388 - Clinical Management of Pre-eruptive Intracoronal Resorption: A Case Report

Introduction: A pre-eruptive intracoronal resorption (PEIR) is an abnormal radiolucent lesion within non-erupted teeth, first described by Skillen in 1941. Typically located directly below the dentin-enamel junction on the central or mesial portion, the crown appears to be intact, and it rarely affects the pulp. Histologically, PEIR exhibits soft tissue with similar spindle-shaped cells, resorption cells, and fibrous connective tissue cells. The pathogenesis involves resorptive cells, such as osteoclasts, multinucleated giant cells, and chronic inflammatory cells, which attack the dentin through the micro-perforation, originating from the surrounding bone or undifferentiated in the dental follicle. No correlation with race, gender, medical conditions, or use of fluoride supplementation has been established. However, Seow suggests a link between PEIR and ectopic tooth positions due to abnormal local pressure. The management depends on the extension of the lesion.

The case report details the evaluation of a 7-year-old female with a medical history of Asthma, taking Flovent and allergic to red dyes. The patient sought assessment for lost teeth and dental caries. Clinical and radiographic examinations revealed multiple caries, missing teeth (K and T) due to caries, and congenitally missing teeth (4, 13, 20, and 29). Notably, pre-eruptive intracoronal resorption was identified on teeth 19 and 32. Upon clinical and radiographic evaluation tooth 19 was partially erupted with a combined enamel and dentin defect, and no coronal cavitation was detected. Tooth 32 has not erupted yet with a combined enamel and dentin defect. The patient reported no history of pain upon evaluation.