We treated a case of eruption sequestrum in an 8-year 1-month old boy. The patient first came to our clinic with a chief complaint of discomfort in the mandibular. The literature relating to so-called eruption sequestra is reviewed. Two cases in which there were calcified fragments adjacent to the crowns of all four first. Eruption Sequestrum is an unusual disturbance, which consists of fragments of calcified mass overlying the crown of erupting permanent mandibular molar teeth .
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In the same case, histopathological examination showed non-vital bone, as reported elsewhere 1,2,5. This major occurrence in mandibular first molars can be due to these teeth with an ectopic path of eruption, with the mesial cusps at some stage lying mesial to the distal root of the second primary molar 3.
J Clin Pediatr Dent ; Articles lacking sources from December All articles lacking sources.
Although ES has been reported as a sequestfum consisting of compact, non-viable bone 1,2,5Watkins 3 described a sequetsrum composed of dentin and covered in areas by fragments of bacteria-infected cementum. Although previously thought to have little clinical significance 1ES may retain biofilm accumulation and lead to pericoronitis, localized swelling, discomfort during mastication, and demineralization or dental caries if it remains for a prolonged time 2.
At the 1-week postoperative appointment, the patient was evaluated clinically, although no significant signs and symptoms were revealed.
Eruption sequestrum – case report and histopathological findings
A biopsy of the area was excised under local anesthesia. This paper reports a case of unilateral eruption sequestrum in a 7-year-old Brazilian boy and describes its histopathological findings. J Dent Child ; Signs of necrosis were found on the periphery. As its early recognition is important for preventing a future inadequate surgical intervention, the fragment was removed surgically in this patient, as in other cases 2.
Na periferia, sinais de necrose foram evidenciados. Clinical and radiographic follow-up visits scheduled at short intervals and then every 6 months revealed normal postoperative conditions.
Views Read Edit View history. How to cite this article. Eruption sequestra in children. Eruption sequestrum is an uncommon disturbance in eruption and consists of small fragments of calcified tissue overlying the crowns of erupting permanent molar teeth, especially at the time of eruption of the mandibular first molars.
Apoptosis of the reduced enamel epithelium and its implications for bone resorption during tooth eruption. ES is usually observed at the time of eruption of the mandibular first molars, but it has been noted occurring with maxillary first molars and mandibular second molars 1,2. Osteolysis Hajdu-Cheney syndrome Ainhum. Within the bone itself, the haversian canals eruptiom blocked with sequesttum tissue, and the bone becomes surrounded by thickened periosteum.
There was neither history of pain nor evidence of dental caries or abnormality in other soft tissues. Eruption sequestrum ES is an uncommon condition first reported as an osseous fragment overlying the crown of an erupting permanent molar prior to or immediately after the emergence of the cuspal tips through the oral mucosa 1.
Unsourced material may be challenged and removed. Br Dent J ; However, no signs of viable bone were evident throughout the specimen. Eruption sequestrae – three case reviews. Thus further investigations should be performed to elucidate its microscopic aspects.
Informed written consent was obtained from the patient’s mother and this report was approved by the institutional Ethics Committee Protocol This article does not cite any sources. ES is a mass coronally of the erupting tooth with broader borders 3. This can occur due to reduction of osteoclast activity and of bone resorption mediated by dental follicle during tooth eruption caused by apoptosis of reduced enamel epithelium 4.
In an unusual case of ES, the specimen consisted of a small irregular calcified mass, composed of dentin and covered in areas by fragments of bacteria-infected cementum 3. The pathological process is as follows:. Services on Demand Journal. December Learn how and when to remove this template message.
The position of this spicule overlies directly the central occlusal fossa, but within the soft tissue 3. The biopsy tissue was composed of a 0. At the same time as this, new bone is forming known as involucrum. The aim of this paper is to eruptiion a case of unilateral ES in a 7-year-old Brazilian boy and to describe its histopathological findings.
Microscopic examination revealed large trabeculae with erupttion lacunae and a minimal amount of existing spongy bone consisting of acute inflammatory cells neutrophils. Thus, a small osseous fragment can occasionally separate from the contiguous bone and emerge through the alveolar bone.
ES is an uncommon clinical finding. Due to the avascular nature of this bone, antibiotics which travel to sites of infection via the bloodstream poorly penetrate these tissues, hence the difficulty in treating chronic osteomyelitis. If seen radiographically before tooth eruption, its intraoral appearance may be predicted 1.