DOI: 10.25259/apos_89_2023 ISSN: 2321-1407

A standardized hands-on protocol effectively enhanced orthodontic education on bonding clear aligner attachments

Shijia Li, Li Mei, Jianru Yi, Ehab A. Abdulghani, Wei Zheng, Yu Li
  • Orthodontics


The objectives of this study were to develop and evaluate the effectiveness of a hands-on approach for training orthodontic postgraduates to bond clear aligner (CA) attachments.

Material and Methods:

Twenty orthodontic novice postgraduate students were recruited for the study and randomly divided into two groups. The training group (n = 10) received theory teaching followed by a hands-on training approach; the control group (n = 10) received only theory teaching. The students’ performance of bonding attachments, including bonding failure, marginal flash, and morphological defects, was assessed by a panel of clinical supervisors.


The hands-on training approach promoted the students’ performance of bonding CA attachments, with an increased success rate (from 34% ± 6% to 81% ± 6%, P < 0.01) and a reduced operating time (from 89 ± 5 min to 65 ± 4 min, P < 0.01) compared with the control group. The most challenging parts of attachment bonding were found to be resin loading, followed by template removal and flash removal.


The hands-on approach developed in the present study was effective to train orthodontic postgraduates to bond CA attachments, with an increased success rate and reduced operating time.

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