The effect of using dental loupes on the accuracy of aligner attachments and flash adhesive area after bonding

OBJECTIVE: This study aimed to assess whether the use of dental loupes improves the accuracy of aligner attachments and reduces the amount of composite flash after bonding. METHODS: Six epoxy resin-printed models (n=14 teeth per model) were created to produce upper arches. All attachments were bonded with G-ænial Posterior composite using the same aligner template, and the protocols differed regarding the use of a dental loupe. The attachments were bonded using the dental magnifying loupe at 2.5X magnification in the "with loupe" Group 1 (n=42 teeth), and with the naked eye in the "without loupe" Group 2 (n=42 teeth). All bonded attachments were scanned and compared to those of a reference model using Geomagic Control X software to assess accuracy, with a focus on the highest deviations (defects and excesses) between the reference attachment and the results from different bonding protocols. The amounts of flash adhesive were also measured. Independent Samples T-test and Mann-Whitney U test were used. The significance level was set at 0.05. RESULTS: The maximum deviation in excess was 0.46 mm (0.2-1.21) in Group 2, which was higher than the value in Group 1 (0.38 mm, 0.18-0.79) (p=0.048). Regarding the flash adhesive area, the "without loupe" group showed a significantly higher value (42.01±10.32 mm²) compared to the "with loupe" group (31.79±5.38 mm²) (p<0.001). CONCLUSIONS: Using a magnifying dental loupe revealed significantly lower values in both the flash adhesive area around the attachment and the maximum vertical excess on the attachment surface. Clinicians are advised to use dental loupes during bonding attachments.