Abstract:
Preeruptive intracoronal radiolucency (PEIR) is a rare dental anomaly often incidentally detected during routine radiographic examinations. This condition manifests as a radiolucent lesion beneath the enamel-dentin junction of unerupted teeth, particularly in mandibular molars, posing diagnostic and management challenges due to its asymptomatic nature. The treatment of PEIR depends on the extent of the lesion and the degree of pulp involvement. Case series: This case series reports on four patients with progressive PEIR. In Cases 1 and 2, lesions were incidentally discovered in panoramic radiographs during orthodontic planning (mandibular permanent second molars), and additional surgical exposure to access the lesion was required as teeth were only partially erupted. Interestingly, in Case 3, the PEIR was not visible in earlier radiographs though the crown of the tooth was already mineralized (mandibular permanent second molar). For Case 4, the tooth presented with symptoms of reversible pulpitis (mandibular permanent first molar). All lesions were treated with indirect pulp capping using biocompat-ible material. The patients were followed up for a period of up to 8 years to evaluate treatment success. Indirect pulp capping and restorations were found to be successful in all four cases in the last follow-up: 1 year (Case 2), 1.4 years (Case 4), 1.5 years (Case 1), and 8 years (Case 3). Conclusion: This case series demonstrates the effectiveness of early intervention via surgical exposure and indirect pulp capping and restoration for managing severe cases of PEIR. However, further research with larger samples and long follow-up is necessary.
摘要:
背景:爆发前冠状声像差(PEIR)是一种罕见的牙齿异常,通常在常规影像学检查中偶然发现。这种情况表现为未萌出牙齿的釉质-牙本质交界处下方的射线可透病变,特别是在下磨牙中,由于其无症状性质,对诊断和管理提出了挑战。PEIR的治疗取决于病变的程度和牙髓受累的程度。
方法:本病例系列报告了4例进行性爆发前冠状声像差的患者。在病例1和2中,在正畸计划期间在OPG中偶然发现了病变(下永久性第二磨牙),由于牙齿仅部分萌出,因此需要额外的手术暴露才能进入病变。有趣的是,在情况3中,尽管牙齿的牙冠已经矿化(第二下恒磨牙),但在早期的X射线中PEIR并不可见。对于病例4,牙齿表现出可逆性牙髓炎的症状(下恒第一磨牙)。所有病变均使用生物相容性材料进行间接髓盖处理。对患者进行长达8年的随访,以评估治疗成功。在最后一次随访中,发现在所有四个案例中,间接牙髓覆盖和修复都是成功的:1年(案例2),1.4年(案例1),1.5年(案例4),8年(案例3)。
结论:本系列病例证明了通过手术暴露和间接盖髓和修复的早期干预对处理严重PEIR病例的有效性。然而,需要更大样本的进一步研究和长期随访。