Effectiveness and efficiency of indirect bonding techniques: An umbrella review with meta-analysis of the pooled findings

IF 1.8 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

International Orthodontics Pub Date : 2025-06-30 DOI:10.1016/j.ortho.2025.101036

Ziad Mohamad Alhafi , Mohammad Y. Hajeer , Mohammad Khursheed Alam , Safwan Jaber , Samer T. Jaber

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引用次数: 0

Abstract

Objectives

This umbrella review aimed to critically evaluate the available evidence regarding the accuracy, bond failure rate, working and chairside time, and oral hygiene associated with the indirect bonding of orthodontic brackets.

Material and methods

An electronic search was performed using the following databases: Cochrane Library, Scopus®, Web of Science™, EMBASE®, PubMed®, SciELO, and LILACS. The search was for systematic reviews published between January 1968 and January 2025. There were no restrictions on language or date of publication. The process of screening, study selection, data extraction, and methodological quality assessment using A Measurement Tool to Assess Systematic Reviews-2 (AMSTAR-2) was performed by two independent authors. The most reliable evidence was identified using the Jadad decision algorithm. Data were combined and analyzed using random-effects meta-analysis.

Results

Out of 66 studies eligible for assessment, 15 were selected for full-text assessment. Seven systematic reviews were included, five of which contained meta-analyses. According to the AMSTAR-2 tool, the included reviews varied in methodological quality from moderate to critically low, with four receiving the lowest rating, thus limiting the overall certainty of the available evidence. The meta-analysis of the pooled findings showed acceptable transfer accuracy for indirect bonding methods, with no significant difference compared to direct bonding. The bracket bond failure rate was also comparable in both techniques. Indirect bonding technique was associated with shorter chairside time but longer total working time. Finally, there is no reliable evidence in the current literature about oral hygiene and indirect bonding.

Conclusions

Based on the available evidence from the systematic reviews, within the limitations of the available evidence, direct and indirect bonding techniques did not significantly differ in bracket placement accuracy, bonding failure rate, and oral hygiene. Indirect bonding may require less chairside time but a longer overall working time than direct bonding.

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间接连接技术的有效性和效率：综合研究结果的荟萃分析综述

目的本综述旨在批判性地评估关于正畸托槽间接粘接的准确性、粘接失败率、工作和椅边时间以及口腔卫生的现有证据。材料和方法使用以下数据库进行电子检索：Cochrane Library、Scopus®、Web of Science™、EMBASE®、PubMed®、SciELO和LILACS。研究对象是1968年1月至2025年1月间发表的系统综述。没有对语言或出版日期的限制。筛选、研究选择、数据提取和使用评估系统评价的测量工具-2 （AMSTAR-2）进行方法学质量评估的过程由两位独立作者完成。使用Jadad决策算法确定最可靠的证据。使用随机效应荟萃分析对数据进行合并和分析。结果66项符合评估条件的研究中，有15项入选全文评估。纳入了7个系统综述，其中5个包含元分析。根据AMSTAR-2工具，纳入的评价在方法学质量上从中等到极低不等，其中4个评价获得最低评级，从而限制了现有证据的总体确定性。综合结果的荟萃分析显示，间接粘接方法的传递精度可以接受，与直接粘接方法相比没有显著差异。在两种技术中，支架粘合失败率也具有可比性。间接粘接技术与较短的椅边时间有关，但与较长的总工作时间有关。最后，在目前的文献中，没有可靠的证据表明口腔卫生和间接结合。结论根据系统评价的现有证据，在现有证据的限制下，直接和间接粘接技术在支架放置准确性、粘接失败率和口腔卫生方面没有显著差异。与直接粘接相比，间接粘接可能需要更少的椅边时间，但总体工作时间更长。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Orthodontics DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

2.50

自引率

13.30%

发文量

审稿时长

26 days

期刊介绍： Une revue de référence dans le domaine de orthodontie et des disciplines frontières Your reference in dentofacial orthopedics International Orthodontics adresse aux orthodontistes, aux dentistes, aux stomatologistes, aux chirurgiens maxillo-faciaux et aux plasticiens de la face, ainsi quà leurs assistant(e)s. International Orthodontics is addressed to orthodontists, dentists, stomatologists, maxillofacial surgeons and facial plastic surgeons, as well as their assistants.