Abstract
A palatal radicular groove (PRG) is a morphological deformity, occurring during tooth development. It is usually located on the palatal aspect of maxillary incisors and frequently associated with periodontal or endodontic-periodontal lesions. Some treatment options were described for such lesions, including primary endodontic treatment and periodontal surgery and extraction with intentional replantation after removal of a PRG and endodontic treatment. The present paper reported two cases of PRG-associated deep intrabony defects, successfully treated with periodontal surgery with enamel matrix derivative (EMD) application and mechanical removal of PRGs, avoiding endodontic treatment or retreatment. The complexity of the diagnostic process was also discussed.
Highlights
The present paper reported two cases of Palatal radicular groove (PRG)-associated deep intrabony defects, successfully treated with periodontal surgery with enamel matrix derivative (EMD) application and mechanical removal of PRGs, avoiding endodontic treatment or retreatment
[4] The treatment options for endodontic-periodontal lesions related to presence of PRG include primary endodontic treatment [4] usually associated to periodontal surgery that was limited in the site of the defect. [9,15,5] Other authors described the extraction of the affected tooth when a complete loss of periodontal support occurred, [4] or extraction and intentional replantation after removal of PRG and extraoral endodontic treatment
The first issue to be discussed is about the diagnostic procedure that led to the diagnosis of PRG-related intrabony defect
Summary
Palatal radicular grooves (PRGs) were first described by Lee and coworkers in 1968, [1] who discussed its clinical characteristics and potential etiology. [1] PRG is usually described as a kind of morphological deformity, occurring during tooth development as a failed attempt to form a new root, [2] usually located on the palatal aspect of permanent maxillary lateral incisors. [3,4] From the anatomical point of view PGR are heterogeneous, generally extending from the central fossa of the incisor, over the cingulum and down apically, on the root surface. [5,4] In some cases, the presence of one PRG was considered as an important adverse prognostic factor, because of the frequently associated wide endodontic-periodontal lesions. [6] Even though a recent classification scheme for tooth, root and canal anomalies was recently proposed, [7] the most common classification for PGR was proposed by Gu and coworkers, [8] who described three different types on the basis of its anatomical extension. [1] PRG is usually described as a kind of morphological deformity, occurring during tooth development as a failed attempt to form a new root, [2] usually located on the palatal aspect of permanent maxillary lateral incisors. [5,4] In some cases, the presence of one PRG was considered as an important adverse prognostic factor, because of the frequently associated wide endodontic-periodontal lesions. [4] The treatment options for endodontic-periodontal lesions related to presence of PRG include primary endodontic treatment [4] usually associated to periodontal surgery that was limited in the site of the defect. The aim of this paper was to present two case reports of PRG-associated deep intrabony defects treated with periodontal surgery and enamel matrix derivative (EMD) application, avoiding endodontic treatment or retreatment. CASE PRESENTATION Both subjects were treated following the principles of the Helsinki Declaration. [17] The operator (SC) informed the patients about the treatment alternatives and about the planned intervention, and both patients signed a written informed consent form before performing the treatment procedures
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