Preeruptive Intracoronal Radiolucencies: Detection and Nine Years Monitoring with a Series of Dental Radiographs

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.

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

“…Included studies were published between 1988 and 2018, had range of patient age from 19 months to 14 years, with no sex predilection. All cases were diagnosed on radiographs, such as panoramic (n = 14, 48.3%), 1 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 periapical (n = 8, 27.6%), 3 , 4 , 6 , 19 , 20 , 21 , 22 and bitewing (n = 7, 24.1%), 8 , 23 , 24 , 25 , 26 , 27 with 24 unerupted teeth and 13 erupted teeth.…”

“… 3 (2017) 19 m Female #74 Periapical radiograph Erupted RCT NR 1w 7 m Good healing Asymptomatic 4 Manmontri et al. 10 (2017) 8 y 8 m #37 Panoramic radiograph Unerupted Monitoring (periodic intraoral and extraoral radiographs) NR Nine years of follow-up Supporting theory: progressive resorption of PEIR may cease or decelerate after tooth eruption 2y3m 3y4m 6y4m Partially erupted Asymptomatic Completely erupted Asymptomatic No changes clinically or radiographically in the PEIR-affected tooth 5 Omar et al. 23 (2015) 11 y NR #37 Bitewing Unerupted Surgical exposure MTA direct pulp capping + cotton pellets + IRM IRM and cotton pellets were removed + Composite NR 8w 3m8w 3y3m8w Asymptomatic Normal root development Asymptomatic Normal root development Asymptomatic 6 Spierer and Fuks 24 (2014) 6 y Male #46 Bitewing Unerupted Surgical exposure Restoration (Glass monomer lining + GIC) Minute gaps in enamel formation Connective tissue, bone and granulation issue 3w 3m3w 1 y Good healing Asymptomatic Normal root development Asymptomatic 7 ...…”

“…Among the 24 unerupted teeth, the reviewed treatment options were surgical exposure and restoration due to large and developing lesions (n = 9, 36%), 6 , 9 , 13 , 17 , 18 , 19 , 21 , 23 , 24 no reports (n = 7, 28%), 14 monitoring and restoration due to small and static lesions (n = 4, 16%), 1 , 8 , 22 , 25 extraction due to large lesion, unrecoverable residual, extensive pulpal involvement, or benefit of orthodontic treatment (n = 3, 16%), 11 , 16 , 20 and observation due to small and static lesion without restoration (n = 1, 4%). 10 …”

“…In this study, according to its progressive nature based on lesion size, PEIR lesions can be divided into two major types: static 1 , 8 , 10 , 22 , 25 , 26 and developing. 3 , 4 , 6 , 8 , 9 , 11 , 12 , 13 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 23 , 24 , 27 Most previous treatment plans were based on lesion size.…”

“…However, most case reports lack histological analyses of lesions, which supports the diagnosis of PEIR. 1 , 3 , 6 , 8 , 9 , 10 , 12 , 13 , 14 , 16 , 17 , 18 , 19 , 21 , 23 , 24 , 25 Although the etiology of each case is not clear, a review of treatment modalities helps to create a treatment plan for clinical management. The period of follow-up of included case reports is heterogeneous, from 2 months to 6 years 9 months.…”