Clinical Effect Analysis of Digital Guide-Assisted Accurate Bracket Positioning in Orthodontic Patients: A Prospective Randomized Controlled Trial

Yan Feng

doi:10.63313/hmt.9025

Authors

Yan Feng Lincoln University College, Petaling Jaya 47301, Malaysia Author

DOI:

https://doi.org/10.63313/hmt.9025

Keywords:

Digital Positioning Guide, Orthodontic Bracket Placement, Adolescent Orthodontics, Indirect Bonding, CAD/CAM

Abstract

Precise bracket placement is foundational to fixed orthodontic therapy, yet conven-tional direct bonding is limited by restricted intraoral access and visual estimation errors. This prospective, single-center, parallel-group randomized controlled trial enrolled 80 adolescent patients aged 12–18 years and compared a CAD/CAM digi-tal positioning guide (DG) workflow with conventional direct bonding (CDB). Par-ticipants were randomized 1:1 using a computer-generated sequence stratified by Angle classification and age cohort. The primary outcome was mean three-dimensional Euclidean deviation between planned and actual bracket cen-troid positions, assessed by post-bonding intraoral scan superimposition. Second-ary outcomes included arch bonding time, positional-error archwire adjustments, estimated active treatment duration, and patient-reported discomfort on a 100-mm visual analogue scale (VAS). The DG group achieved significantly lower mean overall positional deviation (0.31 ± 0.12 mm) vs. the CDB group (0.74 ± 0.21 mm; p*< 0.001; Cohen's d= 2.49). Mean arch bonding time was reduced by 18.5% in the DG group (27.4 ± 4.1 min vs. 33.6 ± 5.3 min; p< 0.001). Positional-error archwire adjustments were substantially fewer in the DG group (0.4 ± 0.6 vs. 2.1 ± 0.9 per patient; p< 0.001). Estimated active treatment duration was 2.6 months shorter for DG patients. VAS discomfort scores did not differ significantly between groups. Dig-ital guide-assisted bracket placement achieves substantially superior three-dimensional accuracy and enhances bonding efficiency in adolescent ortho-dontic patients without increasing procedural discomfort, supporting its adoption as a precision complement to contemporary digital orthodontic workflows.

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