The adhesive pre-coated bracket system along with the application of light curing for orthodontic bracket placement were compared with a conventional adhesive system, in a prospective randomized study. Of 38 consecutive patients requiring fixed orthodontic appliances, half were treated with adhesive pre-coated brackets and half with a no-mix adhesive. The timings for the clinical stages involved in bracket placement, were recorded. This also included the time and reliability of bracket identification and orientation. The peri-bracket flash distribution, time taken for clean up at the subsequent visit, the site, and number of bracket failures at the time of bracket placement and during the first 3 months, were recorded. The study showed that althought the time taken to place and care the adhesive pre-coated system was longer than for the no-mix system, this difference was not statistically significant. However, this difference in time was compensated for in the time taken for bracket orientation in the control group and subsequent clean up at the second visit. Both the bracket failure rate and peri-bracket flash scores were reduced in the adhesive pre-coated group as compared with the control and these differences were statistically significantly. Other advantages of the adhesive pre-coated system are reported.

Obstructive sleep apnoea (OSA) is a potentially fatal breathing disorder, yet is widely under-diagnosed. It is a multifactorial condition associated with high morbidity, a degree of mortality and is associated with an increase risk of car crashes. A case is presented which demonstrates the inter-disciplinary approach to this condition and the successful treatment through mandibular advancement by orthodontic means followed by orthognathic surgery. The experience of this patient illustrates the importance of the disciplines of orthodontics and oral and maxillofacial surgery in the multidisciplinary management of these patients.

Patients are frequently being asked to wear orthodontic retainers for as long as they want their teeth to remain in the post-treatment position. Fixed retainers, which are placed on the lingual surface of anterior teeth only, have the advantage of minimal compliance issues but are not without their problems related to wire fracture, adhesive failure and potential gingival or periodontal disease. Plastic retainers, although associated with relatively good aesthetics and compliance, have limitations related to their physical and mechanical properties. This paper describes a chrome cobalt metal retainer that could be used as a long-term retainer with few drawbacks. The properties of chrome cobalt are described and the clinical procedure is outlined.

Snoring and sleep apnea are chronic conditions. This article describes the use of cobalt chrome mandibular advancement appliances as a long-term, robust addition to the appliances used to treat these conditions. The clinical indications, appliance design, construction stages and special features of using cast alloy bases are described.

A simple technique is described to position and maintain a wire retainer during direct bonding using a custom made acrylic carrier.