A 3000 year old case of an unusual dental lesion: Pre-eruptive intracoronal resorption

Objective: To determine the cause of a large dental lesion, tentatively identified as a case of pre-eruptive intra-coronal resorption (PEIR), in the permanent second mandibular molar of a young individual from an Iron Age cemetery at Tel Erani (Israel), dated to ca. 3000 years B.P. The provisional diagnosis was based on the massive size of the lesion in a young individual in whom the adjacent teeth were caries-free and showed no visible enamel defects. Design: The lower molars of Tel Erani on the affected side were radiographed and compared to radiographs of a modern clinical case of PEIR treated by one of us (U.Z) and the internal structure and mineral content of the lesion examined in detail using energy-dispersive X-ray spectroscopy (EDS). Results: The Tel Erani specimen closely resembled the modern clinical case of PEIR. Moreover, both cases occurred in young individuals in whom the adjacent teeth were caries-free. Examination with SEM revealed absence of dentine in the affected tooth from Tel Erani, together with changes in structure and mineral content characteristic of resorption. Conclusions: Our study shows that the changes found in the lower second molar of the 3000 year old mandible from Tel Erani are characteristic of PEIR and demonstrate the antiquity of this condition.