Labial IDB as it is often called has existed for a long time. 45 years ago “Silverman and Cohen” first described it and throughout the 70’s 80’s and 90’s various techniques were developed, using various bonding materials to position orthodontic brackets to dental models in the hope of increasing precision and decreasing chair time. Most articles found that there was some increase in accuracy, but it really depended on extra factors that aren’t there in ‘direct bonding’, such as correct impressions, good accurate models that were an identical copy of the teeth to be bonded, the communication with the lab for the bonding prescription, individuals doing the bracket positioning and of course lastly the transfer system into the mouth! So as we see there has to be protocols that are followed strictly. But nearly all articles were unanimous in the conclusion that chair time was saved and the indirect bonding technique was less stressful for both the patient and clinician.

However nearly all of the common methods used before, and even today were what we call “Eye & Hand”. That is the person bonding the brackets to the models uses their ‘hands’, with the help of bracket tweezers or jigs and their ‘eyes’ to follow various reference lines drawn onto the model, using gauges and maybe measuring calipers. Actually this is still true for most CAD CAM systems until recently. Only height and ‘Tip’ can be accurately programmed leaving ‘Torque in slot’ somewhat to hope...hoping that the pre-programmed bracket system chosen would deliver it!

As we now know this is the problem in both ‘Direct’ and most ‘Indirect’ bonding of orthodontic brackets and is all due to Tooth Morphology. With varying morphology, torque in slot will change and can even differ significantly between two adjacent central incisors! (Go to our download page for articles about this). As we developed our techniques for Lingual orthodontic indirect bonding, which we know has a lot of problems with morphology of the lingual surfaces, then we thought to apply the same principles to our labial indirect bonding. By using the same instruments TAD and BPD (now the T.T.S. and B.P.I.), then we can accurately program a torque value into the bracket slots of our IDB technique.

LIBIAL Indirect Bonding