Prevalence and characteristics of intracoronal resorption in unerupted teeth in the permanent dentition: a retrospective study

Pre-eruptive intramural resorption in unerupted teeth: a cone-beam computed tomography evaluation of prevalence and related factors

OBJECTIVE

Pre-eruptive intramural resorption (PEIR) is defined as an abnormal, well-circumscribed radiolucency within the coronal dentin of the tooth, which is often overlooked in plain radiographs. This study aimed to investigate the prevalence of PEIR and its related factors using cone-beam computed tomography (CBCT).

METHODS

CBCT images of 590 unerupted teeth were evaluated for the presence of PEIR, location of PEIR, number of lesions in the affected tooth, PEIR score, tooth angulation, tooth position, and pericoronal space. Binary logistic tests were used to analyze the association between the characteristics of PEIR and the patient's demographic data and related factors.

RESULTS

The tooth prevalence of PEIR was 13.6% among unerupted teeth. However, it was noteworthy that 19.2% of the unerupted teeth with PEIR were planned to be kept. PEIR was significantly associated with transverse (p = 0.020), inverted-angulated (p = 0.035), and centrally-positioned teeth (p = 0.043). The severity of PEIR was more pronounced in teeth with distal (p = 0.019), lingual (p = 0.023), or inverted-angulated (p = 0.040) positions, and in the absence of pericoronal space (p = 0.036).

CONCLUSION

PEIR should be suspected in transverse, inverted-angulated, centrally positioned unerupted teeth, particularly in molars, with no pericoronal space. Further monitoring through CBCT is recommended in such cases.

CLINICAL RELEVANCE

The management of unerupted teeth does not always involve surgical removal. Instead, they could be utilized for artificial eruption or tooth transplantation. The present study emphasizes the significance of early detection of PEIR. Clinical recommendations for screening PEIR in unerupted teeth are also proposed, which can be applied to routine plain radiographs.

Cone-beam computed tomography-based investigation of pre-eruptive intracoronal resorption prevalence

This retrospective study aimed to investigate the prevalence of pre-eruptive intracoronal resorption (PEIR) using cone-beam computed tomography (CBCT) and to explore the mechanism and characteristics of PEIR development. CBCT images of patients aged ≤ 20 years with unerupted teeth at Hiroshima University Hospital were collected. We examined 1530 patients with 10,576 unerupted teeth. Teeth with PEIR were identified for the detailed location and size of the PEIR in the crown using multiplanar reconstruction. The subject and tooth prevalence rates of PEIR were 1.96% and 0.31%, respectively. The teeth that were the most commonly affected by PEIR were mandibular third molars (3.09%). The prevalence of PEIR was significantly higher in females than in males, and higher in the mandible than in the maxilla. No significant difference between in the position of PEIR within the crown was observed. Moreover, CBCT imaging revealed the onset of PEIR in one case. This study demonstrated the prevalence of PEIR and identified statistically significant sex- and location-based differences. Furthermore, one case of CBCT imaging supports the hypothesis that the onset of PEIR was due to resorption after completion of the crown.

Pre-eruptive intracoronal resorption of permanent dentition: A new classification and a multidisciplinary study

The aims of this study were to develop a new classification for pre-eruptive intracoronal resorption(PIR) with different resorption areas and sizes and to compare the new classification scores among observers from different specialities and professional experience. The PIR was evaluated according to the new classification by two dentomaxillofacial radiologists and two endodontists. Information regarding the patient's age, gender, systemic diseases, the number of PIR, the affected tooth area and the size of the PIR was recorded. The new classification system showed that PIR six and seven defects were the most detected. Regarding jaw regions, the highest reliability was seen in the maxillary central teeth between observers I and IV, and maxillary premolar-molar teeth between observers II and III. This study revealed that PIR can be found in both root and crown dentine. Professional experience and specialty and awareness of the PIR defect may affect the diagnosis.

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 (PEIR): A Case Report

Pre-Eruptive Intracoronal Resorption (PEIR) is a rare yet significant phenomenon in which an abnormal, well-circumscribed, radiolucent area develops in the tooth prior to eruption. This case report outlines the treatment of a 12 year old Hispanic female who was referred for endodontic evaluation of tooth #31 and subsequently diagnosed with PEIR. The patient's chief complaint was recorded as "spontaneous pain" in the lower right quadrant of her jaw. Clinical examination revealed a partially erupted tooth #31 with no visible decay. Radiographic examination, including a cone beam computed tomography scan, led to the detection of a radiolucent area surrounding the pulp chamber on the mesial aspect of tooth #31. Radiographically, the enamel appeared intact with no signs of perforation. Based on the clinical and radiographic evaluation, tooth #31 was determined to have PEIR, with the pulpal and periapical diagnosis of "Symptomatic Irreversible Pulpitis" and "Normal Apical Tissue," respectively. The Orthodontic consultation obtained for this patient recommended that tooth #31 be maintained at least until tooth #32 appeared in the oral cavity and could be used as a replacement. Therefore, a treatment plan involving vital pulp therapy and gingivectomy was selected. During the procedure, granulation tissue was excavated and sent for histological evaluation, which concluded the presence of "granulation tissue with acute and chronic inflammation". No caries were detected. Following the procedure, the tooth was found to be asymptomatic with continued root development. A positive response to Electric Pulp Test was achieved after 3.5 years of follow up.

Pre-eruptive intracoronal radiolucencies in permanent dentition of children in Tamil Nadu-A cross-sectional study

BACKGROUND

Pre-eruptive intracoronal radiolucency (PEIR) poses a challenge to paediatric dentists as it cannot be clinically detected.

AIM

To estimate the prevalence and coexisting factors of PEIR in permanent teeth of children and adolescents in western Tamil Nadu, India.

DESIGN

This cross-sectional study assessed 5012 digital panoramic radiographs of children and adolescents below 14 years of age obtained from private digital imaging centers, dental clinics, and dental colleges located in five districts of western Tamil Nadu. The prevalence and PEIR and its coexisting factors were assessed by two independent calibrated investigators. Data were analyzed using the chi-square test.

RESULTS

The subject prevalence and tooth prevalence of PEIR were estimated to be 3.2% and 0.4%, respectively. Maxillary canines and mandibular premolars were commonly involved. Majority of the lesions were limited to less than one-third of dentin thickness (74%) and distal aspect of the crown (45.1%). Ectopic positioning (9.3%) and dental caries in the preceding primary tooth (9.9%) were the most common coexisting factors.

CONCLUSION

Pre-Eruptive Intracoronal Radiolucency defects were commonly seen in maxillary canines, mandibular premolars, and distal aspect of the crown involving less than one-third dentin thickness. Ectopic positioning and caries in primary teeth were commonly seen along with the PEIR defects.

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.

Preeruptive Intracoronal Radiolucencies: Detection and Nine Years Monitoring with a Series of Dental Radiographs

Preeruptive intracoronal radiolucencies (PEIRs) are mostly incidentally found by routine radiographic examination of unerupted teeth. PEIRs are classified into two types according to the nature of the lesion: progressive and nonprogressive. A case report of a 17-year-old boy with a nonprogressive PEIR on the permanent mandibular left second molar is presented. The lesion was initially detected on an unerupted tooth at age eight years, eight months. It was clinically and radiographically assessed yearly. Cone beam computed tomography (CBCT) was used to evaluate the lesion's size and location when the patient was 11 and 14 years old. The assessments confirmed that the lesion was nonprogressive and had no connection to the pulp or oral cavity. Due to the static nature of the detected PEIR during the nine-year follow-up period, the patient's low caries-risk status, and high patient and parental cooperation in periodic dental care, it was decided to place resin sealant on the affected tooth and monitor the lesion without any operative treatment.

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.

Pre-interruptive intracoronal resorption: clinical and radiographic follow-up

ABSTRACT Pre-interruptive intracoronal resorption is a radiolucent lesion localized in dentin, immediately below the amelodentin junction of unerupted teeth. It is rare, asymptomatic, and of idiopathic etiology, generally diagnosed in routine radiographs or in those for orthodontic purposes. A conservative approach, with radiographic follow-up is the treatment recommended until the tooth erupts, and then the intervention is made. However, in cases with symptoms or progression of the lesion, surgical intervention is advisable. To report a case of pre-interruptive intracoronal resorption, with a conservative approach, showing the clinical and radiographic follow-up of this condition. The patient, a nine-year-old Caucasian girl, presented to the Dental Clinic for routine examination. An initial panoramic radiograph was requested, which showed an intracoronal radiolucence in tooth 45 that had not yet erupted. Clinical and radiographic follow-up was made until the affected tooth was completely established in the oral cavity. The treatment recommended for pre-interruptive intracoronal resorption is to have knowledge of the phenomenon, associate its probable etiology and radiographic aspect, as well as its prevalence, occurrence and treatment options, by considering a conservative approach when there are no symptoms.

A comparison of the use of cone-beam computed tomography and panoramic radiography in the assessment of pre-eruptive intracoronal resorption

OBJECTIVE

This study aimed to investigate the prevalence of pre-eruptive intracoronal resorption (PIR) using cone beam computed tomography (CBCT) and panoramic radiography and to compare the findings of these imaging techniques.

METHODS

This retrospective study consisted of 733 patients who had at least one unerupted tooth and had undergoneimaging with both three-dimensional (3D) CBCT and two-dimensional (2D) panoramic radiography. In all the images, the number of teeth with intracoronal resorption, affected tooth type and number, and size and location of the PIR defects were recorded. The McNemar test was used to compare the prevalence of PIR in the CBCT and panoramic images.

RESULTS

Fewer PIR defects were detected in the panoramic images (3.1% of the patients) than in the CBCT images (9.5% of the patients) (p< .001). According to the CBCT images, the distribution of PIR defects was as follows: third molars (59.5%), canine teeth (11.4%), second molars and premolars (7.6% for both), supernumerary teeth (5.1%), second molars (3.8%), central incisors (2.5%), and first premolar and primary second molar teeth (1.5% for both). According to the scoring classification system for PIR defects, PIR 1 defects were the most common (65.8%), followed by PIR 3 (24.1%) and PIR 2 (10.1%). Of these defects, 69.6% were located in the central aspect of the crown. Ectopically positioned teeth showing intracoronal resorption accounted for 51.9% of the cases of PIR.

CONCLUSIONS

CBCT detected more cases of PIR than panoramic radiography. The mandibular third permanent molar was the most commonly affected tooth.

Evaluation of pre-eruptive intracoronal resorption on cone-beam computed tomography: A retrospective study

OBJECTIVES

This retrospective study aimed to investigate the prevalence of pre-eruptive intracoronal resorption (PIR) in unerupted permanent teeth in a Turkish population using cone beam computed tomography (CBCT).

METHOD

A total of 1,317 CBCT images were screened. In all the images, the following were recorded: the number of unerupted teeth, number of teeth with intracoronal resorption, affected tooth type and number, and location of radiolucent defects. Demographic data were also obtained.

RESULTS

The prevalence of intracoronal resorption in the study group was 15.1%, with a prevalence in teeth of 3.5%. The prevalence of intracoronal resorption using CBCT was much higher than that recorded previously using panoramic or bitewing radiographs intracoronal resorption was more common in males (57%) than females (43%). Twenty-three cases were located in the maxilla (48%), and 25 were located in the mandible (52%). The mandibular third molar was the most affected tooth type, followed by maxillary third molars and supernumerary teeth.

CONCLUSION

CBCT can be useful for diagnosing PIR defects because it provides an accurate representation of internal dental anatomy. SCANNING 38:442-447, 2016. © 2016 Wiley Periodicals, Inc.

Pre-eruptive intracoronal dentine radiolucencies in the permanent dentition of Jordanian children

PURPOSE

To determine the prevalence of pre-eruptive intracoronal dentine radiolucencies (PEIR) and subject factors or dental conditions associated with PEIR from orthopantograms (OPGs) in unerupted permanent teeth of children.

METHODS

OPGs were evaluated for 1,571 subjects (807 males, 764 females) with mean age (8.72 ± 2.5) years. Unerupted permanent teeth prior to emergence into the oral cavity were assessed. The Chi square test was used to determine statistical differences between the group showing and the group not showing the defect with regards to sex, stage of dental development, presence of developmental anomalies, and condition of primary predecessor teeth.

RESULTS

Prevalence was (8.1%) by subject and (0.62%) by teeth. All subjects showed only one affected tooth per subject with no significant gender differences. The highest prevalence was in mandibular first premolars (3.02%). Most defects were noted in the mixed dentition stage (89.06%), mainly in the mandible (79.7%) as single lesions at a mesial location intracoronally, and a size of less than one-third of dentine thickness in (50%). Among all variables examined, PEIR defects were significantly associated with mixed dentition stage (p = 0.000) and decayed/filled primary predecessor teeth (p = 0.028).

CONCLUSIONS

PEIR defects occur at a significant prevalence rate in unerupted teeth. Increased awareness and careful radiographic examination of unerupted teeth may improve early detection and treatment of PEIR defects in children.