Pre-eruptive intracoronal resorption in orthodontic patients: A retrospective analysis of 3,143 patients

Global prevalence of pre eruptive intracoronal resorption (PEIR) of teeth: a systematic review of literature

AIM

Pre-eruptive intracoronal resorption (PIER) defects constitute an important part of anomalies associated with unerupted teeth. However, these defects are usually overlooked by clinicians whilst interpreting radiographs. This systematic review was thus orchestrated to find the global prevalence of PEIR.

METHODOLOGY

A comprehensive database search was done until December 2022 for published articles on the prevalence of pre-eruptive intracoronal resorption following preferred reporting items for systematic reviews and meta-analyses guidelines. The review was registered in Prospero (CRD42024501668). The risk of bias was analysed for each study using the Newcastle-Ottawa Quality Assessment Scale for cross-sectional studies.

RESULTS

In total 18 studies were included in the present systematic review. The subject prevalence was 3.54% (range 0.56-27.31%) and tooth prevalence of 0.695% (Range 0.073-2.12%). Males and females were equally affected with no difference based on geography and race. Mandibular teeth showed more incidence of PEIR than maxillary teeth. First premolars were most frequently affected in the mandibular arch, whilst canines were affected most in the maxillary arch.

CONCLUSION

Within the limits of the review, we presented for the first time the global prevalence of PEIR. The condition may be overlooked and could lead to potential complications, thus it is essential to promptly diagnose these defects, thus preventing any further complications. We further suggest that all extirpated soft tissue should be submitted for further evaluation to shed light on the pathogenetic mechanisms involved in the initiation and progression of the disease.

Idiopathic Intracoronal Resorption of Permanent Molars: A Report of Two Cases

Intracoronal resorption (IR) is a condition characterized by the presence of lesions in the dentin of unerupted or erupting teeth, usually located just below the enamel-dentin junction in the occlusal part of the crown. This article presents two cases of IR-one with and one without pulp involvement. In both cases, the teeth were asymptomatic, and the lesions were discovered during routine checkups. The first case presents pre-eruptive IR with pulp involvement in an immature mandibular molar. To preserve the vitality of the growth zone and complete root development, vital pulp therapy was performed through total coronal pulpotomy and application of Biodentine. The second case is also of a mandibular molar with incomplete root development, but although it initially resembled invasive cervical resorption, treatment revealed that the granulation tissue was surrounded by intact enamel and did not affect the pulp or root of the tooth. No carious lesion was found. The tooth was conventionally restored with a composite filling.

Treatment options for impacted maxillary canines and occurrence of ankylotic and resorptive processes: a 20-year retrospective study

BACKGROUND

This 20-year retrospective study aimed to evaluate the treatment methods used in patients with impacted maxillary permanent canines and to determine the occurrence of ankylotic and resorptive processes and their association with potential risk factors.

METHODS

The cohort consisted of 351 consecutive Caucasian patients (120 males and 231 females, mean age 18.4 and 19.9 years, respectively) with 420 impacted maxillary permanent canines. CT and CBCT findings were subsequently confirmed during surgery. Statistical analyses were performed by the generalized linear models, Pearson x2 and Fisher exact tests using the statistical programs R and Statistica v. 14.

RESULTS

A total of 273 (65.0%) impacted canines were aligned in the dental arch by orthodontic traction after surgical exposure, this treatment was predominant in patients under 20 years of age. Surgical extraction was performed in 115 (27.2%) impacted canines and was more common in older patients. Ankylotic changes were recorded in 61 (14.5%) impacted canines. The probability of ankylosis increased with age, particularly after the patient's 20th year of life (p < 0.001). Patients were 1.2% likely to develop ankylosis at age 15 years, 4.3% at age 20 years, 14.1% at age 25 years, and 96.8% at age 45 years. Invasive cervical root resorption (ICRR) was found in 8 (1.9%) canines. In 4 canines (1.0%), root ankylosis in addition to ICRR was observed. In contrast to ankylosis, whose frequency of occurrence increased with age, the occurrence of ICRR resulting from PDL damage during surgery was more typical in younger patients. Canines in a high position above the root apices of the adjacent teeth, with a horizontal inclination of the longitudinal axis, with the crown located deep in the center of the alveolar bone and with labiopalatal position, should be considered critically impacted canines with a high risk to failure of orthodontic traction.

CONCLUSION

In conclusion, the treatment of impacted canines depends mainly on the age of the patient, and the position and inclination of the longitudinal axis of the impacted tooth. To select an adequate treatment method, we recommend CBCT examination, which allows a precise analysis of the position of impacted canines.

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.