Palatogingival groove: A pathway to periodontal destruction

Abstract

Palatogingival or radicular groove is another developmental aberration known to maximally affect the palatal surfaces of maxillary lateral incisors but is often missed during a routine. It is a malformation which presents as a groove or channel that begins in the central fossa, crosses the cingulum of the tooth and extends apically to or beyond the cementoenamel junction at varying distances and directions along the root surface. It serves as a perfect bacterial harbor predisposing to pocket formation, concomitant bone loss and pulpal involvement, thereby encouraging the development of endodontic-periodontal lesions. Depending on severity, the groove may render a direct communication between the periodontium and pulp cavity promoting effortless bacterial invasion. It creates an area where plaque accumulation can be difficult, if not impossible to control using oral hygiene measures. The diagnosis of these grooves is quite difficult, as they cannot be differentiated in the X-ray images. The treatment procedures employed for treating palatogingival grooves will include pulpectomy if the tooth is nonvital along with odontoplasty of the groove or restoration of the groove with glass ionomer cement after the elevation of mucoperiosteal flap. Bone defects around the involved teeth also have to be treated with grafts and membrane. This case report describes the diagnosis and treatment of a palatogingival groove on maxillary lateral incisor.