[Frequency of pre-eruptive intracoronal resorption in panoramic radiographs of peruvians: a cross-sectional study]. / Frecuencia de reabsorción intracoronal preeruptiva en radiografías panorámicas de pacientes peruanos entre 3 y 21 años. Un estudio transversal.

Objective: To determine the frequency of Preeruptive Intracoronal Resorption (PIR) in a sample of digital panoramic radiographs of Peruvian patients between 3 to 21 years of age who attended an oral and maxillofacial radiology center between 2013 and 2021. Material and Methods: This observational study was descriptive, retrospective and cross-sectional. A sample of 1897 digital panoramic radiographs was evaluated to determine the frequency of PIR and its covariates of location, depth, and inclination of the affected teeth. The authors' calibration was performed before the study. The intraoperator agreement was determined by calculating the Kappa coefficient (0.72, CI 0.67-0.76). The radiographs were evaluated by the study's principal author (IEP), and the data were collected in a form designed for the study. The statistical association was determined using the Chi-square test, with a confidence level of 95%, and a p-value of less than 0.05 was considered significant. Results: The frequency of PIR was 3.95%, with no statistically significant difference between sexes (p>0.05). The most common findings were PIR in the lower right second molar (32.5%), a singular defect (89.3%), central location (44.5%), and superficial dentinal involvement (83.1%). These results aligned with existing literature. Conclusions: Our results describe the epidemiological profile of PIR in the present sample as a single radiolucent and small (grade I) defect located centrally in the coronal dentin, often affecting posterior lower teeth with a frequency lesser than 5%. These findings provided valuable insights for clinicians and researchers regarding the frequency and characteristics of PIR in Peruvian patients.

Posteruptive Intracoronal Resorption in a 9-year-old with Molar Incisor Hypomineralization: A Case Report.

Objectives: The case report highlights the management of late-stage sequelae of preeruptive intracoronal resorption (PEIR) with molar incisor hypomineralization (MIH). Materials and methods: A 9-year-old patient presented with occlusal cavitations in her upper and lower permanent molars with vascularized tissue seen within the dentin, without any connections with the dental pulp, and no evidence of carious activity within the lesion. The affected teeth were debrided, and Biodentine™ was placed to preserve the vital pulp. The permanent molars were restored with Hall crowns, and the case was followed up for 2 years. Results: The patient remained asymptomatic throughout the follow-up period. The resulting increase in the bite following the placement of the Hall crown settled within 2 months. Pulp vitality was preserved, and no further resorptive activity was seen in the dentition. Conclusion: Preeruptive intracoronal resorption may go unnoticed and may later present with late-stage manifestations. Patients with PEIR and MIH may end up with an exposed resorptive lesion due to posteruptive breakdown, which may be managed conservatively using Biodentine™. Clinical significance: Resorptive lesions can be conservatively managed without compromising pulpal health. Their early detection and differentiation from dental caries can prove pivotal in the preservation of the affected teeth. How to cite this article: Bhatia K, Malladi U, Thomas NA, et al. Posteruptive Intracoronal Resorption in a 9-year-old with Molar Incisor Hypomineralization: A Case Report. Int J Clin Pediatr Dent 2024;17(6):712-716.

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: A report of two cases treated with Biodentine in mandibular premolars.

Pre-eruptive intracoronal resorption is a rare dental anomaly marked by a radiolucent area within an unerupted tooth. This report discusses the clinical management of pre-eruptive intracoronal resorption in two mandibular premolars through vital pulp therapy using Biodentine as a sealant. Emphasising the significance of timely intervention for preserving pulp vitality and the tooth's integrity, the present case report underscores the necessity of vigilant clinical and radiographic monitoring for early detection and appropriate treatment. By presenting effective strategies for managing pre-eruptive intracoronal resorption, the report contributes to the understanding of this condition and highlights the importance of proactive measures in preserving affected teeth and ensuring favourable long-term outcomes.

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.

Management of preeruptive intracoronal radiolucency (PEIR): a case series with up to 8 years follow-up.

Preeruptive intracoronal radiolucency (PEIR) is a rare dental anomaly often incidentally detected during routine radiographic examinations. This condition manifests as a radiolucent lesion beneath the enamel-dentin junction of unerupted teeth, particularly in mandibular molars, posing diagnostic and management challenges due to its asymptomatic nature. The treatment of PEIR depends on the extent of the lesion and the degree of pulp involvement. Case series: This case series reports on four patients with progressive PEIR. In Cases 1 and 2, lesions were incidentally discovered in panoramic radiographs during orthodontic planning (mandibular permanent second molars), and additional surgical exposure to access the lesion was required as teeth were only partially erupted. Interestingly, in Case 3, the PEIR was not visible in earlier radiographs though the crown of the tooth was already mineralized (mandibular permanent second molar). For Case 4, the tooth presented with symptoms of reversible pulpitis (mandibular permanent first molar). All lesions were treated with indirect pulp capping using biocompat-ible material. The patients were followed up for a period of up to 8 years to evaluate treatment success. Indirect pulp capping and restorations were found to be successful in all four cases in the last follow-up: 1 year (Case 2), 1.4 years (Case 4), 1.5 years (Case 1), and 8 years (Case 3). Conclusion: This case series demonstrates the effectiveness of early intervention via surgical exposure and indirect pulp capping and restoration for managing severe cases of PEIR. However, further research with larger samples and long follow-up is necessary.

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 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.

Resorción intracoronal preeruptiva: reportes radiográficos y tomográficos de cuatro casos / Preeruptive Intracoronal Resorption: X-Ray and Tomographic Reports of Four Cases

RESUMEN La resorción intracoronal preeruptiva (RIPE) se presenta como un defecto ubicado en la dentina coronal próxima a la unión amelodentinaria en la corona de un germen dentario. Este defecto de profundidad y ubicación anteroposterior variables solo puede ser diagnosticado mediante radiografías extraorales, intraorales y tomografías dentales. La etiología no ha sido determinada, pero los estudios de histopatología sugieren que este defecto sería una secuela de resorción dentaria. En el presente manuscrito, se presentan radiografías panorámicas y tomografías de haz cónico (THC) de cuatro pacientes con dicha afección, en las que encontramos los defectos dentinarios y discontinuidades en el esmalte adyacente, por lo que se discutirá la utilidad de la THC en el diagnóstico y la planificación de tratamiento de los casos con RIPE.

ABSTRACT Preeruptive Intracoronal Resorption (PIR) manifests as a defect located in the dentin of a dental germ, adjacent to the amelodentinal junction in the crown. This defect, which varies in depth and anteroposterior location, can only be diagnosed through extraoral and intraoral x-rays, as well as dental tomography. The etiology of PIR remains undetermined, although histopathological studies suggest it could be a consequence of dental resorption. In this paper, panoramic x-rays and cone beam computed tomography (CBCT) scans of four patients with PIR are presented. The dental defects and enamel discontinuities adjacent to them are identified, highlighting the usefulness of CBCT in diagnosing and planning treatment for PIR cases.

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.

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.

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

OBJECTIVE: The 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. MATERIALS: An almost complete skeleton, including the mandible from the Qafzeh site (Qafzeh 9). METHODS: Micro-CT and medical imaging techniques are used to explore inaccessible inner structures and to assess the etiology of identified lesion. RESULTS: Mandibular and dental conditions appear to be growth-related skeletal disorders. CONCLUSION: To 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. SIGNIFICANCE: Identification 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 RESEARCH: This 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.

A Controlled Study of Pre-Eruptive Intracoronal Resorption and Dental Development.

AIM: To compare the prevalence of PEIR in Australian and Saudi Arabian children and to investigate the relationship of PEIR with dental development. STUDY DESIGN: Panoramic (PAN) radiographs of 842 Australian and 456 Saudi children were screened for PEIR. The dental ages of the children with and without PEIR were assessed from the PAN radiographs using the method of Demirjian and co-workers. RESULTS: The subject prevalence of PEIR was not statistically significant between Australian (2%) and Saudi children (0.6%) (p>0.1). The teeth most commonly affected by PEIR were the mandibular second molars and premolars. Dental impaction was observed in 31% of teeth with PEIR compared to only 0.1% of control teeth (p<0.0001). Children with PEIR showed a mean delay in dental development of 0.54±0.85 years compared with ageand gender-matched controls (p<0.0001). CONCLUSIONS: The present study provides the first evidence that there are no differences in PEIR prevalence between Australian and Saudi populations, and that dental development is significantly delayed in children with PEIR.

Pre-eruptive intracoronal resorption in a third upper molar: clinical, tomographic and histological analysis.

Radiolucent or hypodense lesions in the crown of unerupted teeth may be due to pre-eruptive intracoronal resorption. Clinicians must be aware of this risk so that they can diagnose and appropriately treat this condition. The purpose of this study is to present a well-documented clinical case of pre-eruptive intracoronal resorption in an impacted third upper left molar of a 63 year old female patient. This was an unexpected finding, which occurred after cone-beam computed tomography was used to investigate the first upper left molar, which had an acute periradicular abscess. A multidisciplinary team followed up the case to describe clinical, radiographic and histological findings. The available treatment options were discussed, and the tooth extraction was the option chosen. Previous case studies describing such resorption in third upper molars have not been reported. This case shows that all permanent teeth in a pre-eruptive stage must be analysed radiographically to detect early pre-eruptive intracoronal resorption.

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.