Pre-eruptive Intracoronal Resorption Research Articles

Pre-eruptive intracoronal resorption: a familial clinical case and review

Pre-eruptive intracoronal resorption (PEIR) is a rare condition usually detected incidentally on radiographs. The radiographic appearance resembles dental caries; however, the aetiology is not fully understood. The prognosis of affected teeth is highly variable, and management may involve input from multiple specialties. CPD/Clinical Relevance: The present report describes the clinical management of PEIR-affected molars in two family members and discusses the alternatives for treatment.

Pre-eruptive intracoronal resorption: case report

This case describes the presentation of pre-eruptive intracoronal resorption affecting multiple permanent teeth in an 11-year-old female child. Pre-eruptive intracoronal resorption is a lesion that is often located within the dentine, adjacent to the enamel–dentine junction in the occlusal face of the tooth crown. Histological reports have shown the presence of resorptive cells in these lesions. Previous literature presents cases usually affecting a single tooth, in this case 10 permanent teeth were found to be affected. Clinicians should be aware of this diagnosis and its treatment modalities to ensure appropriate management is carried out. CPD/Clinical Relevance: This case highlights pre-eruptive intracoronal resorption for clinicians based in both primary and secondary care settings

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

ObjectivesThe 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 methodsPatients 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. ResultsIn 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. ConclusionsPre-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.

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 ≤ 20years 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.

ASPECTS OF ETIOLOGY, DIAGNOSIS AND TREATMENT OF PREERUPTIVE INTRACORONAL RESORPTION IN CHILDREN (LITERATURE REVIEW)

The purpose of this work was to study the literature on research papers by domestic and foreign authors describing pre-eruption intracoronal resorption. The review discusses issues that indicate the presence of a resorption process in permanent teeth before their eruption. This lesion of the hard tissues of the teeth is rare, and the etiology of this process is not fully understood. The processes of tooth resorption can be observed outside on the root surface or inside the pulp chamber, and if a permanent tooth is involved in this process, this indicates the development of pathological resorption. Along with dental caries and periodontal disease in childhood, processes of resorption of coronal dentin tissue in unerupted permanent teeth can be observed. Some authors describe internal resorption, ectopic positioning, external resorption, and origin from developmental pits on the occlusal surface as etiological factors for preeruptive intracoronal resorption, but other authors suggest that the etiology of this lesion remains poorly understood. The main diagnostic method is an x-ray examination, in which preeruptive intracoronal resorption is accidentally detected and other research methods are additionally used. Histological examination reveals osteoclasts, multinucleated giant cells, macrophages, and serrated edges in this lesion, which may possibly enter the developing tooth from the surrounding bone or through breaks in the dental follicle or enamel epithelium. With a small lesion and if the tooth is close to eruption, periodic X-ray control is necessary, and after eruption, when occlusal access is reached, the defect is restored in order to minimize the attachment of the carious process.

Multiple impacted third molars with pre-eruptive intracoronal resorption in geriatric patients: Two case reports

Background: Pre-eruptive intracoronal resorption (PEIR) is a rare condition usually detected through an incidental radiographic finding. The etiology and pathogenesis of this phenomenon are not fully understood. Purpose: To describe two cases in which multiple impacted third molars with PEIR defects were identified. Cases: Female patients aged 77 and 82 years, respectively, were presented with dental issues. Radiolucencies in the dental crown areas of the impacted maxillary and mandibular third molars were initially detected on the panoramic radiographs. Cone-beam computed tomography (CBCT) was performed to better evaluate the impacted teeth. The results showed that the intracoronal defects extended through more than two-thirds of the thickness of the coronal dentin. Case Managements: Considering the patients’ age and their asymptomatic status, a conservative approach with radiographic follow-up was considered most appropriate. Four-year follow-up checks revealed that the teeth remained asymptomatic in both patients. Conclusion: This case report confirms that PEIR can affect impacted third molars, even in elderly patients. CBCT images are preferred for diagnosing PEIR defects because this method provides an accurate assessment of internal tooth anatomy. With an accurate diagnosis of asymptomatic PEIR, the lesion can be monitored.

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 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 “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.

Birden Fazla Dişte Erüpsiyon Öncesi İntrakoronal Rezorpsiyon: Sıra Dışı Bir Vaka Serisi

Pre-eruptive intracoronal resorption (PIR) is characterized by radiolucent lesion within coronal dental tissue and rarely seen in unerupted permanent teeth. The affected teeth are generally asymptomatic and detected during routine dental radiographic examination. Amelogenesis imperfecta (AI) is a group of relatively rare inherited abnormalities in enamel formation and/or calcification. A history of consanguineous marriage should be considered in individuals with the type of autosomal recessive AI (ARAI). Several dental alterations especially intracoronal resorption of unerupted teeth and failure or delayed eruption are more common in AI patients than in unaffected individuals. This report presents the clinical and radiographic findings of ARAI and PIR cases simultaneously seen in three generations of a family and oral rehabilitation of an unusual member of the same family.

RADIOGRAPHIC CHARACTERISTIC FEATURES OF PRE-ERUPTIVE INTRACORONAL RESORPTION USING CONE-BEAM COMPUTED TOMOGRAPHY

<h3>BACKGROUND</h3> Pre-eruptive intracoronal resorption (PEIR) is a radiolucent lesion that affects the coronal dentin of unerupted teeth. PEIR is a rare condition with unknown cause, and it is usually detected incidentally in routine dental imaging. The radiographic appearance of PEIR resembles that of dental caries; however, some studies have reported clinical and histologic evidence to support the hypothesis that these lesions are likely resorptive in nature. <h3>OBJECTIVE(S)</h3> To characterize the radiographic features of pre-eruptive intracoronal resorption in the unerupted permanent dentition using cone-beam computed tomography (CBCT). <h3>STUDY DESIGN</h3> In this retrospective study, 26 CBCT scans of patients who had at least 1 tooth with a PEIR lesion were evaluated. The following data were recorded: patients' demographic data, number of affected teeth, affected tooth type, location, and extension of the lesion. The communication of lesions with the pulp was also evaluated. <h3>RESULTS</h3> Out of 26 patients (10 female and 16 male), 33 unerupted permanent teeth with PEIR were recorded. Twenty-one of the cases were located in the maxilla and 12 in the mandible. The maxillary third molar was the most affected tooth type, followed by mandibular third molars and supernumerary teeth. Of 26 patients with PEIR, 21 patients had only 1 affected tooth, 3 patients had 2 affected teeth, and 2 patients had 3 affected teeth. Ninety-four of cases showed radiographic evidence of enamel involvement. In 36% of cases, the lesion extended apical to the cementoenamel junction (CEJ), and in 1 of the specimens the lesion extended to the middle third of the root. None of the cases showed evidence of periapical rarefying osteitis. <h3>DISCUSSION/CONCLUSIONS</h3> The findings of this study show that the radiographic patterns of PEIR are distinctly different from those seen with other types of resorptive defect. CBCT imaging is a valuable tool for detection, differential diagnosis, and prognostic evaluation of teeth with PEIR.

Pre-Eruptive Intracoronal Resorption: The Hidden Truth

Pre-Eruptive Intracoronal Resorption: The Hidden Truth

Pre-eruptive Intra-Coronal Resorption: A report of two cases and review of the literature

Pre-eruptive intracoronary resorption is a rare condition mainly affecting pediatric patients. It is a radiographic finding in the dentin of the crown of an unerupted tooth just below the enamel-dentin junction. It is visualized in radiographs as a radiolucent coronal lesion of variable depth; it is well-defined and located in the dentin adjacent to the amelodentinal limit of an unerupted tooth. Historically, this lesion was misdiagnosed as caries and was misnamed pre-eruptive caries, when in reality they were pre-eruptive intracoronal resorptions. We present two rare cases of pre-eruptive intracoronary resorption in patients that needed radiographs for orthodontic purposes. The Oral &amp; Maxillofacial Radiologist detected the existence of pre-eruptive intracoronary resorption in mandibular second premolars and mandibular second molar. These radiographic findings provided the clinician with the advantage of knowing this condition before teeth eruption, allowing for conservative treatment and periodic radiographic follow-up.

Treatment of pre-eruptive intracoronal resorption: A scoping review.

Pre-eruptive intra-coronal resorption (PEIR) is a rare condition that can affect children's dentition. Showing the same aspect of dental caries, these lesions are diagnosed in non-erupted teeth. The aetiology is not yet defined and no consensus on their treatment is available. Thus, the aim of the present scoping review of the literature was to try to establish a protocol for treatment and management of PEIR defects. The search was performed on Medline via PubMed, Science Direct and EBSCOhost' databases using the appropriate Medical Subject Headings (MESH) terms. Studies that described the PEIR were considered eligible and the data from the selected papers were extracted and analysed independently by two authors. Out of 172 articles identified in initial research, 15 articles were selected for reviewing. Interventions varied from preventive treatment to extraction, depending on the lesion severity and its proximity to the pulp. Non-operative procedures, conservative approaches and extractions were recommended for the management of PEIR, depending on the extent of the lesions. Overall, further researches should be conducted to explore the effectiveness of the approaches of PEIR management.

CONE BEAM COMPUTED TOMOGRAPHY PRESENTATION OF CASES WITH PRE-ERUPTIVE INTRACORONAL RESORPTION: A CASE SERIES AND REVIEW OF THE LITERATURE

<h3>Background</h3> Pre-eruptive intracoronal resorption (PEIR) is a rare condition, characterized by the existence of a radiographic radiolucent area inside the coronal dentin before dental eruption. The etiology for PEIR is unknown. However, the following conditions are the proposed etiology for PEIR: being resorptive in nature, local inflammation, ectopic positioning of teeth or teeth with abnormal contact, dental development defects, systemic conditions (herpes <b>z</b>oster infection). <h3>Objective</h3> This report presents the cone beam computed tomography (CBCT) images of 3 cases with PEIR and describes the pattern of resorptive defects in these cases. <h3>Materials and Methods/Clinical and Radiographic Findings</h3> Cases 1 and 2: A 66-year-old female and a 54-year-old male presented for implant evaluation. CBCT images of the first case showed a radiolucent intracoronal area involving an impacted tooth #16, which encroached on the pulp chamber. CBCT images of the second case showed the same radiographic appearance involving the unerupted tooth #1. Case 3: A 64-year-old male came for evaluation of the airway. CBCT images revealed an intracoronal radiolucent area involving the impacted tooth #17 with an intact pulp. The involved tooth was asymptomatic in all cases, and no history of trauma was reported by patients. <h3>Results/Differential or Definitive Interpretation:</h3> On the basis of radiographic presentations and clinical findings, pre-eruptive intracoronal resorption was considered the most likely diagnosis. The management of such lesion ranges from no treatment to surgery, surgical exposure, tooth extraction. The prevalence of PEIR reported on panoramic images in a previous study for both the subject and the tooth were 1.55% to 27.3 % and 0.5% to 2.1%, respectively. The prevalence of PEIR as shown by CBCT in the previous study were 9.5% to 15.1% for subject prevalence and 1.93% to 3.5% for tooth prevalence. The previous study showed that a single tooth was usually affected with PEIR in an individual and that the most commonly affected teeth were the premolars and the molars. <h3>Discussion</h3> PEIR affects the coronal dentin of unerupted teeth. The etiology for PEIR is unknown, and it may be commonly misdiagnosed as dentinal caries because of radiographic similarities. These lesions are usually identified incidentally during radiographic evaluation, and early detection is important for effective management. The diagnosis should be made on the basis of clinical and radiographic findings, and CBCT imaging is a valuable adjunct for early diagnosis.

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

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

Qafzeh 9 mandible (ca 90–100 kyrs BP, Israel) revisited: μ-CT and 3D reveal new pathological conditions

ObjectiveThe aim of this paper is to provide new insights into growth patterns and health of Mousterian hunter-gatherers dated to ca. 90–100 kyrs B.P. from the Qafzeh site. MaterialsAn almost complete skeleton, including the mandible from the Qafzeh site (Qafzeh 9). MethodsMicro-CT and medical imaging techniques are used to explore inaccessible inner structures and to assess the etiology of identified lesion. ResultsMandibular and dental conditions appear to be growth-related skeletal disorders. ConclusionTo our knowledge, Qafzeh 9 offers the earliest evidence of associated mandibular and dental pathological conditions (i.e. non-ossifying fibroma of the mandible, pre-eruptive intracoronal resorption and osteochondritis dissecans of the temporomandibular joint) among early anatomically modern humans, and more generally among Middle Palaeolithic hominins in Southwestern Asia. The diagnoses can be added to other growth-related disorders of skulls previously documented from the Qafzeh site (Tillier, 1999; Tillier et al., 2001), suggesting a quite high and exceptional incidence of these conditions compared to those of Palaeolithic populations. SignificanceIdentification of pathological conditions in subadults from Eurasia dated to the Middle Palaeolithic is documented less often than in adult skeletons. Hence, new results from immature fossil remains are particularly important to our understanding of the past. Suggestions for further researchThis research will be extended to the rest of the skeleton, then to all Qafzeh specimens in order to broaden our understanding of this anatomically modern group.

Pre-eruptive intracoronal resorption on cone beam computed tomography: two case reports

ABSTRACT Pre-eruptive intracoronal resorption (PIR) is a rare lesion that occurs within the dentin of the crown on unerupted teeth. The aim of this article is to report two rare cases of a PIR in impacted canine using cone beam computed tomography (CBCT). High resolution CBCT images (Prexion 3D) were indicated for evaluating of the non-erupted tooth, claiming no other related signs or previous historyto be considered. In the first case, the images revealed an impacted and mesioinclined superior canine. In the coronary portion, it was observed an irregular hypodense lesion, involving the dentin, enamel tissue, and communication with the external surface of the tooth. In the second case, the images showed an impacted superior canine in the vertical position. It also revealed a hypodense lesion with poorly defined limits envolving the dentin, which extends over the crown. In both cases, the tooth was not in contact with the adjacentlateral tooth. Therefore, PIR in impacted teeth is rare, which is frequently diagnosed through routine radiographs. Additionally, CBCT seems to be an invaluable tool for providing accurate information about the exact topography, relationships with adjacent structures, helping, therefore, on the appropriate treatment planning.

A 3000 year old case of an unusual dental lesion: Pre-eruptive intracoronal resorption

ObjectiveTo determine the cause of a large dental lesion, tentatively identified as a case of pre-eruptive intra-coronal resorption (PEIR), in the permanent second mandibular molar of a young individual from an Iron Age cemetery at Tel Erani (Israel), dated to ca. 3000 years B.P. The provisional diagnosis was based on the massive size of the lesion in a young individual in whom the adjacent teeth were caries-free and showed no visible enamel defects. DesignThe lower molars of Tel Erani on the affected side were radiographed and compared to radiographs of a modern clinical case of PEIR treated by one of us (U.Z) and the internal structure and mineral content of the lesion examined in detail using energy-dispersive X-ray spectroscopy (EDS). ResultsThe Tel Erani specimen closely resembled the modern clinical case of PEIR. Moreover, both cases occurred in young individuals in whom the adjacent teeth were caries-free. Examination with SEM revealed absence of dentine in the affected tooth from Tel Erani, together with changes in structure and mineral content characteristic of resorption. ConclusionsOur study shows that the changes found in the lower second molar of the 3000 year old mandible from Tel Erani are characteristic of PEIR and demonstrate the antiquity of this condition.

Treatment of pre-eruptive intracoronal resorption: Case report

Pre-eruptive intracoronal resorption is a rare disease defined as an intracoronal radiolucent lesion. Most are revealed through casual radiological examinations, and are clinically identifiable after eruption. The possible causes of lesions include congenital abnormalities, systemic fluoride uptake, external factors after tooth formation, and eruption of the tooth; however, no definite etiology has been found. Early diagnosis through regular examination is therefore considered to be the best diagnostic method. Treatment may differ depending on the size and progression of the lesion, but conservative treatment is recommended. This case report describes two cases where the lesions were accidentally found while performing a radiologic examination addressing other issues. It is the clinician’s responsibility to identify the size of the lesion and the expected eruption time, and to execute the appropriate treatment.