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European Archives of Paediatric Dentistry

, Volume 13, Issue 4, pp 221–226 | Cite as

Case Report: Pre-eruptive intra-coronal radiolucencies revisited

  • K. P. CounihanEmail author
  • A. C. O’Connell
Article

Abstract

AIM: Pre-eruptive intra-coronal radiolucency (PEIR) describes a radiolucent lesion located in the coronal dentine, just beneath the enamel-dentine junction of unerupted teeth. The prevalence of this lesion varies depending on the type and quality of radiographic exposure and age of patients used for assessment. The aetiology of pre-eruptive intra-coronal radiolucent lesions is not fully understood, but published clinical and histological evidence suggest that these lesions are resorptive in nature. Issues around the diagnosis, treatment planning and clinical management of this lesion are explored using previously unreported cases. CASE REPORTS: Case 1: A ten-year-old girl attended for a routine check-up. An intra-coronal radiolucency in the unerupted lower right second premolar was an incidental finding on orthopantomograph (OPT). The tooth erupted and removal of enamel revealed a space filled with soft red tissue, unlike carious dentine in appearance. The tooth was restored with an indirect pulp cap, resin modified glass ionomer base and composite resin. Tissue from the lesion was removed for histopathological investigation. Root development continued to completion and the tooth remained asymptomatic and vital. Case 2: A six-year-old girl attended for her first dental visit. An intra-coronal radiolucency in a lower right first permanent molar was noted on baseline bite-wing radiographs. The lesion was monitored and fissured sealed upon eruption. The lesion was monitored annually radiographically. The tooth remained symptom free for 5 years. The patient presented on an emergency basis having fractured the distolingual cusp overlying the lesion. There was no pain and the tooth was vital. The softened dentine was removed and the tooth was restored using a preformed metal crown. Case 3: A 12-year-old girl was referred for restoration of mandibular left second permanent molar. Clinically there was extensive occlusal destruction. Review of a previous OPT showed that an intra-coronal radiolucency was present in tooth 37 at least one year prior to its eruption. The large mass of coronal soft tissue was removed, the remaining enamel shell was deemed to be unrestoreable and the tooth was extracted. The patient was referred back to an orthodontist for completion of orthodontic treatment. CONCLUSION: Early detection and classification of the PEIR lesion allows an array of individualised treatments to be provided for successful outcome.

Keywords

Pre-eruptive intra-coronal radiolucency resorption idiopathic 

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References

  1. Blackwood HJJ. Resoprtion of enamel and dentine in the unerupted tooth. Oral Surg Oral Med Oral Pathol 1958; 11:79–85.PubMedCrossRefGoogle Scholar
  2. Brooks JK. Detection of intra-coronal resorption in an unerupted developing premolar: report of a case. J Am Dent Assoc 1988; 116:857–859.PubMedGoogle Scholar
  3. Davidovich E, Kreiner B, Peretz B. Treatment of severe pre-eruptive intracoronal resorption of a permanent second molar. Pediatr Dent 2005; 27:74–77.PubMedGoogle Scholar
  4. Grundy GE, Pyle RJ, Adkins KF. Intra-coronal resorption of unerupted molars. Aust Dent J 1984; 29:175–179.PubMedCrossRefGoogle Scholar
  5. Ignelzi MA, Fields HW, White RP, Bergenholtz G, Booth FA. Intra-coronal radiolucencies within unerupted teeth: case report and review of the literature. Oral Surg Oral Med Oral Pathol 1990; 70:214–220.PubMedCrossRefGoogle Scholar
  6. Hata H, Abe M, Mayanagi H. Multiple lesions of intra-coronal resorption of permanent teeth in the developing dentition: a case report. Pediatr Dent 2007; 29:420–425.PubMedGoogle Scholar
  7. Heithersay GS. Managment of tooth resorption. Aust Dent J 2007; 52 Suppl S105–S121.PubMedCrossRefGoogle Scholar
  8. Holan G, Eidelman E, Mass S. Pre-eruptive coronal resorption of permanent teeth: a report of three cases and their treatment. Pediatr Dent 1994; 16:373–376.PubMedGoogle Scholar
  9. Klambani M, Lussi A, Ruf S. Radiolucent lesion of an unerupted mandibular molar. Am J Orthod Dentofacial Orthop 2005; 127:67–71.PubMedCrossRefGoogle Scholar
  10. McEntire JF, Hermesch CB, Wall BS, Leonard DL. Case report — pre-eruptive intracoronal resorption. Oper Dent 2005; 30:553–556.PubMedGoogle Scholar
  11. McNamara CM, Foley T, O’Sullivan VR, Crowley N, McConnell RT. External resorption presenting as an intra-coronal radiolucent lesion in a pre-eruptive tooth. Oral Diseases 1997; 3:199–201.PubMedCrossRefGoogle Scholar
  12. Moskovitz M, Holan G. Pre-eruptive intra-coronal radiolucent defect: a case of a nonprogressive lesion. J Dent Child 2004; 71:175–178.Google Scholar
  13. Muhler JC. The effect of apical inflammation of the primary teeth on dental caries in the permanent dentition. J Dent Child 1957; 24:209–210.Google Scholar
  14. Nik NN, Rahman RA. Pre-eruptive intra-coronal dentin defects of permanent teeth. J Clin Pediatr Dent 2003; 27:371–375.PubMedGoogle Scholar
  15. O’Neal KM, Gound TG, Cohen DM. Pre-eruptive idiopathic coronal resorption: a case report. J Endod 1997: 23:58–59.PubMedCrossRefGoogle Scholar
  16. Ozden B, Acikgoz A. Prevalence and characteristics of intra-coronal resorption in unerupted teeth in the permanent dentition: a retrospective study. Oral Radiol 2009; 25:6–13.CrossRefGoogle Scholar
  17. Rankow H, Croll TP, Miller AJ. Pre eruptive idiopathic coronal resorption of permanent teeth in children. J Endod 1986; 12:36–39.PubMedCrossRefGoogle Scholar
  18. Seow WK, Hackley D. Pre-eruptive resorption of dentine in the primary and permanent dentitions: case reports and literature review. Pediatr Dent 1996; 18:67–71.PubMedGoogle Scholar
  19. Seow WK. Multiple pre-eruptive intra-coronal radiolucent lesions in the permanent dentition: case report. Pediatr Dent 1998; 20:195–198.PubMedGoogle Scholar
  20. Seow WK, Wan A, McAllan L. The prevalence of pre-eruptive dentin radiolucencies in the permanent dentition. Pediatr Dent 1999a; 21:26–33.PubMedGoogle Scholar
  21. Seow WK, Lu PC, McAllan LH. Prevalence of pre-eruptive intra-coronal dentin defects from panoramic radiographs. Pediatr Dent 1999b; 21:332–339.PubMedGoogle Scholar
  22. Seow WK. Pre-eruptive intra-coronal resorption as an entity of occult caries. Pediatr Dent 2000; 22:370–376.PubMedGoogle Scholar
  23. Seow WK. Diagnosis and management of unusual dental abscesses in children. Aust Dent J 2003; 48:156–168.PubMedCrossRefGoogle Scholar
  24. Skillen WG: So — called intra-follicular caries. Int Dent J 1941; 10:307–308.Google Scholar
  25. Walton JL. Dentin radiolucencies in unerupted teeth: report of two cases. J Dent Child 1980;183-186.Google Scholar
  26. Yamana A, Nakano K, Sasaki H, et al. Radiolucent lesion identified in unerupted mandibular left first permanent molar: case report and literature review. Pediatr Dent J 2010; 20:207–211.CrossRefGoogle Scholar

Copyright information

© European Archives of Paediatric Dentistry 2012

Authors and Affiliations

  1. 1.Department of Paediatric DentistryLeeds Dental InstituteLeedsEngland
  2. 2.Division of Public and Child Dental HealthDublin Dental University HospitalDublin 2Ireland

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