Palato-Radicular Groove and Localized Periodontitis: A Series of Case Reports

Abstract

The aim of this report is to present the management of three cases of different magnitude affecting the periodontal attachment apparatus due to the presence of a palato-radicular groove (PRG). The palato-radicular groove is a developmental anomaly often associated with localized periodontitis and pulpal necrosis. The authors present three cases involving the management of teeth with a palato-radicular groove. In the first case, a 20-year-old woman presented with a 5mm periodontal pocket associated with the maxillary right central incisor but no evidence of pulpal involvement. In the second case, there was extensive bone loss and pulpal necrosis of the maxillary right lateral incisor in a 35-year-old man. The third case involved severe localized periodontitis of the right and left maxillary lateral incisors of a 47-year-old man. This report describes the diagnosis and periodontal management of these three clinical situations. Periodontal complications due to a palatal-radicular groove are relatively rare. However, when they do occur, the diagnosis of a pulpal or localized periodontal lesion can sometimes present a dilemma for the general dentist, particularly if a palato-radicular groove is the etiologic factor. This is because a radicular groove can act like a "funnel," aiding microbial plaque accumulation, and lead to gingivitis, localized periodontitis, and even pulpal necrosis. But with a timely diagnosis and proper clinical management, the tooth or teeth involved can be treated and often retained. Thorough examination of the morphological anomalies associated with the lateral and central incisors, in particular, aided by appropriate diagnostic aids, can lead to accurate diagnosis and management of a tooth or teeth with a palato-radicular groove.