Management of maxillary premolar with pre-eruptive intracoronal resorption: A 5-year follow-up case

Abstract

Aim and objective: The present article aims to describe and discuss the preventive clinical management of a pre-eruptive intracoronal resorption (PEIR) defect on a maxillary right second premolar of an 11-year, 5-month-old girl. Background: Pre-eruptive intracoronal resorption is described as an abnormal, well-circumscribed, radiolucent area, occurring within the coronal dentinal tissue close to the dentinoenamel junction of unerupted teeth and extending into various depths of the dentin. It is a rare anomaly occurring in primary and permanent dentitions. In the past, these defects were misdiagnosed as caries, and were therefore called “pre-eruptive caries” or “hidden caries”. Currently, the most acceptable etiological hypothesis for PEIR is intracoronal resorption by the invasion of resorptive cells into the dentine through breakdowns in the enamel during crown formation. These lesions are often detected accidentally during routine dental radiographic examination. Case description: A fissure sealant was applied to the affected tooth shortly after its eruption. Clinical and radiographical assessments were scheduled every 6 months for a period of 5 years and 5 months. Conclusion: The preventive approach proved to be effective in preserving the tooth vital and asymptomatic with normal root development for the entire follow-up period. Clinical significance: This article raises awareness about misdiagnosed PEIR in primary and permanent dentitions. A close inspection of radiographs, taken during routine visits and orthodontic check-ups, is important for early detection and proper management of such defects.