Pre-eruptive intra-coronal resorption in mandibular third molars

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.

Keywords

• pre-eruptive intracoronal resorption
• lower third molar
• tooth impaction
• inferior alveolar nerve injury