A pre-eruptív intrakoronális reszorpció előfordulása és jelentősége bölcsességfogak esetében

Kata Janovics; Balázs Soós; Zsuzsanna Gurdán; Ana Esther Pacheco; Edina Lempel; Ágnes Bán; József Szalma

doi:10.33891/FSZ.116.3.120-126

Kata Janovics Pécsi Tudományegyetem, Általános Orvostudományi Kar, Klinikai Központ, Fogászati és Szájsebészeti Klinika, Konzerváló Fogászati és Parodontológiai Tanszék https://orcid.org/0000-0002-5528-1503
Balázs Soós Pécsi Tudományegyetem, Általános Orvostudományi Kar, Klinikai Központ, Fogászati és Szájsebészeti Klinika, Arc-, Állcsont-és Szájsebészeti Tanszék https://orcid.org/0000-0002-9101-5974
Zsuzsanna Gurdán Pécsi Tudományegyetem, Általános Orvostudományi Kar, Klinikai Központ, Fogászati és Szájsebészeti Klinika, Gyermek- és Ifjúsági Fogászati Tanszék https://orcid.org/0009-0008-3568-7646
Ana Esther Pacheco Pécsi Tudományegyetem, Általános Orvostudományi Kar, Klinikai Központ, Fogászati és Szájsebészeti Klinika, Arc-, Állcsont-és Szájsebészeti Tanszék https://orcid.org/0000-0003-0756-9200
Edina Lempel Pécsi Tudományegyetem, Általános Orvostudományi Kar, Klinikai Központ, Fogászati és Szájsebészeti Klinika, Konzerváló Fogászati és Parodontológiai Tanszék https://orcid.org/0000-0002-9839-0515
Ágnes Bán Pécsi Tudományegyetem, Általános Orvostudományi Kar, Klinikai Központ, Fogászati és Szájsebészeti Klinika, Konzerváló Fogászati és Parodontológiai Tanszék https://orcid.org/0009-0004-9936-6025
József Szalma Pécsi Tudományegyetem, Általános Orvostudományi Kar, Klinikai Központ, Fogászati és Szájsebészeti Klinika, Arc-, Állcsont-és Szájsebészeti Tanszék https://orcid.org/0000-0002-6006-8758

DOI: https://doi.org/10.33891/FSZ.116.3.120-126

Keywords: pre-eruptive intracoronal resorption, lower third molar, tooth impaction, inferior alveolar nerve injury

Abstract

Introduction: Pre-eruptive intracoronal resorption (PEIR) is a well-defined radiolucent lesion localized to the coronal tooth
tissues. Our study aimed to determine the prevalence of PEIR among impacted lower wisdom teeth and to describe its
possible modifying effect on surgical treatment planning.
Materials and methods: In this retrospective study, from the examined 6775 patients, 21 wisdom teeth of 20 patients,
– affected by PEIR – were included. Demographic data of the patients were collected and radiological analysis using orthopantomography
was performed to assess the extent of PEIR, pulp involvement, ectopic position, rotation, impaction
status, and angulation.
Results: Analyzing the PEIR cases, the gender ratio was 0.67 (8 men, 12 women), with an average age of 31 ± 25 years.
PEIR involving lower wisdom teeth was seen in 0.3% (21/6775) of the patients, which was 30.9% (21/68) of all detected
PEIR lesions. 28.6% of the lesions was advanced (6/21), and 66.7% of these teeth showed a pulp involvement (4/6). Patients
with advanced PEIR were significantly older (50.3 ± 18.3 vs. 23.7 ± 15.2 years; p = 0.0128, Mann-Whitney test).
Ectopic position was observed in 47.6% of the cases (10/21) and rotational position in 9 cases (42.9%). 19% of teeth
with a PEIR lesion, meant an increased risk of nerve damage (4/21). In the case of advanced lesions (grade ≥ 7), the
multiple root darkening sign indicated the increased tendency to nerve damage in 66.7% (4/6).
Conclusions: The presence and characteristics of PEIR can modify and determine the follow-up schedule, or have
an influence on the therapeutic decisions, forcing us to choose between restorative solutions, coronectomy or total extraction.

References

AL-BATAYNEH OB, ALTAWASHI EK: Pre-eruptive intra-coronal resorption of dentine: a review of aetiology, diagnosis, and management. Eur Arch Paediatr Dent. 2020;21(1):1-11. https://doi.org/10.1007/s40368-019-00470-4

ALESSANDRI BONETTI G, BENDANDI M, LAINO L, CHECCHI V, CHECCHI L: Orthodontic extraction: riskless extraction of impacted lower third molars close to the mandibular canal. J Oral Maxillofac Surg. 2007;65(12):2580-2586. https://doi.org/10.1016/j.joms.2007.06.686

BRUNET-LLOBET L, LAHOR-SOLER E, MIRANDA-RIUS J: Oral pain due to severe pre-eruptive intracoronal resorption in permanent tooth. Eur J Paediatr Dent. 2014;15(3):332-334.

DAVIDOVICH E, KREINER B, PERETZ B: Treatment of severe pre-eruptive intracoronal resorption of a permanent second molar. Pediatr Dent. 2005;27(1):74-77.

DE BOER MP, RAGHOEBAR GM, STEGENGA B, SCHOEN PJ, BOERING G: Complications after mandibular third molar extraction. Quintessence Int. 1995;26(11):779-784.

DEMIRTAS O, DANE A, YILDIRIM E: A comparison of the use of cone-beam computed tomography and panoramic radiography in the assessment of pre-eruptive intracoronal resorption. Acta Odontol Scand. 2016;74(8):636-641. https://doi.org/10.1080/00016357.2016.1235227

DEMIRTAS O, TARIM ERTAS E, DANE A, KALABALIK F, SOZEN E: Evaluation of pre-eruptive intracoronal resorption on cone-beam computed tomography: A retrospective study. Scanning. 2016;38(5):442-447. https://doi.org/10.1002/sca.21294

ENGELKE W, BELTRÁN V, CANTÍN M, CHOI EJ, NAVARRO P, FUENTES R: Removal of impacted mandibular third molars using an inward fragmentation technique (IFT) - Method and first results. J Craniomaxillofac Surg. 2014;42(3):213-219. https://doi.org/10.1016/j.jcms.2013.05.003

GHAEMINIA H, GERLACH NL, HOPPENREIJS TJ, KICKEN M, DINGS JP, BORSTLAP WA, ET AL: Clinical relevance of cone beam computed tomography in mandibular third molar removal: A multicentre, randomised, controlled trial. J Craniomaxillofac Surg. 2015;43(10):2158-2167. https://doi.org/10.1016/j.jcms.2015.10.009

GRUNDY GE, PYLE RJ, ADKINS KF: Intra-coronal resorption of unerupted molars. Aust Dent J. 1984;29(3):175-179. https://doi.org/10.1111/j.1834-7819.1984.tb01135.x

JANOVICS K, SOÓS B, TÓTH Á, SZALMA J: Is it possible to filter third molar cases with panoramic radiography in which roots surround the inferior alveolar canal? A comparison using cone-beam computed tomography. J Craniomaxillofac Surg. 2021;49(10):971-979. https://doi.org/10.1016/j.jcms.2021.05.003

KALANTAR MOTAMEDI MR, HEIDARPOUR M, SIADAT S, KALANTAR MOTAMEDI A, BAHREMAN AA: Orthodontic Extraction of High-Risk Impacted Mandibular Third Molars in Close Proximity to the Mandibular Canal: A Systematic Review. J Oral Maxillofac Surg. 2015;73(9):1672-1685.

https://doi.org/10.1016/j.joms.2015.03.031

KLAMBANI M, LUSSI A, RUF S: Radiolucent lesion of an unerupted mandibular molar. Am J Orthod Dentofacial Orthop. 2005;127(1):67-71.

https://doi.org/10.1016/j.ajodo.2004.01.020

LANDI L, MANICONE PF, PICCINELLI S, RAIA A, RAIA R: A novel surgical approach to impacted mandibular third molars to reduce the risk of paresthesia: a case series. J Oral Maxillofac Surg. 2010;68(5):969-974. https://doi.org/10.1016/j.joms.2009.09.097

LE VNT, KIM JG, YANG YM, LEE DW: Treatment of pre-eruptive intracoronal resorption: A systematic review and case report. J Dent Sci. 2020;15(3):373-382. https://doi.org/10.1016/j.jds.2020.02.001

LENZI R, MARCELIANO-ALVES MF, ALVES F, PIRES FR, FIDEL S: Pre-eruptive intracoronal resorption in a third upper molar: clinical, tomographic and histological analysis. Aust Dent J. 2017;62(2):223-227. https://doi.org/10.1111/adj.12444

MANAN NM, MALLINENI SK, KING NM: Case report: idiopathic pre-eruptive coronal resorption of a maxillary permanent canine. Eur Arch Paediatr Dent. 2012;13(2):98-101. https://doi.org/10.1007/BF03262853

MANMONTRI C, MAHASANTIPIYA PM, CHOMPU-INWAI P: Preeruptive Intracoronal Radiolucencies: Detection and Nine Years Monitoring with a Series of Dental Radiographs. Case Rep Dent. 2017;2017:6261407. https://doi.org/10.1155/2017/6261407

MONACO G, VIGNUDELLI E, DIAZZI M, MARCHETTI C, CORINALDESI G: Coronectomy of mandibular third molars: A clinical protocol to avoid inferior alveolar nerve injury. J Craniomaxillofac Surg. 2015;43(8):1694-1699. https://doi.org/10.1016/j.jcms.2015.07.006

OMAR S, CHOI J, NELSON B, SHIN M, CHEN JW: PRE-Eruptive Intracoronal Resorption (PEIR): Literature Review and Case Report. J Calif Dent Assoc. 2015;43(5):255-260.https://doi.org/10.1080/19424396.2015.12222845

PIPPI R: A case of inferior alveolar nerve entrapment in the roots of a partially erupted mandibular third molar. J Oral Maxillofac Surg. 2010;68(5):1170-1173. https://doi.org/10.1016/j.joms.2009.10.007

POGREL MA: An update on coronectomy. J Oral Maxillofac Surg. 2009;67(8):1782-1783. https://doi.org/10.1016/j.joms.2009.03.065

SELVI F, DODSON TB, NATTESTAD A, ROBERTSON K, TOLSTUNOV L: Factors that are associated with injury to the inferior alveolar nerve in high-risk patients after removal of third molars. Br J Oral Maxillofac Surg. 2013;51(8):868-873. https://doi.org/10.1016/j.bjoms.2013.08.007

SEOW WK, HACKLEY D: Pre-eruptive resorption of dentin in the primary and permanent dentitions: case reports and literature review. Pediatr Dent. 1996;18(1):67-71.

SEOW WK, LU PC, MCALLAN LH: Prevalence of pre-eruptive intracoronal dentin defects from panoramic radiographs. Pediatr Dent. 1999;21(6):332-339.

SEOW WK: Multiple pre-eruptive intracoronal radiolucent lesions in the permanent dentition: case report. Pediatr Dent. 1998;20(3):195-198.

SHIRATORI K, NAKAMORI K, UEDA M, SONODA T, DEHARI H: Assessment of the shape of the inferior alveolar canal as a marker for increased risk of injury to the inferior alveolar nerve at third molar surgery: a prospective study. J Oral Maxillofac Surg. 2013;71(12):2012-2019. https://doi.org/10.1016/j.joms.2013.07.030

SKILLEN WG: So-called intra-follicular caries. Ill Dent J. 1941;10:307-e308.

SPIERER WA, FUKS AB: Pre-eruptive intra-coronal resorption: controversies and treatment options. J Clin Pediatr Dent. 2014;38(4):326-328.

https://doi.org/10.17796/jcpd.38.4.dm7652634h12705v

STEINBERG MJ, NICK MJ: Displacement of the Inferior Alveolar Bundle Secondary to Post Coronectomy Root Migration: A Case Report. J Oral Maxillofac Surg. 2021;79(9):1837-1841. https://doi.org/10.1016/j.joms.2021.04.012

SU N, VAN WIJK A, BERKHOUT E, SANDERINK G, DE LANGE J, WANG H, ET AL.: Predictive Value of Panoramic Radiography for Injury of Inferior Alveolar Nerve After Mandibular Third Molar Surgery. J Oral Maxillofac Surg. 2017;75(4):663-679. https://doi.org/10.1016/j.joms.2016.12.013

SUSARLA SM, SIDHU HK, AVERY LL, DODSON TB: Does computed tomographic assessment of inferior alveolar canal cortical integrity predict nerve exposure during third molar surgery?. J Oral Maxillofac Surg. 2010;68(6):1296-1303. https://doi.org/10.1016/j.joms.2010.01.021

SZALMA J, JANOVICS K, PACHECO A, KASZÁS B, LEMPEL E: Pre-eruptive intracoronal resorption in "high-risk" impacted third molars: A report of four cases. J Craniomaxillofac Surg. 2022; 50(10): 798-805. https://doi.org/10.1016/j.jcms.2022.09.004

SZALMA J, LEMPEL E, JEGES S, OLASZ L: Darkening of third molar roots: panoramic radiographic associations with inferior alveolar nerve exposure. J Oral Maxillofac Surg. 2011;69(6):1544-1549. https://doi.org/10.1016/j.joms.2010.09.009

SZALMA J, VAJTA L, LOVÁSZ BV, KISS C, SOÓS B, LEMPEL E: Identification of Specific Panoramic High-Risk Signs in Impacted Third Molar Cases in Which Cone Beam Computed Tomography Changes the Treatment Decision. J Oral Maxillofac Surg. 2020;78(7):1061-1070.

https://doi.org/10.1016/j.joms.2020.03.012

TOLSTUNOV L, JAVID B, KEYES L, NATTESTAD A: Pericoronal ostectomy: an alternative surgical technique for management of mandibular third molars in close proximity to the inferior alveolar nerve. J Oral Maxillofac Surg. 2011;69(7):1858-1866. https://doi.org/10.1016/j.joms.2011.03.002

UMANSKY M, TICKOTSKY N, FRIEDLANDER-BARENBOIM S, FAIBIS S, MOSKOVITZ M: Age Related Prevalence of Pre-Eruptive Intracoronal Radiolucent Defects in the Permanent Dentition. J Clin Pediatr Dent. 2016;40(2):103-106. https://doi.org/10.17796/1053-4628-40.2.103

UZUN I, GUNDUZ K, CANITEZER G, AVSEVER H, ORHAN K: A retrospective analysis of prevalence and characteristics of pre-eruptive intracoronal resorption in unerupted teeth of the permanent dentition: a multicentre study. Int Endod J. 2015;48(11):1069-1076. https://doi.org/10.1111/iej.12404

YÜKSEL HT, TÜRKMENOĞLU A, ÇELIKKOL B, EVIRGEN Ş, GULSAHI K, GULSAHI A: Pre-eruptive intracoronal resorption of permanent dentition: A new classification and a multidisciplinary study [published online ahead of print, 2022 Nov 1]. Aust Endod J. 2022;10.1111/aej.12706.

https://doi.org/10.1111/aej.12706

ZILBERMAN U, MILEVSKI I, YEGOROV D, SMITH P: A 3000 year old case of an unusual dental lesion: Pre-eruptive intracoronal resorption. Arch Oral Biol. 2019;97:97-101. https://doi.org/10.1016/j.archoralbio.2018.10.015

Pre-eruptive intra-coronal resorption in mandibular third molars

Abstract

References