Dr. Lisa Alvetro of Sidney, Ohio first became interested in indirect bonding 10 years ago, attempting to use the analog method with stone models. Like many orthodontists at the time, she found the process excessively labor-intensive.

Technological advances in digital indirect bonding during recent years, however, persuaded Dr. Alvetro to try again. Her positive experiences with the approach have led her to encourage colleagues using traditional bonding to consider switching to DIB.

“The digital process makes all the difference in the efficiency of the workflow from beginning to end,” says Dr. Alvetro. “The software for digital set-ups is now very intuitive and makes it easy to place brackets with precision to get each tooth to the desired position.”

Time required for bonding is reduced significantly for each case utilizing DIB.

“Once the patient is seated in the chair, their bonding time is reduced by about half,” says Dr. Alvetro. “It is easy to train staff to seat indirect bonding trays, or the doctor can do it. The process is completed by the chairside assistant curing the adhesive.”

“The patient experience is also a key benefit of digital indirect bonding,” adds Dr. Alvetro. “Some patients have difficulty sitting still for the time required for traditional bonding. The shorter DIB time frame is great for them. The patient can also be more comfortable, closing their mouth and resting their teeth on the indirect bonding tray.”

DIB Trays: Outsource or Produce In-House?
A standard bracket or a custom bracket system created for the individual patient may be used in DIB workflow. Using a standard bracket, DIB tray production may be outsourced or trays may be printed in-house on a 3D printer. With a custom bracket system, DIB trays will be produced by a supplier and delivered to the orthodontist, with brackets loaded into the trays.

Dr. Alvetro utilizes a 3D printer in her office for printing models for aligners and retainers, and also prints many DIB trays. Decision-making on trays depends in part on what type of brackets will be used, based on the needs of the case and patient preferences such as esthetic brackets.

“If we print the trays in the office, we do everything in-house utilizing the digital software setup, DIBS AI,” she says. “When outsourcing of indirect bond tray production is preferred , the decrease in costs and turnaround time have allowed for outsourcing to be a viable option.”

AAO Members Receive Discounts on DIB Trays & Custom Brackets
As a member of the AAO Committee on Technology (CTECH), Dr. Alvetro was instrumental in the development of the Digital Indirect Bonding and Custom Bracket Systems section of AAO TechSelect, which provides AAO member discounts for several orthodontic technologies.

TechSelect DIB and custom bracket systems partner companies offer AAO member discounts for expenses such as initial set-up fee (where applicable) or third-party trays. The partners include DIBS AI, Lightforce, KLOwen and Monolithic/Braces on Demand.

As with all other products on TechSelect offering AAO member discounts, a member simply selects the product on the TechSelect page and clicks on Add to My List.  A company representative then follows up with the orthodontist to conclude the purchase at the discounted price.

TechSelect has additional DIB resources including in-depth product information and comparisons; a step-by-step how-to guide for every part of the DIB workflow process, from selection through bonding, a financial considerations overview; and a 2023 AAO Annual Session panel video on DIB implementation. The video features Dr. Christian Groth, moderator and panelists including Dr. Pat Brady, Dr. Brandon Martin, Dr. Geoff Sudit and Dr. Alvetro.

“DIB has brought great benefits for our practice in terms of efficiency, the patient experience and precision bracket placement,” says Dr. Alvetro. “For any orthodontist who has not considered it, today’s DIB is worth a close look.”

Learn More
Recent research validating DIB includes an April 2023 study in the AJO-DO: “Accuracy of 3-Dimensional–Printed Customized Transfer Tray Using a Flash-Free Adhesive System in Digital Indirect Bonding: An in Vivo Study.”

The 2024 Annual Session will offer a lecture series on DIB on Saturday morning, May 4 at the Ernest N. Morial Convention Center in New Orleans:

● That Was Fast: Digital Indirect Bonding Enhancing Practice Efficiencies
Dr. Megan LeCornu
● Considerations with Digital Indirect Bonding: Custom vs. Conventional, In-office vs. Lab,Tray Design & Printer/Resin Selection
Dr. Brandon Owen
● Clinical & Operational Considerations for a Practice Using Personalized Appliances
Dr. Alfred Griffin
● Digital Indirect Bonding Panel Discussion
Drs. Megan LeCornu, Brandon Owen & Alfred Griffin

For more information or assistance with TechSelect, stop by the TechSelect booth in the Innovation Pavilion, located near the AAO Pavilion in the 2024 Annual Session Exhibit Hall.