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Gurunathan D, Pandiar D, Krishnan RP. Global prevalence of pre eruptive intracoronal resorption (PEIR) of teeth: a systematic review of literature. Eur Arch Paediatr Dent 2025; 26:225-232. [PMID: 39775794 DOI: 10.1007/s40368-024-00987-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Accepted: 12/04/2024] [Indexed: 01/11/2025]
Abstract
AIM Pre-eruptive intracoronal resorption (PIER) defects constitute an important part of anomalies associated with unerupted teeth. However, these defects are usually overlooked by clinicians whilst interpreting radiographs. This systematic review was thus orchestrated to find the global prevalence of PEIR. METHODOLOGY A comprehensive database search was done until December 2022 for published articles on the prevalence of pre-eruptive intracoronal resorption following preferred reporting items for systematic reviews and meta-analyses guidelines. The review was registered in Prospero (CRD42024501668). The risk of bias was analysed for each study using the Newcastle-Ottawa Quality Assessment Scale for cross-sectional studies. RESULTS In total 18 studies were included in the present systematic review. The subject prevalence was 3.54% (range 0.56-27.31%) and tooth prevalence of 0.695% (Range 0.073-2.12%). Males and females were equally affected with no difference based on geography and race. Mandibular teeth showed more incidence of PEIR than maxillary teeth. First premolars were most frequently affected in the mandibular arch, whilst canines were affected most in the maxillary arch. CONCLUSION Within the limits of the review, we presented for the first time the global prevalence of PEIR. The condition may be overlooked and could lead to potential complications, thus it is essential to promptly diagnose these defects, thus preventing any further complications. We further suggest that all extirpated soft tissue should be submitted for further evaluation to shed light on the pathogenetic mechanisms involved in the initiation and progression of the disease.
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Affiliation(s)
- Deepa Gurunathan
- Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Deepak Pandiar
- Department of Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India.
| | - Reshma Poothakulath Krishnan
- Department of Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
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Hristov K, Zlateva V. Idiopathic Intracoronal Resorption of Permanent Molars: A Report of Two Cases. Case Rep Dent 2025; 2025:9610040. [PMID: 40027256 PMCID: PMC11871979 DOI: 10.1155/crid/9610040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2024] [Accepted: 02/07/2025] [Indexed: 03/05/2025] Open
Abstract
Intracoronal resorption (IR) is a condition characterized by the presence of lesions in the dentin of unerupted or erupting teeth, usually located just below the enamel-dentin junction in the occlusal part of the crown. This article presents two cases of IR-one with and one without pulp involvement. In both cases, the teeth were asymptomatic, and the lesions were discovered during routine checkups. The first case presents pre-eruptive IR with pulp involvement in an immature mandibular molar. To preserve the vitality of the growth zone and complete root development, vital pulp therapy was performed through total coronal pulpotomy and application of Biodentine. The second case is also of a mandibular molar with incomplete root development, but although it initially resembled invasive cervical resorption, treatment revealed that the granulation tissue was surrounded by intact enamel and did not affect the pulp or root of the tooth. No carious lesion was found. The tooth was conventionally restored with a composite filling.
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Affiliation(s)
- Krasimir Hristov
- Department of Pediatric Dentistry, Faculty of Dental Medicine, Medical University of Sofia, Sofia, Bulgaria
| | - Victoria Zlateva
- Department of Pediatric Dentistry, Faculty of Dental Medicine, Medical University of Sofia, Sofia, Bulgaria
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Almashaikhi J, Elkhodary HM, Bhadila GY, Felemban OM, Al Tuwirqi AA. Diagnostic accuracy and radiographic interpretation of pre-eruptive intra-coronal resorption among dental practitioners using eye-tracking technology. Digit Health 2025; 11:20552076251315620. [PMID: 39949845 PMCID: PMC11822827 DOI: 10.1177/20552076251315620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2024] [Accepted: 01/09/2025] [Indexed: 02/16/2025] Open
Abstract
Background Pre-eruptive intra-coronal resorption (PEIR) is a condition in which unerupted teeth exhibit coronal radiolucency consistent with resorptive loss of coronal tooth structure. These lesions are discovered incidentally on routine radiographs. Aim To measure the radiographic interpretation and diagnostic accuracy of PEIR among dental practitioners at King Abdulaziz University Dental Hospital using eye-tracking technology. Methods In this cross-sectional study, 125 interns, general dentists, and postgraduate residents examined five panoramic radiographs, including a case of impaction, and the rest were radiographs with PEIR of different severities. In this study, PEIR recognition was assessed using a validated questionnaire uploaded to an eye-tracking device (Sensomotoric Instruments SMI). Results The findings revealed an association between the severity of the PEIR lesion and the detection of the affected teeth. As the severity increased, the participants were more able to identify the affected teeth, and the percentage of overlooking decreased. The dentist's level of education and years of clinical experience influenced the diagnostic accuracy and radiographic interpretation of the PEIR lesions. Conclusions The diagnostic accuracy and radiographic interpretation of PEIR lesions were affected by participants' level of education and years of clinical experience. Based on this study, PEIR lesions may remain undetected until they reach advanced stages.
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Affiliation(s)
- Jamila Almashaikhi
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Heba M. Elkhodary
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Pedodontics and Oral Health, Faculty of Dental Medicine for Girls, Al Azhar University, Cairo, Egypt
| | - Ghalia Y. Bhadila
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Osama M. Felemban
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Amani A. Al Tuwirqi
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Pérez Lip IE, García Rupaya CR, Ruiz García de Chacón VE. [Frequency of pre-eruptive intracoronal resorption in panoramic radiographs of peruvians: a cross-sectional study]. REVISTA CIENTÍFICA ODONTOLÓGICA 2024; 12:e207. [PMID: 39444726 PMCID: PMC11495175 DOI: 10.21142/2523-2754-1203-2024-207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 06/19/2024] [Indexed: 10/25/2024] Open
Abstract
Objective To determine the frequency of Preeruptive Intracoronal Resorption (PIR) in a sample of digital panoramic radiographs of Peruvian patients between 3 to 21 years of age who attended an oral and maxillofacial radiology center between 2013 and 2021. Material and Methods This observational study was descriptive, retrospective and cross-sectional. A sample of 1897 digital panoramic radiographs was evaluated to determine the frequency of PIR and its covariates of location, depth, and inclination of the affected teeth. The authors' calibration was performed before the study. The intraoperator agreement was determined by calculating the Kappa coefficient (0.72, CI 0.67-0.76). The radiographs were evaluated by the study's principal author (IEP), and the data were collected in a form designed for the study. The statistical association was determined using the Chi-square test, with a confidence level of 95%, and a p-value of less than 0.05 was considered significant. Results The frequency of PIR was 3.95%, with no statistically significant difference between sexes (p>0.05). The most common findings were PIR in the lower right second molar (32.5%), a singular defect (89.3%), central location (44.5%), and superficial dentinal involvement (83.1%). These results aligned with existing literature. Conclusions Our results describe the epidemiological profile of PIR in the present sample as a single radiolucent and small (grade I) defect located centrally in the coronal dentin, often affecting posterior lower teeth with a frequency lesser than 5%. These findings provided valuable insights for clinicians and researchers regarding the frequency and characteristics of PIR in Peruvian patients.
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Affiliation(s)
- Iván Eduardo Pérez Lip
- Universidad Peruana Cayetano Heredia. Lima, Perú. , , Universidad Peruana Cayetano Heredia Universidad Peruana Cayetano Heredia Lima Peru
| | - Carmen Rosa García Rupaya
- Universidad Peruana Cayetano Heredia. Lima, Perú. , , Universidad Peruana Cayetano Heredia Universidad Peruana Cayetano Heredia Lima Peru
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Shimabukuro K, Konishi M, Wongratwanich P, Nagasaki T, Ohtsuka M, Suei Y, Nakamoto T, Kakimoto N. Cone-beam computed tomography-based investigation of pre-eruptive intracoronal resorption prevalence. Odontology 2024; 112:256-263. [PMID: 37248355 DOI: 10.1007/s10266-023-00824-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/19/2023] [Indexed: 05/31/2023]
Abstract
This retrospective study aimed to investigate the prevalence of pre-eruptive intracoronal resorption (PEIR) using cone-beam computed tomography (CBCT) and to explore the mechanism and characteristics of PEIR development. CBCT images of patients aged ≤ 20 years with unerupted teeth at Hiroshima University Hospital were collected. We examined 1530 patients with 10,576 unerupted teeth. Teeth with PEIR were identified for the detailed location and size of the PEIR in the crown using multiplanar reconstruction. The subject and tooth prevalence rates of PEIR were 1.96% and 0.31%, respectively. The teeth that were the most commonly affected by PEIR were mandibular third molars (3.09%). The prevalence of PEIR was significantly higher in females than in males, and higher in the mandible than in the maxilla. No significant difference between in the position of PEIR within the crown was observed. Moreover, CBCT imaging revealed the onset of PEIR in one case. This study demonstrated the prevalence of PEIR and identified statistically significant sex- and location-based differences. Furthermore, one case of CBCT imaging supports the hypothesis that the onset of PEIR was due to resorption after completion of the crown.
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Affiliation(s)
- Kiichi Shimabukuro
- Department of Oral and Maxillofacial Radiology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan.
| | - Masaru Konishi
- Department of Oral and Maxillofacial Radiology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan
| | - Pongsapak Wongratwanich
- Department of Oral Biomedical Sciences, Division of Oral Diagnosis, Khon Kaen University, Khon Kaen, Thailand
| | - Toshikazu Nagasaki
- Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masahiko Ohtsuka
- Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yoshikazu Suei
- Department of Oral and Maxillofacial Radiology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan
| | - Takashi Nakamoto
- Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Naoya Kakimoto
- Department of Oral and Maxillofacial Radiology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan
- Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Gurdán Z, Balázs D, Pásti D, Fathi M, Maróti P, Kardos K, Pacheco A, Szalma J. Pre-eruptive intracoronal resorption in orthodontic patients: A retrospective analysis of 3,143 patients. Heliyon 2023; 9:e18699. [PMID: 37560674 PMCID: PMC10407135 DOI: 10.1016/j.heliyon.2023.e18699] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 07/18/2023] [Accepted: 07/25/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVES The aim of this retrospective study was to analyze the occurrence and characteristics of pre-eruptive intracoronal resorptions in a clinical orthodontic patient population. MATERIALS AND METHODS Patients treated in an orthodontic department (University of Pécs, Pécs, Hungary) were included. Unerupted teeth on panoramic radiographs were analyzed for intracoronal radiolucent lesions. For each patient, the demographic data, jaw localization, number of unerupted teeth with pre-eruptive intracoronal resorption lesions, number of lesions per tooth, size and localization of pre-eruptive intracoronal resorption defects, affected tooth's surface, pulp involvement and ectopic position of the tooth with defects were recorded. RESULTS In the 3,143 patients investigated, 55 teeth in 49 patients showed pre-eruptive intracoronal resorption lesions (subject incidence: 1.56%). The incidence on unerupted teeth was 0.25%. Pre-eruptive intracoronal resorption was significantly more common in mandibles (43 mandibular vs. 12 maxillary lesions) with an odds ratio of 12.84 (95% Confidence Interval: 5.19-31.74) and no gender differences were found (p = 0.746). The occurrence of pre-eruptive intracoronal resorption was highest in the youngest (7-10 years) mixed dentition status group (p < 0.001). Most of the lesions (44 of 55, or 80.0%) were localized in the dentin, occupying two-third or less of the dentin thickness. Only 12.73% (7/55) of the lesions were not localized on the occlusal surface. Of the lesions, 89.1% (49/55) showed no obvious size increase over an average follow-up of 36.4 ± 8.1 months. CONCLUSIONS Pre-eruptive intracoronal resorption may occur mainly in the mixed dentition stage in orthodontic patients. Careful and attentive radiographic evaluations may facilitate early detection and follow-up of the lesions' possible dimensional changes, especially when resorption influences orthodontic extraction therapy.
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Affiliation(s)
- Zsuzsanna Gurdán
- Department of Orthodontics, Medical School, University of Pécs, 1. Tüzér st., Pécs, 7623, Hungary
| | - Dorottya Balázs
- Department of Orthodontics, Medical School, University of Pécs, 1. Tüzér st., Pécs, 7623, Hungary
| | - Dóra Pásti
- Department of Orthodontics, Medical School, University of Pécs, 1. Tüzér st., Pécs, 7623, Hungary
| | - Meetra Fathi
- Department of Orthodontics, Medical School, University of Pécs, 1. Tüzér st., Pécs, 7623, Hungary
| | - Péter Maróti
- 3D Printing and Visualisation Centre, University of Pécs, 2. Boszorkány st., Pécs, 7624, Hungary
| | - Kinga Kardos
- 3D Printing and Visualisation Centre, University of Pécs, 2. Boszorkány st., Pécs, 7624, Hungary
| | - Ana Pacheco
- Department of Oral and Maxillofacial Surgery, Medical School, University of Pécs, 1. Tüzér st., Pécs, 7623, Hungary
| | - József Szalma
- Department of Oral and Maxillofacial Surgery, Medical School, University of Pécs, 1. Tüzér st., Pécs, 7623, Hungary
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Asokan S, Geethapriya PR, Varshini R K, Cs SD. Pre-eruptive intracoronal radiolucencies in permanent dentition of children in Tamil Nadu-A cross-sectional study. Int J Paediatr Dent 2022; 32:428-435. [PMID: 34672046 DOI: 10.1111/ipd.12922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/02/2021] [Accepted: 09/07/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Pre-eruptive intracoronal radiolucency (PEIR) poses a challenge to paediatric dentists as it cannot be clinically detected. AIM To estimate the prevalence and coexisting factors of PEIR in permanent teeth of children and adolescents in western Tamil Nadu, India. DESIGN This cross-sectional study assessed 5012 digital panoramic radiographs of children and adolescents below 14 years of age obtained from private digital imaging centers, dental clinics, and dental colleges located in five districts of western Tamil Nadu. The prevalence and PEIR and its coexisting factors were assessed by two independent calibrated investigators. Data were analyzed using the chi-square test. RESULTS The subject prevalence and tooth prevalence of PEIR were estimated to be 3.2% and 0.4%, respectively. Maxillary canines and mandibular premolars were commonly involved. Majority of the lesions were limited to less than one-third of dentin thickness (74%) and distal aspect of the crown (45.1%). Ectopic positioning (9.3%) and dental caries in the preceding primary tooth (9.9%) were the most common coexisting factors. CONCLUSION Pre-Eruptive Intracoronal Radiolucency defects were commonly seen in maxillary canines, mandibular premolars, and distal aspect of the crown involving less than one-third dentin thickness. Ectopic positioning and caries in primary teeth were commonly seen along with the PEIR defects.
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Affiliation(s)
- Sharath Asokan
- Department of Pediatric and Preventive Dentistry, KSR Institute of Dental Science and Research, Tiruchengode, India
| | - P R Geethapriya
- Department of Pediatric and Preventive Dentistry, KSR Institute of Dental Science and Research, Tiruchengode, India
| | - Kirthi Varshini R
- Department of Pediatric and Preventive Dentistry, KSR Institute of Dental Science and Research, Tiruchengode, India
| | - Sri Darshini Cs
- Department of Pediatric and Preventive Dentistry, KSR Institute of Dental Science and Research, Tiruchengode, India
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Pre-eruptive intra-coronal resorption of dentine: a review of aetiology, diagnosis, and management. Eur Arch Paediatr Dent 2019; 21:1-11. [PMID: 31414395 DOI: 10.1007/s40368-019-00470-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 08/02/2019] [Indexed: 02/06/2023]
Abstract
AIM To discuss prevalence, characteristics, aetiology and pathophysiology, diagnosis and management of pre-eruptive intra-coronal radiolucency/resorption (PEIR) defects, and to highlight the clinical significance of PEIR. METHODS A literature research from Pubmed Medline database was adopted to identify the relevant published articles related to PEIR using keyword search strategy; other papers were obtained through searching the reference lists. Significant findings were summarised and presented in this review. RESULTS Subject prevalence was (0.2-27.3%) and tooth prevalence was (0.2-3.5%); depending on factors such as type of radiograph used for assessment, demographic factors, age range included, and dentition stage. Currently, the most acceptable etiologic theory for PEIR is intra-coronal resorption by invasion of resorptive cells into forming dentine via an interruption of crown formation; most likely to be caused by local factors such as ectopic position of affected tooth or adjacent tooth next to it. Diagnosis of PEIR lesions occurs, as they are noted incidentally on routine dental radiographs of unerupted teeth. A management protocol for PEIR defects has been suggested based on the literature. The clinical significance of these lesions is that they could constitute a large proportion of occult caries, and can be associated with developmental defects, ectopic positioning and supernumerary teeth, and a delay in dental development. CONCLUSIONS Early diagnosis of PEIR defects by careful viewing of radiographs of unerupted teeth is important as part of clinical examinations to allow early treatment.
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Zilberman U, Hassan J, Leiboviz-Haviv S. Molar incisor hypomineralization and pre-eruptive intracoronal lesions in dentistry-diagnosis and treatment planning. World J Stomatol 2019; 7:20-27. [DOI: 10.5321/wjs.v7.i2.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 01/14/2019] [Accepted: 01/28/2019] [Indexed: 02/06/2023] Open
Abstract
The aim of this study is to report the diagnostic features, prevalence, mineral content, clinical significance and treatment options of molar incisor hypomineralization (MIH) and pre-eruptive intracoronal lesions (PEIR), in order to minimize miss-treatment of primary and permanent teeth in young children. MIH was defined as the occurrence of hypomineralization of one up to four permanent first molars from a systemic origin and frequently associated with affected incisors. PEIR are lesions that are located in the occlusal portion of the crown of unerupted permanent or primary teeth. The prevalence of MIH was reported between 2.5%-40% in the permanent first molars and 0%-21.8% in primary second molars. PEIR was observed in 2%-8% of children, mainly in mandibular second premolars and second and third permanent molars. A number of possible causes for MIH were mentioned, including environmental changes, diet and genetics in prenatal and postnatal periods, but all are questionable. In PEIR, the resorption of the intracoronal dentine begins only after crown development is complete and is caused by giant cells resembling osteoclast observed histologically on the dentine surface close to the pulp. The mineral content in MIH is reduced in comparison to normal enamel and dependent on the severity of the lesion. In PEIR the resorbed surface of enamel showed less mineral content. The hypomineralized enamel in MIH is not suitable for restorations with amalgam or composite materials, and the best material should be based on remineralization material like glass-ionomers. Similar, the resorbed dentin surface in PEIR should be covered by the biocompatible and re-mineralizing glass-ionomer cement.
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Affiliation(s)
- Uri Zilberman
- Pediatric Dental Clinic, Barzilai Medical University Center, Ashkelon 7830604, Israel
| | - Jomanna Hassan
- Pediatric Dental Clinic, Barzilai Medical University Center, Ashkelon 7830604, Israel
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