New radiological findings and radiculomegaly in oculofaciocardiodental syndrome with a novel BCOR mutation: A case report.

RATIONALE: Oculofaciocardiodental syndrome (OFCD) patients who show radiculomegaly are very rare. We treated a new OFCD patient orthodontically, and performed longitudinal observation for 30 years. New findings, termed calcified-dental-papillae (CDPs) beneath open-apices (OAs) of developing radiculomegalies, pulp-stone-like-calcifications (PSLCs) and the process of radiculomegaly development were observed. A novel mutation of BCL-6 interacting corepressor (BCOR) was identified. Cone-beam-computed-tomography (CBCT) images of the radiculomegalies clarified their morphology. PATIENT CONCERNS: A female patient and her parents were referred to orthodontic clinic for alignment of the teeth. DIAGNOSIS: A CDP that harbored bulbous-round-calcified-tissue in the dental papilla beneath the OA of a developing radiculomegaly was found radiographically. PSLCs were observed in the dental pulp. Genetic analysis revealed a novel mutation c.265G>A on Exon 4 and diagnosed as OFCD. CBCT images confirmed round-calcified-tissue and PSLC and that the length of an affected canine was 38.0 mm and calculated as +14.8SD. These novel findings were not observed in lateral incisors and molars. INTERVENTIONS: Observation was performed for 29 years and 3 months including orthodontic treatment for 2 years and 9 months. OUTCOME: Longitudinal follow-up for 26 years and 7 months after the treatment revealed that the development of radiculomegaly every few months or years, CDPs beneath OAs and PSLCs were observed. CDPs, PSLCs, and OAs were associated with radiculomegaly. The patient and the affected teeth including aligned teeth showed no particular change after the completion of the radiculomegaly. CBCT images showed bulbous-calcified-tissue and PSLCs in the mature dental pulp associated with radiculomegaly. LESSONS: The radiographical findings of CDP, OA and PSLC help early diagnose of OFCD and have importance for initiating orthodontic treatment until radiculomegaly completion.

Clinical effect of CO(2) laser in reducing pain in orthodontics.

OBJECTIVE: To test the hypothesis that there is no difference in the pain associated with orthodontic force application after the application of local CO(2) laser irradiation to the teeth involved. MATERIALS AND METHODS: Separation modules were placed at the distal contacts of the maxillary first molars in 90 patients in this single-blinded study. In 60 of these patients (42 females and 18 males; mean age = 19.22 years) this was immediately followed by laser therapy. The other 30 patients (18 females and 12 males; mean age = 18.8 years) did not receive active laser irradiation. Patients were then instructed to rate their levels of pain on a visual analog scale over time, and the amount of tooth movement was analyzed. RESULTS: Significant pain reductions were observed with laser treatment from immediately after insertion of separators through day 4, but no differences from the nonirradiated control side were noted thereafter. No significant difference was noted in the amount of tooth movement between the irradiated and nonirradiated group. CONCLUSIONS: The hypothesis was rejected. The results suggest that local CO(2) laser irradiation will reduce pain associated with orthodontic force application without interfering with the tooth movement.

Clinical evaluation of a low-friction attachment device during canine retraction.

OBJECTIVE: The present study used a split-mouth design to compare the amount of canine movement and the retraction time between brackets with Clear Snap and brackets with stainless steel ligature wires for three different levels of retraction force. MATERIALS AND METHODS: A sample of 30 patients was used. After initial leveling, the canine was retracted using a 50-g (n = 10), 100-g (n = 10), or 150-g (n = 10) closed-coil spring. The canine on one side was chosen at random, and Clear Snap was attached to the bracket during the retraction period. The other side was used as a control. The amount of canine retraction was measured with a digital vernier caliper. Statistical analysis was performed by analysis of variance. RESULTS: The average canine retraction time was approximately 2 to 3 months less in all experimental groups (50, 100, and 150 g) compared to the control group. In the control group, 150 g resulted in a shorter duration of canine retraction compared to 50 g. There was no significant difference in the duration of canine retraction among the experimental groups. A greater amount of mean total canine movement was observed in all experimental groups compared to the control groups. CONCLUSION: A shorter duration of canine retraction time was observed with Clear Snap attached when compared with the control. The authors suggest that with the use of Clear Snap, less than 50 g of force may effectively retract a canine.