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Table 2 Summary of the included studies

From: Effectiveness, efficiency and adverse effects of using direct or indirect bonding technique in orthodontic patients: a systematic review and meta-analysis

Study Study design Observation period Participants Intervention (Indirect bonding adhesives) Comparison/Control (Direct bonding adhesives) Outcomes
Outcomes Indirect Direct
Aguirre 1982 [24] RCT (split-mouth) 3 months Sex: not specified Age: patients from graduate practice Inclusion criteria: receiving the orthodontic appliance Brackets: Ormco standard, with a mesh pad Endur (self-curing) (Lab adhesive: Sugar Daddy Tray: Citricon silicone impression material) Not specified Bracket placement accuracy refer to the original data
Working time (min, mean ± SD) LS: 29.8 ± 0.8 CS: 23.7 ± 1.1 T: 53. 5 42.0 ± 0.9
Bond failure rate 4/98 (4.10%) 5/94 (5.30%)
Dalessandri 2012 [12] RCT (split-mouth) 2 years and 6 months ±4 months Sex: male 13, female 17 Age: 11.2–12.8 years Inclusion criteria: attending an orthodontics department of a university and undergoing fixed orthodontic treatment (Victory braces, Low Profile series, MBT prescription, 0.022-in. slot, power arm on canines, 3 M Unitek); no presence of systemic or local (caries, periodontal pockets, mucosal alterations) pathologies; no need for surgical or extended restorative adjunctive procedures; no enamel development alterations; no dietary restrictions or intolerances Brackets: Victory braces, Low Profile series, MBT prescription, 0.022-in. slot, power arm on canines 3 M Unitek (light-cured) (Lab adhesive: removable adhesive (Vinavil, Vinavil SpA) Tray: a first bracket transfer matrix in a soft material (Copyplast 0.5 mm, Scheu Dental GmbH) was prepared with a pressure molding machine (Biostar VI, Scheu Dental Technology). and a second transfer matrix with a 1-mm thick Duran (Scheu Dental GmbH) foil was developed) 3 M Unitek (light-cured) Oral hygiene status (number of new caries) 2 2
Oral hygiene status (plaque accumulation index) 0.97 ± 0.29 1.71 ± 0.97
Oral hygiene status (number of new white spots) 8 21
Hodge 2004 [7] RCT (split-mouth) Not specified Sex: not specified Age: not specified Inclusion criteria: requiring full treatment with preadjusted edgewise appliances in both arches Brackets: not specified Not specified Not specified Bracket placement accuracy (bracket placement errors; mm/°, mean ± SD) V: −0.20 ± 0.08 H: −0.05 ± 0.10 A: 0.02 ± 0.05 V: −0.27 ± 0.46 H: −0.11 ± 0.30 A: 0.08 ± 0.14
Huang 2016 [28] RCT Not specified Sex: male 12, female 33 Age:15–30 years Inclusion criterion: requiring fixed orthodontic appliance therapy; with good oral hygiene; no periodontal diseases, caries, fluorosis, cracked-teeth, and partially erupted cases etc., heights of clinical crowns were similar Brackets: Damon3MX self-ligating brackets (Ormco, US) 3 M Unitek Sondhi™ Rapid-set (3 M, US) (Lab adhesive: 3 M Unitek Transbond™ XT (3 M, US) (light-cured) Tray: using translucent soft silicone to make the soft layer and rigid tray refinement) 3 M Unitek Transbond™ XT (3 M, US) (light-cured) Working time (min, mean) LS: 56.4 CS: 34.13 T: 90.53 T: 43.5
Thiyagarajah 2006 [25] RCT (split-mouth) 12 months Sex: not specified Age: 12–15 (mean13.6) years Inclusion criteria: requiring orthodontic treatment with full upper and lower pre-adjusted edgewise appliances; no caries, large restorations, fluorosis, hypoplasia or abnormalities of crown morphology Brackets: MBT™ Versatile+ Bracket System Transbond TM XT (light-cured) (Lab adhesive: 3 M Unitek laboratory adhesive; Tray: 0.45 mm Drufolen WTM transparent tray) Transbond TM XT (light-cured) Bond failure rate 6/279 (2.15%) 8/274 (2.92%)
Vijayakumar 2014 [26] RCT (split-mouth) 6 months Sex: male 12, female 18 Age: 15–28 (mean 21.73) years Inclusion criteria: requiring fixed orthodontic appliance therapy; with full complement of tooth and good oral hygiene; no deep-bite, crowns and veneers, and partially erupted cases Brackets: MBT −022 brackets Transbond XT (light cure adhesive) (Lab adhesive: Transbond XT light cure adhesive; Tray: constructed using soft clear thermo-plastic sheet of 2 mm thickness in a bio-star machine) Transbond XT (light-cured) Bond failure rate 23/262 (8.78%) 27/256 (10.55%)
Yıldırım 2018 [27] RCT Direct bonding: 12.0 ± 3.1 months; indirect bonding: 11.4 ± 2.4 months Sex: male 7, female 23 Age: Direct: 11.7–19.2 (14.6 ± 2.4) years; indirect: 11.4–21(16.7 ± 5.1) years Inclusion criterion: complete permanent dentition, including second molars with bilateral Angle Class I molar and canine relationships, no previous orthodontic treatment, no skeletal discrepancy, mild or moderate crowding Brackets: 0.018-in slot stainless steel Roth prescription Empower 2 self-ligating brackets and 0.018-in Non Convertible LP direct bond molar tubes, American Orthodontics, Sheboygan, Wis Transbond Supreme LV Low Viscosity Light Cure Adhesive; 3 M Unitek (light-cured) (Lab adhesive: Transbond Plus Color Change Adhesive; Tray: 2-layer transfer tray prepared using translucent soft silicone [Memosil 2; Heraeus Kulzer] and thermoformed rigid Essix plastic [Raintree Essix, New Orleans, La]) Transbond Plus Color Change Adhesive; 3 M Unitek (light-cured) Working time (min, mean ± SD) LS: 45.54 ± 4.33 CS: 26.51 ± 3.33 T: 72.05 ± 5.2 T: 53.02 ± 4.72
Oral hygiene status (plaque accumulation index; median ± interquartile range) 11.67 ± 16.66 5 ± 10.00
Oral hygiene status (white spot lesions formation; median ± interquartile range) 0.00 ± 0.08 0.00 ± 0.16
Bond failure rate 45/420 (10.71%) 30/420 (7.14%)
Zachrisson 1978 [18] RCT (split-mouth) 6 months Sex: male14, female 28 Age: 11–15 (13 ± 1.5) years Inclusion criteria: at least 4 permanent teeth in a quadrant Bracket: metal brackets with mesh-backed bases Edur (self-curing) (Lab adhesive: Sugar Daddy; Tray: Optosil, silicone putty impression material) Edur (self-curing) Oral hygiene status (number of gingival index score) 0:24 1:1235 2:154 0:39 1:1556 2:148
Oral hygiene status (number of plaque index score along bracket) 0:658 1:635 2:78 0:983 1:685 2:72
Oral hygiene status (number of plaque index score along gingiva) 0:517 1:717 2:164 0:755 1:818 2:167
Bond failure rate 9/104 (8.65%) 5/121 (4.13%)
  1. RCT randomized controlled trial, LS laboratorial stage, CS clinical stage, T total, V vertical, H horizontal, A angular