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Karimi Z, Alloussi ME. Regenerative endodontic treatment of necrotic permanent teeth with pre-eruptive intracoronal radiolucency: a case report. Prim Dent J 2024; 13:79-83. [PMID: 38888081 DOI: 10.1177/20501684241251587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
Pre-eruptive intracoronal radiolucency is a rare dental anomaly with unclear aetiology, generally asymptomatic and diagnosed through routine radiographs. Failure to diagnose and treat it early can lead to rapid pulp damage, potentially compromising root development. The presented clinical report describes a mandibular second premolar with pre-eruptive intracoronal radiolucency that caused early pulp necrosis with arrest of root formation and emphasises the endodontic management using regenerative endodontic therapy.
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Affiliation(s)
- Zakaria Karimi
- Zakaria Karimi DMD, MDentSci Associate Professor in Conservative Dentistry, Department of Conservative Dentistry, Faculty of Dentistry, Mohammed V University, Mohammed V Military teaching hospital, Rabat, Morocco
- Mustapha El Alloussi DMD, MDentSci Private practice and former Professor of higher education, Faculty of Dentistry, Mohammed V University, Mohammed V Military teaching hospital, Rabat, Morocco
| | - Mustapha El Alloussi
- Zakaria Karimi DMD, MDentSci Associate Professor in Conservative Dentistry, Department of Conservative Dentistry, Faculty of Dentistry, Mohammed V University, Mohammed V Military teaching hospital, Rabat, Morocco
- Mustapha El Alloussi DMD, MDentSci Private practice and former Professor of higher education, Faculty of Dentistry, Mohammed V University, Mohammed V Military teaching hospital, Rabat, Morocco
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Szalma J, Janovics K, Pacheco A, Kaszás B, Lempel E. Pre-eruptive intracoronal resorption in "high-risk" impacted third molars: A report of four cases. J Craniomaxillofac Surg 2022; 50:S1010-5182(22)00131-7. [PMID: 36224052 DOI: 10.1016/j.jcms.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 09/04/2022] [Accepted: 09/18/2022] [Indexed: 10/14/2022] Open
Abstract
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.
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Affiliation(s)
- József Szalma
- Department of Oral and Maxillofacial Surgery, Medical School, University of Pécs, 5. Dischka St., 7621, Pécs, Hungary.
| | - Kata Janovics
- Department of Conservative Dentistry and Periodontology, Medical School, University of Pécs, 5. Dischka St., 7621, Pécs, Hungary
| | - Ana Pacheco
- Department of Oral and Maxillofacial Surgery, Medical School, University of Pécs, 5. Dischka St., 7621, Pécs, Hungary
| | - Bálint Kaszás
- Department of Pathology, Medical School, University of Pécs, 12. Szigeti St., 7624 Pécs, Hungary
| | - Edina Lempel
- Department of Conservative Dentistry and Periodontology, Medical School, University of Pécs, 5. Dischka St., 7621, Pécs, Hungary
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Zilberman U, Abramov J, Smith P. Supernumerary roots in maxillary deciduous canines: A rare anomaly with a long history. Arch Oral Biol 2021; 132:105292. [PMID: 34743803 DOI: 10.1016/j.archoralbio.2021.105292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/13/2021] [Accepted: 10/15/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To describe two maxillary deciduous bi-rooted canines, one archeological and one modern, and examine the possible etiology of this condition. DESIGN Two cases of bi-rooted canines were described and compared to published examples. Both specimens were radiographed and measured and compared to one-rooted samples. The archeological specimen was scanned using CBCT to facilitate detailed examination of the deciduous teeth. The extracted modern tooth was embedded in epoxy resin and two coronal sections were cut, one through the crown and one through the roots and examined with a light microscope. RESULTS The bi-rooted canines were larger than the control samples. They showed none of the features commonly associated with gemination. The radiographs and scans showed that the canine roots in the archeological case diverged mesio-distally like the buccal roots in the adjacent first deciduous molar. In the clinical case, the root trunk was elongated mesio-distally and the furcation was located very close to the apex with a C-shaped root canal. CONCLUSIONS Both variants of the condition described above are rare in deciduous canines. They do not seem to be associated with fusion or gemination. However, as the teeth are relatively flattened bucco-lingually and we tentatively propose that this form results from spatial constraints during the early stages of crown development that have contributed to the development of additional roots. The megadont dimension of the recent bi-rooted deciduous canine may affect root development and the necessity of two mesio-distally located roots for anchorage in the maxilla.
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Affiliation(s)
- Uri Zilberman
- Barzilai Medical University Center, Ashkelon, Affiliated to Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Julia Abramov
- National Natural History Collections, The Hebrew University, Jerusalem, Israel.
| | - Patricia Smith
- Laboratory of Bioanthropology and Ancient DNA, Faculties of Medicine and Dental Medicine, Hebrew University, Jerusalem, Israel.
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Ambriss B, Moukarzel C, Ezzeddine M, Bacho R. Management of Maxillary Premolar with Pre-eruptive Intracoronal Resorption: A 5-year Follow-up Case. Int J Clin Pediatr Dent 2021; 14:161-166. [PMID: 34326604 PMCID: PMC8311761 DOI: 10.5005/jp-journals-10005-1881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
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.
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Affiliation(s)
- Bourane Ambriss
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Carla Moukarzel
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Mohamed Ezzeddine
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Riad Bacho
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
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Ren HY, Zhao YS, Yoo YJ, Zhang XW, Fang H, Wang F, Perinpanayagam H, Kum KY, Gu Y. Mandibular molar C-shaped root canals in 5th millennium BC China. Arch Oral Biol 2020; 117:104773. [PMID: 32512259 DOI: 10.1016/j.archoralbio.2020.104773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/14/2020] [Accepted: 05/16/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The aim of this study was to analyze the occurrence and variations in C-shaped canals in ancient Chinese teeth and compare the differences of these features between ancient and age-matched modern populations. DESIGN Approximately 5000-year-old craniofacial bone remains were collected from the fossils of 38 individuals (total: 68 mandibular second molars) excavated from the Jiaojia site. The control group comprised of an equal number of randomly selected modern samples. We used cone-beam computed tomography to scan the mandible along the apex-crown axis and analyzed the canal morphology, based on Fan's categorization criterion, at 2 mm, 5 mm, and 8 mm to the apical level. Grooves on the lingual and buccal sides were also recorded. RESULTS The proportion of C-shaped roots among ancient samples on the left and right sides were 48.57 % (17/35 teeth) and 54.55 % (18/33 teeth), respectively, and 51.47 % (35/68 teeth) in the total sample. Conversely, in the control group, 44.12 % (15/34) and 38.24 % (13/34) occurred on the left and right sides, respectively, and 41.18 % (28/68) in the total sample. Among the C-shaped canals from the Jiaojia site samples, the classification type changed between two adjacent levels in 84.31 % of samples. Approximately 35 (51.5 %) teeth had a fused root, 20 (29.41 %) had one shallow buccal and one deep lingual groove. The occurrence of C-shape variation was not significantly correlated with time (p>0.05). CONCLUSIONS This study identified a high rate of C-shaped root canals among individuals of Jiaojia who lived approximately 5000 years ago.
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Affiliation(s)
- Hui Ying Ren
- School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Shandong Province, PR China
| | - Yong Sheng Zhao
- Institute of Cultural and Heritage, Shandong University, Qingdao, PR China
| | - Yeon-Jee Yoo
- Department of Conservative Dentistry, Dental Research Institute, National Dental Care Center for Persons with Special Needs, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - Xiao Wen Zhang
- School of History and Culture, Shandong University, Jinan, PR China
| | - Hui Fang
- School of History and Culture, Shandong University, Jinan, PR China
| | - Fen Wang
- School of History and Culture, Shandong University, Jinan, PR China
| | - Hiran Perinpanayagam
- Division of Restorative Dentistry, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada
| | - Kee-Yeon Kum
- Department of Conservative Dentistry, Dental Research Institute, National Dental Care Center for Persons with Special Needs, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - Yu Gu
- Department of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Shandong Province, PR China.
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Le VNT, Kim JG, Yang YM, Lee DW. Treatment of pre-eruptive intracoronal resorption: A systematic review and case report. J Dent Sci 2020; 15:373-382. [PMID: 32952895 PMCID: PMC7486503 DOI: 10.1016/j.jds.2020.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 02/10/2020] [Indexed: 12/02/2022] Open
Abstract
Background/purpose Pre-eruptive intracoronal resorption (PEIR) is usually detected accidently in radiographs. However, treatment modality is still not reported systematically. The current study aimed to conduct a systematic review of the treatment modality of PEIR case reports and to report a case on the preservation of a vital pulp with surgical exposure in permanent maxillary canine. Materials and methods We systematically searched case reports from PubMed/MEDLINE, EMBASE, and Web of science databases. The treatment modality, suspected etiology, and follow up periods were collected from each study and reviewed by two authors independently. Results The initial search identified 100 studies. After the title/abstract screening, 37 articles received a full-text reading; and finally, 24 articles (29 patients and 37 affected teeth) were selected for the final review. Among the 24 unerupted teeth, surgical opening and restoration treatment of PEIR was chosen as a high priority for treatment options (n = 9, 36%). Among the 13 erupted teeth, restoration was applied for the prevention such as developing in size and fracture (n = 4, 31%). Conclusion According to this systematic review, treatment modalities were based on the progressive nature of the lesion size and eruption state to establish the optimal approach for each patient. Clinicians should take into account the eruption status, lesion progression, the size of the lesion, and the degree of pulp involvement.
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Affiliation(s)
- Van Nhat Thang Le
- Department of Pediatric Dentistry and Institute of Oral Bioscience, School of Dentistry, Jeonbuk National University, Jeonju, Republic of Korea.,Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, Republic of Korea.,Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Jae-Gon Kim
- Department of Pediatric Dentistry and Institute of Oral Bioscience, School of Dentistry, Jeonbuk National University, Jeonju, Republic of Korea.,Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, Republic of Korea.,Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Yeon-Mi Yang
- Department of Pediatric Dentistry and Institute of Oral Bioscience, School of Dentistry, Jeonbuk National University, Jeonju, Republic of Korea.,Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, Republic of Korea.,Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Dae-Woo Lee
- Department of Pediatric Dentistry and Institute of Oral Bioscience, School of Dentistry, Jeonbuk National University, Jeonju, Republic of Korea.,Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, Republic of Korea.,Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
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Currell SD, Cakar T. Incidental observation of pre-eruptive intracoronal resorption after seven years. Aust Dent J 2019; 64:376-379. [PMID: 31506946 DOI: 10.1111/adj.12720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2019] [Indexed: 11/28/2022]
Abstract
Pre-eruptive intracoronal resorption (PIER) can be described by the presence of coronal radiolucency in a unerupted tooth. Upon eruption, the resorbed dentine might leave the occlusal layer of enamel unsupported and susceptible to fracture, potentially exposing the pulp chamber and root canals to the oral flora. With current case studies showing unfavourable endodontic and restorative consequences of PIER lesions when left untreated, this case report presents an unchanged lesion, 7 years following initial identification.
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Affiliation(s)
- S D Currell
- Private Practice, Gold Coast, Queensland, Australia
| | - T Cakar
- Private Practice, Gold Coast, Queensland, Australia
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Zilberman U, Hassan J, Leiboviz-Haviv S. Molar incisor hypomineralization and pre-eruptive intracoronal lesions in dentistry-diagnosis and treatment planning. World J Stomatol 2019; 7:20-27. [DOI: 10.5321/wjs.v7.i2.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 01/14/2019] [Accepted: 01/28/2019] [Indexed: 02/06/2023] Open
Abstract
The aim of this study is to report the diagnostic features, prevalence, mineral content, clinical significance and treatment options of molar incisor hypomineralization (MIH) and pre-eruptive intracoronal lesions (PEIR), in order to minimize miss-treatment of primary and permanent teeth in young children. MIH was defined as the occurrence of hypomineralization of one up to four permanent first molars from a systemic origin and frequently associated with affected incisors. PEIR are lesions that are located in the occlusal portion of the crown of unerupted permanent or primary teeth. The prevalence of MIH was reported between 2.5%-40% in the permanent first molars and 0%-21.8% in primary second molars. PEIR was observed in 2%-8% of children, mainly in mandibular second premolars and second and third permanent molars. A number of possible causes for MIH were mentioned, including environmental changes, diet and genetics in prenatal and postnatal periods, but all are questionable. In PEIR, the resorption of the intracoronal dentine begins only after crown development is complete and is caused by giant cells resembling osteoclast observed histologically on the dentine surface close to the pulp. The mineral content in MIH is reduced in comparison to normal enamel and dependent on the severity of the lesion. In PEIR the resorbed surface of enamel showed less mineral content. The hypomineralized enamel in MIH is not suitable for restorations with amalgam or composite materials, and the best material should be based on remineralization material like glass-ionomers. Similar, the resorbed dentin surface in PEIR should be covered by the biocompatible and re-mineralizing glass-ionomer cement.
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Affiliation(s)
- Uri Zilberman
- Pediatric Dental Clinic, Barzilai Medical University Center, Ashkelon 7830604, Israel
| | - Jomanna Hassan
- Pediatric Dental Clinic, Barzilai Medical University Center, Ashkelon 7830604, Israel
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