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Specialty Registrar in Paediatric Dentistry, Community Dental Services, Kent Community Health NHS Foundation Trust; Royal London Dental Hospital, Barts Health NHS Trust, London
Senior Dental Officer in Paediatric Dentistry, Community Dental Services, Kent Community Health NHS Foundation Trust; Royal London Dental Hospital, Barts Health NHS Trust, London
This case describes the presentation of pre-eruptive intracoronal resorption affecting multiple permanent teeth in an 11-year-old female child. Pre-eruptive intracoronal resorption is a lesion that is often located within the dentine, adjacent to the enamel–dentine junction in the occlusal face of the tooth crown. Histological reports have shown the presence of resorptive cells in these lesions. Previous literature presents cases usually affecting a single tooth, in this case 10 permanent teeth were found to be affected. Clinicians should be aware of this diagnosis and its treatment modalities to ensure appropriate management is carried out.
CPD/Clinical Relevance: This case highlights pre-eruptive intracoronal resorption for clinicians based in both primary and secondary care settings
Article
Pre-eruptive intracoronal resorption (PEIR) is most commonly detected as an incidental finding on radiographs.1 Its diagnosis is challenging, the presence of pre-eruptive radiographs of affected teeth aids its diagnosis.2 PEIR prevalence is 2–8% by subject and 0.6–2% by tooth. Mandibular first premolar teeth are most likely to be affected, followed by second and third molars.3 This condition usually affects a single tooth, the authors are unaware of any case reports that have shown ten or more teeth to have been affected. PEIR most commonly affects teeth in the permanent dentition, with few reports affecting the primary dentition;4 however, this may be because radiographs are rarely taken of primary teeth prior to eruption.
Several theories of the aetiology of PEIR have been proposed; however, it remains poorly understood.5 Earlier literature refers to these lesions as ‘pre-eruptive caries’, as they were deemed to closely resemble carious lesions, however there is weak evidence for this association.1 The most accepted theory for the aetiology of the PEIR is intracoronal resorption by invasion of resorptive cells into the forming dentine via an interruption of crown formation.6 Histologically, multinucleated giant cells, osteoclasts and chronic inflammatory cells have been described as related factors, suggesting that the PEIR process involves resorption of calcified dental tissues.7
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