# Comparison Between Direct, Virtual Aided by Clinician and Artificial Intelligence Bonding Techniques in Orthodontics

**Authors:** Tarek ElShebiny, Johana Cortés‐Mercado, Neda Stefanovic, Juan Martín Palomo

PMC · DOI: 10.1111/ocr.70032 · Orthodontics & Craniofacial Research · 2025-10-13

## TL;DR

This study compares direct, virtual, and AI bonding techniques in orthodontics and finds statistically and clinically significant differences between some methods.

## Contribution

The study introduces a comparison of AI bonding techniques with traditional and virtual methods in orthodontics.

## Key findings

- Statistically significant differences were found between direct and AI bonding techniques.
- Clinically significant differences were observed in four tooth types for AI versus direct bonding.
- Differences between AI and virtual indirect bonding fall below 0.25 mm, suggesting no clinical significance.

## Abstract

The purpose of this study was to determine if there are any clinically significant differences between direct, virtual indirect, and artificial intelligence (AI) bonding techniques.

This in vivo study analysed 840 teeth selected from 14 patients undergoing orthodontic treatment with full fixed appliances. Anatomical superimpositions were performed, and data were collected as both numerical values and colour‐coded deviation maps to assess the differences between direct, AI, and virtual indirect bonding techniques.

The intraclass correlation coefficient test showed good correlation (0.894). The Kruskal–Wallis comparison showed a statistically significant difference when comparing direct to virtual indirect and direct to AI. Descriptive statistics showed 4 values with clinically significant differences when comparing direct to virtual indirect. Descriptive statistics showed 3 values with clinically significant differences when comparing direct to AI. Root mean square (RMS) discrepancies exceeding 0.50 mm were found in four tooth types (AI vs. Direct) and three (Clinician vs. Direct).

We found statistically and clinically significant differences between AI and virtual indirect when compared to direct bonding. With our data, we could infer that if we compare AI versus virtual indirect, there might not be any clinically significant differences since the differences between them fall below 0.25 mm.

## Full-text entities

- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12927125/full.md

## References

16 references — full list in the complete paper: https://tomesphere.com/paper/PMC12927125/full.md

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Source: https://tomesphere.com/paper/PMC12927125