Objectives: 1) to assess different methods of recycling orthodontic brackets, 2) to evaluate Shear Bond Strength (SBS) of (a) new, (b) recycled and (c) repeated recycled stainless steel brackets (i) with and (ii) without bracket base primer. Study Design: A total of 180 extracted human premolar teeth and 180 premolar stainless steel brackets were used. One hundred teeth and 100 brackets were divided into five groups of 20-teeth each. Four methods of recycling orthodontic brackets were used in each of the first four groups while the last one (group V) was used as the control. Groups (I-V) were subjected to shear force within half an hour until the brackets debond. SBS was measured and the method showing the highest SBS was selected. A New group (VI) was recycled twice with the selected method. Six subgroups (1-6) were established; the primer was applied for three sub-groups, and the composite was applied for all brackets. Brackets were subjected to the same shear force, and SBS was measured for all sub-groups. Results: There was a significant difference between the mean SBS of the sandblasting method and the means of SBS of each of the other three methods. There was however, no significant difference between the mean SBS of the new bracket and the mean SBS of recycled bracket using sandblasting. The mean SBS of all sub-groups were more than that recommended by Reynolds (17) in 1975. Brackets with primer showed slightly higher SBS compared to those of brackets without bonding agent. Conclusion: To decrease cost, sandblasted recycled orthodontic brackets can be used as an alternative to new brackets. It is recommended to apply a bonding agent on the bracket base to provide greater bond strength. Key words:Recycled bracket, shear bond strength, sandblasting, stainless steel orthodontic bracket.

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Aim: To assess occlusal outcomes of orthodontic treatment for patients with complete cleft lip and palate. Design: Retrospective assessment using the Peer Assessment Rating (PAR) index. Setting: Consecutive patients treated by one consultant orthodontist at a tertiary care cleft center. Participants: One hundred twenty-seven patients with either complete unilateral cleft lip and palate (UCLP) or bilateral cleft lip and palate (BCLP) consecutively treated with fixed appliances. Intervention: Fixed orthodontic appliance treatment and orthognathic surgery when required. Outcomes: The PAR index assessment was carried out by a calibrated-independent assessor. Treatment duration, the number of patient visits, and data on dental anomalies were drawn from patient records and radiographs. Results: One hundred two patients’ study models were assessed after exclusions. Mean start PAR score for UCLP (n = 71) was 43.9 (95% CI, 41.2-46.6, SD 11.5), with a mean score reduction of 84.3% (95% CI, 81.9-86.7, SD 10.1). The UCLP mean treatment time was 23.7 months with 20.1 appointments. Mean start PAR score for BCLP (n = 31) was 43.4 (95% CI, 39.2-47.6, SD 11.4), with a mean score reduction of 80.9% (95% CI, 76.3-85.5, SD 12.5). The BCLP mean treatment time was 27.8 months with 20.5 appointments. Conclusion: These results compare well with other outcome reports, including those for patients without a cleft, and reflect the standard of care provided by an experienced cleft orthodontist. As with high-volume surgeons, orthodontic treatment for this high need group is favorable when provided by a high-volume orthodontist. These findings may be used for comparative audit with similar units providing cleft care.

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The current coronavirus pandemic is changing the way healthcare professionals provide services to patients. Healthcare professionals are required to provide quality care while reducing the risk of viral transmission. This pandemic has disrupted the timely multidisciplinary team care for patients with clefts across the globe. Thus, telemedicine has been recognized and accepted by various medical and dental specialists as a viable alternative to face-to-face consultation. In addition, telemedicine incorporating a digital workflow in cleft management will further reduce the risk of viral transmission and enhance the quality of treatment being provided to these patients.