Bonding for an Exquisite Finish. All You Need to Know About Digital Indirect Bonding. Dalia-ElBokle / George Antonopoulos. Episode 126. September 8th 2021 Part 3

Play episode
Hosted by
Farooq Ahmed

Join me for a summary of Dalia El Bokle’s lecture exploring finishing in orthodontics. Part 3 focuses on digital indirect bonding, from scan to tray production




Straight wire appliance – based on bracket placement will correct tooth in 3 planes of space

  • Not true – evidenced by finishing bends


Ideal bracket placement through indirect bonding IDB

  • Level marginal ridges posteriorly
  • Constant smile arc anteriorly


Digital indirect bonding time saving

  • Brackets placed Layman 2019
    • Time saving
      • 21 minutes – digital indirect bonding Vs manual direct bonding
      • 8 minutes – clinical time indirect Vs direct bonding



Different methods of making an indirect digital bonding tray

Method 1:

  • Printed model
  • VFR transfer tray
  • Transfer tray made from the model


Method 2

  • Printer tray (not model)
  • Cost $105
  • Tray biocompatible tray
  • Cover occlusal half of the teeth and lingual aspect
  • Insert bracket into model
  • Advantage
    • No model printing
    • Clean base technique


Method 3 –

  • Key pads – digitally planned material between bracket base and tooth
    • Customises the bracket base
    • Advantage
      • Less flash
      • Accuracy of bracket position in on the keypad
      • Torque + in and out can be customised per tooth
    • Models printed
    • Lab place the brackets manually with composite onto the model with jigs
    • Transfer tray made from the model



Case submission for DIDB

  • Send STL file to lab
  • Prescription for set up, e.g.
    • Bracket selection customisation: Standard Damon Brackets, low torque lower incisors, high torque LL4.
    • Teeth bonded: 7-7 Upper and lower
    • Bracket positioning customisation: Smile arc – 0.5mm incisal U1s Vs U2s
  • Clinician approval of set up
    • Library of brackets – specify which type of bracket


Digital indirect bonding workflow overview

  1. Scan patients
  2. Orthodontist prescription
  3. CAD –Software system to place bracket and customise base / bracket
  4. Print model
  5. Brackets placed on model: allowing for bracket base customisation through either keypads or jigs, customising bracket base with composite
  6. CAM – Lab design indirect bonding tray (IBT)
    1. VFR
    2. Silicone transfer tray / Memosil material
  7. Process IBT
  8. Post processing chemical and UV light
  9. Insert bracket into tray with key holes as guides


Advantages of DIDB

  • Full digital pathway with scanning
  • Less working time
  • Fewer appointments
  • Can alter prescription



  • Cost
  • Learning curve
  • Production waste




Join the discussion

More from this show

Your subscription could not be saved. Please try again.
Your subscription has been successful.

Never miss an episode or blog!

Subscribe now