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CASE REPORT
International Journal of Paediatric Dentistry 2017 Conclusion. Dentists who treat children must take
into consideration the possibility of pre-eruptive
Case Report. This report describes a rare case of a lesions in the primary dentition that may cause
19-month-old girl with pre-eruptive intracoronal involvement of the pulp, either before or shortly
resorption in the lower left first primary molar post-eruption.
which had erupted a few weeks earlier and had
deep caries. The treatment is described.
2017 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd 1
2 Y. Schwimmer, R. Zeltser & M. Moskovitz
Discussion
To the best of our knowledge, this is the first
report of a case of pre-eruptive intracoronal
resorption in a first primary molar and only
the second case describing such a lesion in
primary teeth.
It is likely that the bacteria from the oral
cavity penetrating a microscopic defect in the
newly erupted teeth were the cause for the
pulp necrosis due to post-eruptive coloniza-
Fig. 2. Pre-treatment radiograph. (a) bitewing, (b) periapical
radiograph.
tion, and not the cause of the lesion1.
In the present case, the fact that the tooth
Due to her young age, the importance of erupted a few weeks before the abscess
preserving the tooth and the identified aetiol- appearance with intact coronal enamel and a
ogy endodontic therapy was performed under large lesion in the dentin led us to assume
conscious sedation and local anaesthetics. The that we were dealing with a pre-eruptive
canals were obturated using Metapex (Meta intracoronal resorption. Once in the oral cav-
Biomed co. Ltd., Yeonje-ri, Cheong-won-gun, ity, the lesion became infected and it was
Chungcheongbuk-do, Korea). only a matter of time until signs and symp-
One week post-treatment, a check-up revealed toms of the dental abscess appeared.
uneventful healing, the swelling had decreased As in Seow and Hackleys report, the differ-
significantly and the treatment was considered ential diagnosis of an abscess of unknown
successful. A routine check-up seven months aetiology should always include internal non-
post-operative showed normal tissue around the carious defects1. It is most likely that in this
left lower first primary molar (Fig. 3). case, the aetiology of the defect was dentin
2017 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Pre-eruptive resorption in a primary molar 3
References
Why this case report is important to paediatric 1 Seow WK, Hackley D. Pre-eruptive resorption of dentin
dentists in the primary and permanent dentitions: case reports
This is the only known documented case of occult car- and literature review. Pediatr Dent 1996; 18: 6771.
ies in the first primary molar that has deteriorated into
2 Seow WK. Pre-eruptive intracoronal resorption as an
a dental abscess.
Dentists who treat children must take into account
entity of occult caries. Pediatr Dent 2000; 22: 370376.
the possibility of pre-eruptive lesions in primary denti- 3 Davidovich E, Kreiner B, Peretz B. Treatment of sev-
tion that may cause involvement of the pulp, either ere pre-eruptive intracoronal resorption of a perma-
before or shortly post-eruption. nent second molar. Pediatr Dent 2005; 27: 7477.
2017 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd