Review Article| Volume 11, ISSUE 6, P190-196, December 2022

In-house three-dimensional designing and printing customized brackets

  • Nearchos C. Panayi
    Corresponding author: Scientific Collaborator, Department of Dentistry, European University Cyprus, Nicosia, Cyprus, 232 Leontiou A’, office 11, 3020 Limassol, Cyprus.
    Scientific Collaborator, School of Dentistry, European University Cyprus, Nicosia, Cyprus

    Visiting Research Scientist, Clinic of Orthodontics & Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland

    Orthodontist Specialist, Private Office, Limassol, Cyprus
    Search for articles by this author
Published:November 05, 2022DOI:


      • Three-dimensional (3D) technology is changing the way orthodontics is being practiced.
      • In-house 3D designing of customized brackets is possible using Ubrackets computer-aided design software.
      • In-house 3D printing of customized brackets is possible using VAT technology printers.
      • 3D printing of brackets can be performed using hybrid ceramic resin or zirconia slurry.
      • Complete customization consists of mechanical and biological customization.


      Digital technology is one of the major advancements during the past years that changed many aspects of our daily life. Medicine and dentistry were positively affected from the very first years of this digital evolution. Orthodontics is not an exception to this global digitization. Intraoral scanners, computer-aided design software, three-dimensional printers, and new materials were invented and introduced in dentistry and orthodontics during the last 20 years. The ability to include a small digital laboratory in the orthodontic office helped the creation of the in-house manufacturing concept. Continuously, the ability to design appliances that fit exactly to the teeth of the patient allowed the digital customization of almost every orthodontic appliance. Lately, the development of computer-aided design software called Ubrackets enabled the orthodontist to design and print customized orthodontic brackets in the orthodontic office. The designing workflow follows a specific protocol, which makes designing fast and easy. Three-dimensional printing of brackets can be performed using hybrid ceramic resin or zirconia slurry. Although some controversial studies exist, customized brackets have not been extensively studied despite that. A new term, “biological customization” is proposed, which takes into consideration the different biology of each patient, as opposed to teeth roots, bone turnover, and characteristics. Complete treatment customization should necessarily include mechanical and biological customization.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of the World Federation of Orthodontists
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Panayi NC.
        DIY orthodontics: design it yourself.
        Quintessence Publishing, Chicago2021
        • Panayi N
        • Eliades T.
        In-office 3-dimensional-printing: does the hype obscure the hazards for the operator?.
        Am J Orthod Dentofacial Orthop. 2022; 161: 757-759
        • Nowak R
        • Olejnik A
        • Gerber H
        • Frątczak R
        • Zawiślak E.
        Comparison of tooth- and bone-borne appliances on the stress distributions and displacement patterns in the facial skeleton in surgically assisted rapid maxillary expansion-a finite element analysis (FEA) study.
        Materials (Basel). 2021; 14: 1152
        • Nojima LI
        • Nojima MDCG
        • Cunha ACD
        • Guss NO
        • Sant'Anna EF
        Mini-implant selection protocol applied to MARPE.
        Dent Press J Orthod. 2018; 23: 93-101
        • Angle EH.
        The latest and best in orthodontic mechanism.
        Dent Cosmos. 1928; 70: 1143-1156
        • Angle EH.
        The latest and best in orthodontic mechanism.
        Dent Cosmos. 1929; 71: 164-174
        • Angle EH.
        The latest and best in orthodontic mechanism.
        Dent Cosmos. 1929; 72: 260-270
        • Angle EH.
        The latest and best in orthodontic mechanism.
        Dent Cosmos. 1929; 73: 409-421
        • Andrews LF.
        The straight-wire appliance: syllabus of philosophy and techniques.
        Rev. ed. San Diego: University of Michigan publications, 1975
        • Wiechmann D
        • Rummel V
        • Thalheim A
        • Simon JS
        • Wiechmann L.
        Customized brackets and archwires for lingual orthodontic treatment.
        Am J Orthod Dentofac Orthop. 2003; 124: 593-599
        • Panayi NC
        • Tsolakis AI.
        In-house computer-aided design and 3-dimensional printing of customized orthodontic brackets using hybrid ceramic resin: is it the time for the orthodontist to take over?.
        Am J Orthod Dentofac Orthop. 2021; 1: 187-193
        • Panayi NC.
        In-house customization of lingual orthodontic brackets using Ubrackets computer-aided design orthodontic software.
        Am J Orthod Dentofac Orthop. 2022; 2: 325-334
        • Duret F
        • Preston JD.
        CAD/CAM imaging in dentistry.
        Curr Opin Dent. 1991; 1: 150-154
        • Mormann W
        • Brandestini M
        • Ferru A
        • Lutz F
        • Krejci I.
        Marginal adaptation of adhesive porcelain inlays in vitro.
        Rev Mens Suisse Odonto Stomatol. 1985; 95 ([in German]): 1118-1129
        • Abdulhameed O
        • Al-Ahmari A
        • Ameen W
        • Mian SH.
        Additive manufacturing: challenges, trends, and applications.
        Adv Mech Eng. 2019; 11 (168781401882288)
        • Kodama H.
        Automatic method for fabricating a three-dimensional plastic model with photo-hardening polymer.
        Rev Sci Instrum. 1981; 52: 1770-1773
        • stereolithography Hull C.On
        Virtual Phys Prototyping. 2012; 7: 177
        • Papageorgiou SN
        • Polychronis G
        • Panayi N
        • Zinelis S
        • Eliades T.
        New aesthetic in-house 3D-printed brackets: proof of concept and fundamental mechanical properties.
        Prog Orthod. 2022; 23: 6
        • Eliades 1, T
        • Gioka C
        • Zinelis S
        • Eliades G
        • Makou M
        Plastic brackets: hardness and associated clinical implications.
        World J Orthod. 2004; 5: 62-66
        • Rueggeberg FA
        • Margeson DH.
        The effect of oxygen inhibition on an unfilled/filled composite system.
        J Dent Res. 1990; 69: 1652-1658
        • Ligon SC
        • Husár B
        • Wutzel H
        • Holman R
        • Liska R.
        Strategies to reduce oxygen inhibition in photoinduced polymerization.
        Chem Rev. 2014; 114: 557-589
      1. Slurry. Updated 2022. Available from: [accessed 25 August 2022].

        • Mouiya M
        • Bouazizi A
        • Abourriche A
        • et al.
        Effect of sintering temperature on the microstructure and mechanical behavior of porous ceramics made from clay and banana peel powder.
        Results Mater. 2019; 4100028
        • Tabatabaian F.
        Color in zirconia-based restorations and related factors: a literature review.
        J Prosthodont. 2018; 27: 201-211
        • Penning EW
        • Peerlings RHJ
        • Govers JDM
        • et al.
        Orthodontics with customized versus noncustomized appliances: a randomized controlled clinical trial.
        J Dent Res. 2017; 96: 1498-1504
        • Menini A
        • Cozzani M
        • Sfondrini MF
        • Scribante A
        • Cozzani P
        • Gandini P
        A 15-month evaluation of bond failures of orthodontic brackets bonded with direct versus indirect bonding technique: a clinical trial.
        Prog Orthod. 2014; 15: 70
        • Brown MW
        • Koroluk L
        • Ko CC
        • Zhang K
        • Chen M
        • Nguyen T.
        Effectiveness and efficiency of a CAD/CAM orthodontic bracket system.
        Am J Orthod Dentofacial Orthop. 2015; 148: 1067-1074
        • Weber II, DJ
        • Koroluk LD
        • Phillips C
        • Nguyen T
        • Proffit WR
        Clinical effectiveness and efficiency of customized vs. conventional preadjusted bracket systems.
        J Clin Orthod. 2013; 47: 261-268
        • Lim S
        • Kim E.
        Evolution to the customized brackets: Part I. Problem of preadjusted brackets.
        Clinical J Korean Assoc Orthodontists. 2020; 10: 68-78
        • Miethke RR
        • Melsen B.
        Effect of variation in tooth morphology and bracket position on first and third order correction with preadjusted appliances.
        Am J Orthod Dentofacial Orthop. 1999; 116: 329-335
        • Creekmore TD
        • Kunik RL.
        Straight wire: the next generation.
        Am J Orthod Dentofacial Orthop. 1993; 104: 8-20
        • Jheon AH
        • Oberoi S
        • Solem RC
        • Kapila S.
        Moving towards precision orthodontics: an evolving paradigm shift in the planning and delivery of customized orthodontic therapy.
        Orthod Craniofac Res. 2017; 20: 106-113