Abstract
This report describes two cases of preeruptive dentinal defects with a small pulp exposure. In these cases, radiographs taken previously suggested that the defects were not present when the dental crowns of the affected teeth were completely formed.
One case was an 8-year-old boy. Clinical examination revealed a recently erupted maxillary right central incisor with a large defect on the mesial and lingual surface. The defect was 5 mm wide and 6mm long, and was filled with a soft tissue associated with gingival tissue. The tissue was curetted away, revealing a small pulp exposure.
Another case was a 10-year-old girl. A bitewing radiograph taken for the recall examination revealed a radiolucent area in the coronal aspect of the unerupted mandibular right second molar. The tooth was covered completely by gingival tissue. The crown of the affected tooth was surgically exposed under local anesthesia, revealing a normal occlusal surface with a intact enamel surface that could not be penetrated with a sharp dental explorer. When the intact enamel on the occlusal surface was removed, an empty large defect with a small pulp exposure was observed in the dentin.
Both cases were treated by direct pulp capping with calcium hydroxide powder in sterile saline, followed by a glass ionomar interim restoration. They were followed up over the next 2 years. All clinical and radiographic features indicated normal pulp vitality and normal root formation. It was most likely that in these cases, the defects of the crowns were resorptive lesions, because they were progressive, but the etiology of the coronal resorption was unknown.
