Idiopathic pre-eruptive coronal resorption of a maxillary permanent canine

Pre-eruptive intracoronal resorption in orthodontic patients: A retrospective analysis of 3,143 patients

OBJECTIVES

The aim of this retrospective study was to analyze the occurrence and characteristics of pre-eruptive intracoronal resorptions in a clinical orthodontic patient population.

MATERIALS AND METHODS

Patients treated in an orthodontic department (University of Pécs, Pécs, Hungary) were included. Unerupted teeth on panoramic radiographs were analyzed for intracoronal radiolucent lesions. For each patient, the demographic data, jaw localization, number of unerupted teeth with pre-eruptive intracoronal resorption lesions, number of lesions per tooth, size and localization of pre-eruptive intracoronal resorption defects, affected tooth's surface, pulp involvement and ectopic position of the tooth with defects were recorded.

RESULTS

In the 3,143 patients investigated, 55 teeth in 49 patients showed pre-eruptive intracoronal resorption lesions (subject incidence: 1.56%). The incidence on unerupted teeth was 0.25%. Pre-eruptive intracoronal resorption was significantly more common in mandibles (43 mandibular vs. 12 maxillary lesions) with an odds ratio of 12.84 (95% Confidence Interval: 5.19-31.74) and no gender differences were found (p = 0.746). The occurrence of pre-eruptive intracoronal resorption was highest in the youngest (7-10 years) mixed dentition status group (p < 0.001). Most of the lesions (44 of 55, or 80.0%) were localized in the dentin, occupying two-third or less of the dentin thickness. Only 12.73% (7/55) of the lesions were not localized on the occlusal surface. Of the lesions, 89.1% (49/55) showed no obvious size increase over an average follow-up of 36.4 ± 8.1 months.

CONCLUSIONS

Pre-eruptive intracoronal resorption may occur mainly in the mixed dentition stage in orthodontic patients. Careful and attentive radiographic evaluations may facilitate early detection and follow-up of the lesions' possible dimensional changes, especially when resorption influences orthodontic extraction therapy.

Pre-eruptive intracoronal resorption in "high-risk" impacted third molars: A report of four cases

Pre-eruptive intracoronal resorption (PEIR) is usually an incidental finding as a radiolucent lesion within the coronal dentin of unerupted teeth. Through the four cases reported here, authors would demonstrate deeply impacted "high-risk" third molars with PEIR defects, showing an increased risk of inferior alveolar nerve (IAN) injury. However, follow-up or coronectomy may eliminate or reduce the risk of neurosensory disturbances, in case of PEIR lesions this can be contradictory due to the unpredictable reactions of the third molar's pulp. Cases show the important role of preoperative imaging in the diagnostics and management of deeply impacted PEIR third molars and highlight the need for investigations regarding coronectomy in such cases.

Idiopathic coronal resorption in impacted permanent teeth and its relationship with age: radiologic study

Purpose

The purpose of this study was to evaluate the relationship between idiopathic coronal resorption and age in adult patients.

Materials and methods

3405 digital panoramic radiographs present in the archive of the radiology department belonging to 1584 males and 1821 females aged 25 and over were assessed by two oral and maxillofacial radiologists. The patients' age, gender, number of impacted teeth, number and position of teeth with idiopathic coronal resorption and the extent of coronal resorption were recorded on standard forms.

Results

A thousand and nine impacted teeth were observed in 622 patients (304 males and 318 females) with a mean age of 36,92 (±10,85). Idiopathic coronal resorption was present in 26 of the 622 patients with a frequency of 4.2%. One patient had two teeth with idiopathic coronal resorption; resulting in as 27 teeth and a frequency of 2.7% according to tooth number. There were 13 (50%) females and 13 (50%) males having idiopathic coronal resorption. There was no significant difference between genders. The presence of idiopathic coronal resorption increased with advanced age (v: 0,193, p<0.05). There was no statistically significant difference between the extent of the coronal resorption and age.

Conclusion

The presence of idiopathic coronal resorption increases with advancing age. Idiopathic coronal resorption is detected incidentally during radiographic examination. Thus, dentists should consider this situation and should perform periodically radiographic examination of impacted teeth.

Management of Maxillary Premolar with Pre-eruptive Intracoronal Resorption: A 5-year Follow-up Case

Aim and objective

The present article aims to describe and discuss the preventive clinical management of a pre-eruptive intracoronal resorption (PEIR) defect on a maxillary right second premolar of an 11-year, 5-month-old girl.

Background

Pre-eruptive intracoronal resorption is described as an abnormal, well-circumscribed, radiolucent area, occurring within the coronal dentinal tissue close to the dentinoenamel junction of unerupted teeth and extending into various depths of the dentin. It is a rare anomaly occurring in primary and permanent dentitions. In the past, these defects were misdiagnosed as caries, and were therefore called “pre-eruptive caries” or “hidden caries”. Currently, the most acceptable etiological hypothesis for PEIR is intracoronal resorption by the invasion of resorptive cells into the dentine through breakdowns in the enamel during crown formation. These lesions are often detected accidentally during routine dental radiographic examination.

Case description

A fissure sealant was applied to the affected tooth shortly after its eruption. Clinical and radiographical assessments were scheduled every 6 months for a period of 5 years and 5 months.

Conclusion

The preventive approach proved to be effective in preserving the tooth vital and asymptomatic with normal root development for the entire follow-up period.

Clinical significance

This article raises awareness about misdiagnosed PEIR in primary and permanent dentitions. A close inspection of radiographs, taken during routine visits and orthodontic check-ups, is important for early detection and proper management of such defects.

How to cite this article

Ambriss B, Moukarzel C, Ezzeddine M, et al. Management of Maxillary Premolar with Pre-eruptive Intracoronal Resorption: A 5-year Follow-up Case. Int J Clin Pediatr Dent 2021;14(1):161–166.

Pre-eruptive intra-coronal resorption of dentine: a review of aetiology, diagnosis, and management

AIM

To discuss prevalence, characteristics, aetiology and pathophysiology, diagnosis and management of pre-eruptive intra-coronal radiolucency/resorption (PEIR) defects, and to highlight the clinical significance of PEIR.

METHODS

A literature research from Pubmed Medline database was adopted to identify the relevant published articles related to PEIR using keyword search strategy; other papers were obtained through searching the reference lists. Significant findings were summarised and presented in this review.

RESULTS

Subject prevalence was (0.2-27.3%) and tooth prevalence was (0.2-3.5%); depending on factors such as type of radiograph used for assessment, demographic factors, age range included, and dentition stage. Currently, the most acceptable etiologic theory for PEIR is intra-coronal resorption by invasion of resorptive cells into forming dentine via an interruption of crown formation; most likely to be caused by local factors such as ectopic position of affected tooth or adjacent tooth next to it. Diagnosis of PEIR lesions occurs, as they are noted incidentally on routine dental radiographs of unerupted teeth. A management protocol for PEIR defects has been suggested based on the literature. The clinical significance of these lesions is that they could constitute a large proportion of occult caries, and can be associated with developmental defects, ectopic positioning and supernumerary teeth, and a delay in dental development.

CONCLUSIONS

Early diagnosis of PEIR defects by careful viewing of radiographs of unerupted teeth is important as part of clinical examinations to allow early treatment.

Pre-eruptive coronal resorption of unerupted molar teeth in orthodontic patients

Pre-eruptive coronal resorption (PCR) is a rare phenomenon affecting unerupted permanent teeth. The aetiology of PCR is unknown and is often detected as an incidental finding. The prognosis of affected teeth can be extremely variable and may involve multidisciplinary management. The lower second permanent molars are commonly affected. The following is a description of three clinical cases of PCR affecting lower permanent molars in orthodontic patients.

Pre-emptive Intracoronal Radiolucency in First Permanent Molar

Pre-eruptive intracoronal radiolucency (PECR) is characterized by the existence of a radiographic radiolucent area inside the coronal dentin prior to dental eruption. It is a rare clinical entity of unknown etiology, usually asymptomatic and diagnosed through routine radiographs. The aim of this article is to report the treatment of a PECR in an 8-year-old girl. Surgical procedure to expose the crown was conducted; upon tooth eruption, the radiolucent lesion was accessed and the tooth was restored. The case has an 18-month follow-up and emphasis on aspects linked to diagnosis and clinical approach was discussed. How to cite this article: Ilha MC, Kramer PF, Ferreira SH, Ruschel HC. Pre-eruptive Intracoronal Radiolucency in First Permanent Molar. Int J Clin Pediatr Dent 2018;11(2):151-154.

Prevalence of pre-eruptive intracoronal radiolucencies in Thai children and adolescents: A retrospective study

AIM

The aim of the present study was to determine the prevalence, location, size, and tooth type of pre-eruptive intracoronal radiolucencies (PEIR) from panoramic radiographs in Thai patients.

METHODS

A retrospective study of PEIR was conducted on 1599 panoramic radiographs of 629 Thai males and 970 Thai females with an age range of 4-20 years (average age: 14.0 ± 4.0 years). Each radiograph was reviewed by two calibrated examiners. The age and sex of the patients, location, size, and tooth type of the lesions were recorded. The SPSS program was used for statistical analysis.

RESULTS

The PEIR were found in 0.32% of tooth samples (29/9060) and 1.63% of patients (26/1599). There was no statistical difference in the presence of PEIR between both sexes. The mandibular second molars were the most affected teeth. The lesions were mostly located at the central part of the crown. The lesion sizes were mostly limited to less than one-third of dentinal thickness.

CONCLUSIONS

The present study showed that the prevalence of PEIR in Thai samples is 1.63%. This could raise dentists' awareness in reviewing unerupted teeth in panoramic radiographs. Early detection of the lesions should aid in proper treatment planning of affected teeth to prevent complications from carious invasion after tooth eruption.