Abstract: Objective To explore four-handed operation technology in orthodontic referral process. Methods 50 patients with orthodontic referral were randomly divided into experimental group and control group, the operation of both groups were performed by the same senior doctors. USE West Baltic non-mixing type enamel bonding resin, and brackets selection of domestic Ossur MBT orthodontic brackets were used in the operation. The patients of the control group were applied with non-four hands technique, the entire operation process was assisted by a nurse ,a physician completed the operation. The experimental group received four hand manipulation techniques, in the course of treatment a full-time nurse assisted the physician in practices, conducted strict implementation of disinfection system, complete equipment delivery, every wet assistance, public education and other auxiliary work. The comparison of the operating time, the terms of the bracket drop rate after operation for 30 days and the degrees of the patients’ comfort between the two groups were compared. Results The differences in comfort of the patients between the experimental group and the control group were not statistically significant, the operating time, the terms of the bracket drop rate in the experimental group after operation for 30 days were better than that of the control group. Conclusion Four-handed technique applied can obviously improve the success rate of bracket bonding, reduce the intensity of the doctor's work and shorten the treating time and there is not significant difference in terms of patients’ comfort between the two groups.

Key words: four-handed operation, brackets bond, oral