case_images: PMC5723957_01
case_images: Cropped panoramic radiographs demonstrating a PEIR-affected tooth (permanent mandibular left second molar) when the patient was (a) 8 years, 8 months old, (b) 10 years, 11 months old, (c) 12 years, 5 months old, (d) 13 years, 4 months old, (e) 15 years, 3 months old, and (f) 17 years, 4 months old. There was no obvious progression of PEIR size or changes in the PEIR location noted from this film series.
case_images: CRID2017-6261407.001.jpg
case_images: PMC5723957_05_CRID2017-6261407.001.jpg
case_images: fig1
case_images: Because of the patient's age and low caries-risk status, he has been recalled every 6 to 12 months, and has had radiographic examination of the lesion every 12 months (Figures 1, 2, and 5). There were no changes clinically or radiographically in the PEIR-affected tooth (Figures 1, 2, and 5).
case_images: PMC5723957_02
case_images: Cropped panoramic radiographs demonstrating a PEIR-affected tooth (permanent mandibular left second molar) when the patient was (a) 8 years, 8 months old, (b) 10 years, 11 months old, (c) 12 years, 5 months old, (d) 13 years, 4 months old, (e) 15 years, 3 months old, and (f) 17 years, 4 months old. There was no obvious progression of PEIR size or changes in the PEIR location noted from this film series.
case_images: CRID2017-6261407.001.jpg
case_images: PMC5723957_05_CRID2017-6261407.001.jpg
case_images: fig1
case_images: Because of the patient's age and low caries-risk status, he has been recalled every 6 to 12 months, and has had radiographic examination of the lesion every 12 months (Figures 1, 2, and 5). There were no changes clinically or radiographically in the PEIR-affected tooth (Figures 1, 2, and 5).
case_images: Periapical radiographs of the PEIR-affected tooth (permanent mandibular left second molar) when the patient was (a) 10 years, 11 months old, (b) 11 years, 5 months old, (c) 15 years, 3 months old, and (d) 17 years, 4 months old. The tooth is in the normal path of eruption, has normal crown formation, and has had continuing root formation since the first radiograph.
case_images: CRID2017-6261407.002.jpg
case_images: PMC5723957_05_CRID2017-6261407.002.jpg
case_images: fig2
case_images: Because of the patient's age and low caries-risk status, he has been recalled every 6 to 12 months, and has had radiographic examination of the lesion every 12 months (Figures 1, 2, and 5). There were no changes clinically or radiographically in the PEIR-affected tooth (Figures 1, 2, and 5).
case_images: PMC5723957_03
case_images: Periapical radiographs of the PEIR-affected tooth (permanent mandibular left second molar) when the patient was (a) 10 years, 11 months old, (b) 11 years, 5 months old, (c) 15 years, 3 months old, and (d) 17 years, 4 months old. The tooth is in the normal path of eruption, has normal crown formation, and has had continuing root formation since the first radiograph.
case_images: CRID2017-6261407.002.jpg
case_images: PMC5723957_05_CRID2017-6261407.002.jpg
case_images: fig2
case_images: Because of the patient's age and low caries-risk status, he has been recalled every 6 to 12 months, and has had radiographic examination of the lesion every 12 months (Figures 1, 2, and 5). There were no changes clinically or radiographically in the PEIR-affected tooth (Figures 1, 2, and 5).
case_images: Sagittal slices of the PEIR-affected tooth (permanent mandibular left second molar) reconstructed from the first CBCT when the patient was 11 years, 5 months old. PEIR presented as an obvious radiolucency within the dentin with no direct exposure of the lesion or dentin to the oral cavity. The distance from the midfloor of the lesion to the roof of the pulpal area was 1.58 mm. The PEIR dimension is 3.75 mm occluso-gingival depth, 5.52 mm bucco-lingual width, and 3.05 mm mesio-distal length.
case_images: CRID2017-6261407.003.jpg
case_images: PMC5723957_03_CRID2017-6261407.003.jpg
case_images: fig3
case_images: Consequently, cone beam computed tomography (CBCT) (Planmeca Promax 3D, Planmeca) was further used to reaffirm the characteristics of the lesion (Figure 3).
case_images: Occlusal appearance of the PEIR-affected tooth (permanent mandibular left second molar) (a) after sealant placement when the patient was 12 years, 5 months old and (b) at a follow-up visit when the patient was 14 years, 9 months old.
case_images: CRID2017-6261407.004.jpg
case_images: PMC5723957_04_CRID2017-6261407.004.jpg
case_images: fig4
case_images: The affected tooth was reevaluated clinically and radiographically twice yearly until the patient was 14 years, nine months old (Figures 1, 1, 4, and 5).
case_images: PMC5723957_04
case_images: Cropped panoramic radiographs demonstrating a PEIR-affected tooth (permanent mandibular left second molar) when the patient was (a) 8 years, 8 months old, (b) 10 years, 11 months old, (c) 12 years, 5 months old, (d) 13 years, 4 months old, (e) 15 years, 3 months old, and (f) 17 years, 4 months old. There was no obvious progression of PEIR size or changes in the PEIR location noted from this film series.
case_images: CRID2017-6261407.001.jpg
case_images: PMC5723957_05_CRID2017-6261407.001.jpg
case_images: fig1
case_images: Because of the patient's age and low caries-risk status, he has been recalled every 6 to 12 months, and has had radiographic examination of the lesion every 12 months (Figures 1, 2, and 5). There were no changes clinically or radiographically in the PEIR-affected tooth (Figures 1, 2, and 5).
case_images: Occlusal appearance of the PEIR-affected tooth (permanent mandibular left second molar) (a) after sealant placement when the patient was 12 years, 5 months old and (b) at a follow-up visit when the patient was 14 years, 9 months old.
case_images: CRID2017-6261407.004.jpg
case_images: PMC5723957_04_CRID2017-6261407.004.jpg
case_images: fig4
case_images: The affected tooth was reevaluated clinically and radiographically twice yearly until the patient was 14 years, nine months old (Figures 1, 1, 4, and 5).
case_images: Bitewing radiographs of the PEIR-affected tooth (permanent mandibular left second molar) when the patient was (a) 13 years, 4 months old, (b) 15 years, 3 months old, and (c) 17 years, 4 months old. The PEIR has no connection to the enamel or the pulp of the affected tooth.
case_images: CRID2017-6261407.005.jpg
case_images: PMC5723957_05_CRID2017-6261407.005.jpg
case_images: fig5
case_images: Because of the patient's age and low caries-risk status, he has been recalled every 6 to 12 months, and has had radiographic examination of the lesion every 12 months (Figures 1, 2, and 5). There were no changes clinically or radiographically in the PEIR-affected tooth (Figures 1, 2, and 5).
case_images: Sagittal slices of the PEIR-affected tooth (permanent mandibular left second molar) reconstructed from the second CBCT when the patient was 14 years, 9 months old. The PEIR location was reconfirmed to be just under the dentino-enamel junction and not connected to the pulp chamber or oral environment. The distance between the midfloor of the lesion and the pulpal area is 2.00 mm. The PEIR dimension is 2.30 mm occluso-gingival depth, 4.00 mm bucco-lingual width, and 3.40 mm mesio-distal length.
case_images: CRID2017-6261407.006.jpg
case_images: PMC5723957_04_CRID2017-6261407.006.jpg
case_images: fig6
case_images: To confirm the size, location, and invasion of the lesion to surrounding structures, CBCT (NewTom VGi, NewTom, Verona, Italy) (Figure 6) was repeated three years later.
case_images: PMC5723957_05
case_images: Cropped panoramic radiographs demonstrating a PEIR-affected tooth (permanent mandibular left second molar) when the patient was (a) 8 years, 8 months old, (b) 10 years, 11 months old, (c) 12 years, 5 months old, (d) 13 years, 4 months old, (e) 15 years, 3 months old, and (f) 17 years, 4 months old. There was no obvious progression of PEIR size or changes in the PEIR location noted from this film series.
case_images: CRID2017-6261407.001.jpg
case_images: PMC5723957_05_CRID2017-6261407.001.jpg
case_images: fig1
case_images: Because of the patient's age and low caries-risk status, he has been recalled every 6 to 12 months, and has had radiographic examination of the lesion every 12 months (Figures 1, 2, and 5). There were no changes clinically or radiographically in the PEIR-affected tooth (Figures 1, 2, and 5).
case_images: Periapical radiographs of the PEIR-affected tooth (permanent mandibular left second molar) when the patient was (a) 10 years, 11 months old, (b) 11 years, 5 months old, (c) 15 years, 3 months old, and (d) 17 years, 4 months old. The tooth is in the normal path of eruption, has normal crown formation, and has had continuing root formation since the first radiograph.
case_images: CRID2017-6261407.002.jpg
case_images: PMC5723957_05_CRID2017-6261407.002.jpg
case_images: fig2
case_images: Because of the patient's age and low caries-risk status, he has been recalled every 6 to 12 months, and has had radiographic examination of the lesion every 12 months (Figures 1, 2, and 5). There were no changes clinically or radiographically in the PEIR-affected tooth (Figures 1, 2, and 5).
case_images: Bitewing radiographs of the PEIR-affected tooth (permanent mandibular left second molar) when the patient was (a) 13 years, 4 months old, (b) 15 years, 3 months old, and (c) 17 years, 4 months old. The PEIR has no connection to the enamel or the pulp of the affected tooth.
case_images: CRID2017-6261407.005.jpg
case_images: PMC5723957_05_CRID2017-6261407.005.jpg
case_images: fig5
case_images: Because of the patient's age and low caries-risk status, he has been recalled every 6 to 12 months, and has had radiographic examination of the lesion every 12 months (Figures 1, 2, and 5). There were no changes clinically or radiographically in the PEIR-affected tooth (Figures 1, 2, and 5).