Pre-emptive Intracoronal Radiolucency in First Permanent Molar

Regenerative endodontic treatment of necrotic permanent teeth with pre-eruptive intracoronal radiolucency: a case report

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.

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.

ANALYSIS OF DENTAL CARIES IN THE PERMANENT FIRST MOLARS AND RELATED FACTORS WITH CHILDREN AGED 10–12 YEARS IN SOUTHERN CHINA

In order to investigate and analyze the caries status of permanent first molars (PFMs) in children aged 10 to 12 years in Southern China and to analyze the related factors, from January to August 2019, a multi-stage, stratified, cluster, and random sampling method had been used to select 6208 children from 22 schools in Guangzhou city for oral health examinations and questionnaires. The total caries rate of the PFMs was 39.40%, total DMFT score was [Formula: see text], the filling rate of caries was 3.38%, and the rate of fissure sealant was 5.89%. The percentage of PFM caries was statistically significant between female and boys, urban and rural areas, only-children and non-only children, and between ethnic minorities and Han ethnic groups ([Formula: see text]). The difference between urban and rural areas was statistically significant ([Formula: see text]). Multivariate logistic regression analysis showed that the number of daily toothbrushes, the number of desserts eaten, milk drinking before bedtime, being the only-child, and the parents’ level of education were the independents influencing the factors of for developing dental caries. The incidence of dental caries in the PFMs of children aged 10–12 years in Southern China is high, and the rate of fissure sealant and the rate of dental fillings are low. There are a lot of differences between urban and rural areas, where children’s oral health knowledge is poor, and poor oral hygiene behaviors and dietary habits exist.

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.

Treatment of pre-eruptive intracoronal resorption: A systematic review and case report

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.

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.