CASE REPORT
Radiolucent Lesions in Intracoronal Dentin of Unerupted Premolars
Report of Three Cases
2018 Volume 56 Issue 4 Pages 450-459
Details
2018 Volume 56 Issue 4 Pages 450-459
Radiolucent lesions within intracoronal dentin located adjacent to the amelodentinal junction of unerupted developing teeth is a rare phenomenon, with most cases noted in molars and premolars, and more often in mandibular as compared to maxillary teeth. The majority of affected teeth are as ymptomatic, with the lesions incidentally discovered during a routine radiographic examination in bitewing and panoramic radiographs and the finding is often erroneously referred to as “pre-erupted caries”. Several theories for development of pre-eruptive intracoronal radiolucency (PEIR) have been proposed, though it is currently widely accepted that PEIR is resorptive in nature, while the etiology remains unclear.
We describe three teeth with PEIR due to idiopathic resorption, a maxillary second premolar, man dibular first premolar, and mandibular second premolar in three 9-year-old girls. The defects were lo calized within dentin without lesion progression until eruption. Removal of intact enamel on occlusal surfaces and empty defects with soft, grayish, and flaky dentin was performed with an excavator until hard dentin was reached. The defects were then treated by indirect pulp capping with calcium hydrox ide, glass ionomer lining, and composite resin restoration. Affected teeth remained asymptomatic with continued root development.
It appears that the dentin defects in our patient were due to the resorptive process, though the etiol ogy of the idiopathic pre-eruptive intracoronal resorption is unknown. In the present cases, the lesions were incidentally discovered in radiographic imaging conducted prior to their eruption into the oral cavity, though were missed in the initial radiographs.
We consider that practitioners may not notice the initial signs, especially with small lesions. Thus,it is important to examine radiographic images for abnormalities in regard to number, size, shape, and position of unerupted permanent teeth, as well as PEIR.
