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Yang S, Zhang C, Shi Y, Yang H, Wang D. Effects of single unilaterally impacted mesiodens on maxillary central incisors: A 3D quantitative assessment based on cone-beam computed tomography. Int J Paediatr Dent 2024. [PMID: 38803007 DOI: 10.1111/ipd.13218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 04/24/2024] [Accepted: 05/15/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Mesiodens usually lead to the malposition and abnormal morphology of maxillary central incisors. AIM To evaluate the detrimental effects of single unilaterally impacted mesiodens on the three-dimensional positions and morphology of the maxillary central incisor using cone-beam computed tomographic (CBCT) examinations. DESIGN A total of 321 patients aged 5-17 years with single unilaterally impacted mesiodens were included and divided into two groups: mixed dentition group (5-10 years) and early permanent dentition group (11-17 years). CBCT data for these patients were retrospectively analyzed to compare the inclination, rotation, angulation, and morphology of maxillary central incisors between the affected and contralateral control sides. The morphology, orientation, and spatial location of mesiodens were also assessed. RESULTS Central incisors on the affected side showed significant palatal crown inclination, shorter root, shorter tooth, and greater crown-to-root ratio in both groups, whereas significant mesial crown angulation was only observed in the mixed dentition group. CONCLUSION Impacted mesiodentes result in the displacement and impaired root development of central incisors, strongly suggesting timely clinical management of these abnormal teeth, such as the early removal of mesiodens and orthodontic treatments.
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Affiliation(s)
- Shengjun Yang
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chi Zhang
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yijin Shi
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Haochuan Yang
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Dongmiao Wang
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, Jiangsu, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
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Ngamsom S, Arayapisit T, Asavanamuang P, Anurakwongsri R, Sonthinane K, Kretapirom K. Pre-eruptive intramural resorption in unerupted teeth: a cone-beam computed tomography evaluation of prevalence and related factors. Clin Oral Investig 2024; 28:279. [PMID: 38671170 PMCID: PMC11052776 DOI: 10.1007/s00784-024-05677-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/21/2024] [Indexed: 04/28/2024]
Abstract
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.
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Affiliation(s)
- Supak Ngamsom
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Mahidol University, 6 Yothi rd, Thung Phaya Thai, Ratchathewi, Bangkok, 10400, Thailand
| | - Tawepong Arayapisit
- Department of Anatomy, Faculty of Dentistry, Mahidol University, 6 Yothi rd, Thung Phaya Thai, Ratchathewi, Bangkok, 10400, Thailand
| | - Phanit Asavanamuang
- Mahidol International Dental School, Faculty of Dentistry, Mahidol University, 6 Yothi rd, Thung Phaya Thai, Ratchathewi, Bangkok, 10400, Thailand
| | - Raksayam Anurakwongsri
- Mahidol International Dental School, Faculty of Dentistry, Mahidol University, 6 Yothi rd, Thung Phaya Thai, Ratchathewi, Bangkok, 10400, Thailand
| | - Kittikarn Sonthinane
- Mahidol International Dental School, Faculty of Dentistry, Mahidol University, 6 Yothi rd, Thung Phaya Thai, Ratchathewi, Bangkok, 10400, Thailand
| | - Kornkamol Kretapirom
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Mahidol University, 6 Yothi rd, Thung Phaya Thai, Ratchathewi, Bangkok, 10400, Thailand.
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Shimabukuro K, Konishi M, Wongratwanich P, Nagasaki T, Ohtsuka M, Suei Y, Nakamoto T, Kakimoto N. Cone-beam computed tomography-based investigation of pre-eruptive intracoronal resorption prevalence. Odontology 2024; 112:256-263. [PMID: 37248355 DOI: 10.1007/s10266-023-00824-x] [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] [Received: 03/24/2023] [Accepted: 05/19/2023] [Indexed: 05/31/2023]
Abstract
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.
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Affiliation(s)
- Kiichi Shimabukuro
- Department of Oral and Maxillofacial Radiology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan.
| | - Masaru Konishi
- Department of Oral and Maxillofacial Radiology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan
| | - Pongsapak Wongratwanich
- Department of Oral Biomedical Sciences, Division of Oral Diagnosis, Khon Kaen University, Khon Kaen, Thailand
| | - Toshikazu Nagasaki
- Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masahiko Ohtsuka
- Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yoshikazu Suei
- Department of Oral and Maxillofacial Radiology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan
| | - Takashi Nakamoto
- Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Naoya Kakimoto
- Department of Oral and Maxillofacial Radiology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan
- Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Yüksel HT, Türkmenoğlu A, Çelikkol B, Evirgen Ş, Gulsahi K, Gulsahi A. Pre-eruptive intracoronal resorption of permanent dentition: A new classification and a multidisciplinary study. AUST ENDOD J 2023; 49 Suppl 1:162-169. [PMID: 36317538 DOI: 10.1111/aej.12706] [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] [Received: 01/13/2022] [Revised: 10/10/2022] [Accepted: 10/17/2022] [Indexed: 11/05/2022]
Abstract
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.
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Affiliation(s)
- Halil Tolga Yüksel
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Usak University, Uşak, Turkey
| | - Ayşegül Türkmenoğlu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Usak University, Uşak, Turkey
| | - Berk Çelikkol
- Department of Endodontics, Faculty of Dentistry, Usak University, Uşak, Turkey
| | - Şehrazat Evirgen
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Usak University, Uşak, Turkey
| | - Kamran Gulsahi
- Department of Endodontics, Faculty of Dentistry, Baskent University, Ankara, Turkey
| | - Ayşe Gulsahi
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Baskent University, Ankara, Turkey
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Gurdán Z, Balázs D, Pásti D, Fathi M, Maróti P, Kardos K, Pacheco A, Szalma J. Pre-eruptive intracoronal resorption in orthodontic patients: A retrospective analysis of 3,143 patients. Heliyon 2023; 9:e18699. [PMID: 37560674 PMCID: PMC10407135 DOI: 10.1016/j.heliyon.2023.e18699] [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] [Received: 01/19/2023] [Revised: 07/18/2023] [Accepted: 07/25/2023] [Indexed: 08/11/2023] Open
Abstract
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.
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Affiliation(s)
- Zsuzsanna Gurdán
- Department of Orthodontics, Medical School, University of Pécs, 1. Tüzér st., Pécs, 7623, Hungary
| | - Dorottya Balázs
- Department of Orthodontics, Medical School, University of Pécs, 1. Tüzér st., Pécs, 7623, Hungary
| | - Dóra Pásti
- Department of Orthodontics, Medical School, University of Pécs, 1. Tüzér st., Pécs, 7623, Hungary
| | - Meetra Fathi
- Department of Orthodontics, Medical School, University of Pécs, 1. Tüzér st., Pécs, 7623, Hungary
| | - Péter Maróti
- 3D Printing and Visualisation Centre, University of Pécs, 2. Boszorkány st., Pécs, 7624, Hungary
| | - Kinga Kardos
- 3D Printing and Visualisation Centre, University of Pécs, 2. Boszorkány st., Pécs, 7624, Hungary
| | - Ana Pacheco
- Department of Oral and Maxillofacial Surgery, Medical School, University of Pécs, 1. Tüzér st., Pécs, 7623, Hungary
| | - József Szalma
- Department of Oral and Maxillofacial Surgery, Medical School, University of Pécs, 1. Tüzér st., Pécs, 7623, Hungary
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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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Asokan S, Geethapriya PR, Varshini R K, Cs SD. Pre-eruptive intracoronal radiolucencies in permanent dentition of children in Tamil Nadu-A cross-sectional study. Int J Paediatr Dent 2022; 32:428-435. [PMID: 34672046 DOI: 10.1111/ipd.12922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/02/2021] [Accepted: 09/07/2021] [Indexed: 11/26/2022]
Abstract
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.
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Affiliation(s)
- Sharath Asokan
- Department of Pediatric and Preventive Dentistry, KSR Institute of Dental Science and Research, Tiruchengode, India
| | - P R Geethapriya
- Department of Pediatric and Preventive Dentistry, KSR Institute of Dental Science and Research, Tiruchengode, India
| | - Kirthi Varshini R
- Department of Pediatric and Preventive Dentistry, KSR Institute of Dental Science and Research, Tiruchengode, India
| | - Sri Darshini Cs
- Department of Pediatric and Preventive Dentistry, KSR Institute of Dental Science and Research, Tiruchengode, India
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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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Pre-eruptive intra-coronal resorption of dentine: a review of aetiology, diagnosis, and management. Eur Arch Paediatr Dent 2019; 21:1-11. [PMID: 31414395 DOI: 10.1007/s40368-019-00470-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 08/02/2019] [Indexed: 02/06/2023]
Abstract
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.
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10
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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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Preeruptive Intracoronal Radiolucencies: Detection and Nine Years Monitoring with a Series of Dental Radiographs. Case Rep Dent 2017; 2017:6261407. [PMID: 29279779 PMCID: PMC5723957 DOI: 10.1155/2017/6261407] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 10/02/2017] [Accepted: 10/18/2017] [Indexed: 11/18/2022] Open
Abstract
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.
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Manmontri C, Chompu-Inwai P, Mahasantipiya PM, Prapayasatok S. Prevalence of pre-eruptive intracoronal radiolucencies in Thai children and adolescents: A retrospective study. ACTA ACUST UNITED AC 2017; 9:e12303. [PMID: 29055115 DOI: 10.1111/jicd.12303] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Revised: 08/06/2017] [Accepted: 08/11/2017] [Indexed: 02/06/2023]
Abstract
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.
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Affiliation(s)
- Chanika Manmontri
- Department of Orthodontics and Pediatric Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Papimon Chompu-Inwai
- Department of Orthodontics and Pediatric Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | | | - Sangsom Prapayasatok
- Department of Oral Biology and Diagnostic Sciences, Chiang Mai University, Chiang Mai, Thailand
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