use of orthodontic mini-implants in the anterior region. This case reports a ten-year-old child with history of avulsion of superior central incisors. The therapeutic approach was planned to promote physiological teeth contacts and acceptable esthetics and phonetics. First, the occlusal-gingival insertion of two orthodontic mini-implants was performed in the alveolar ridge, and, immediately after that, two provisional crowns were attached to the implants. The interventions achieved satisfactory cosmetic and functional results. After one-year follow-up, the adjacent periodontal tissues remained without signs and/or symptoms of inflammation. The provisional crowns presented no mobility and fractures. During radiographic examination, a healthy bone tissue appearance was observed. The simplicity of mini-implant installation makes them a promising alternative for temporary prosthetic rehabilitation of patients undergoing growth and development. The technique provides positive aesthetic and functional results that may reflect on self-esteem and social inclusion of children and adolescents.

Objectives: To compare the accuracy of bonding orthodontic attachments in a digital environment with the direct bonding procedure depending on the level of the orthodontist's clinical experience. Materials and Methods: A total of 1120 artificial teeth of 40 identical models (20 solid sets + 20 digital sets) were divided into four groups: (1) direct bonding (experienced clinicians). (2) direct bonding (postgraduate students), (3) virtual bonding (experienced clinicians), and (4) virtual bonding (postgraduate students). The differences in individual position of the placed attachments were measured after three-dimensional superimposition of the models using customized software. Results: In the interoperator comparison, experienced clinicians were more exact than postgraduate students in virtual bonding in the angular dimension. Between the bonding techniques, virtual bonding was more accurate than the direct technique. The prevalence of errors was higher in the direct procedure than virtual bonding, and the errors were more significant in the premolar and molar teeth. Conclusions: Clinical experience had a positive influence in achieving a higher rate of correctness/accuracy in the angular dimension only during virtual bonding. Virtual bonding was more accurate than direct bonding in the vertical and horizontal dimensions. Early diagnosis of errors in the bonding positions of attachments could be of benefit to both clinicians and patients by predicting discrepancies that may lead to undesirable orthodontic movements.

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