Palato-radicular Groove Research Articles

Isolated periodontal pockets: a clinical review

An isolated periodontal pocket is a perplexing clinical entity that usually poses a diagnostic challenge to the oral health professional. Although periodontal pockets are easy to detect, they can be easily missed during a routine clinical examination. The broad range of aetiological factors that can result in an isolated periodontal pocket makes identifying the cause difficult. The aetiology can be as simple as an overhanging restoration or food impaction due to open interproximal contacts, to more complex and uncommonly occurring presentations, such a palato-radicular groove or cemental tears. Although previous classifications proposed by the American Academy of Periodontology and European Federation of Periodontology have discussed this topic under different headings, an explicit classification on isolated periodontal pockets based on aetiology is currently missing. Isolated periodontal pockets are easily undiagnosed, with associated cases presenting with substantial destruction necessitating complex multidisciplinary treatment. This article highlights the various causes of an isolated periodontal pocket, and provides a systematic and easy clinical aetiology-based classification. The proposed classification categorizes isolated periodontal pockets into those occurring due to: (1) developmental anomalies of the teeth; (2) iatrogenic causes; and (3) pathological conditions. Further studies are essential to validate this classification. CPD/Clinical Relevance: Early detection of easily missed isolated periodontal pockets is of clinical value during initial screening to avoid delayed diagnosis and treatment.

Palatoradicular groove and periodontal disease- A case report

Palatoradicular groove is an important anatomic factor that presents accessibility problems and worsens the prognosis of periodontal disease. Palato-radicular groove is a rare developmental anomaly with prevalence rate of 2.8-8.5%. Most commonly affected tooth is the maxillary lateral incisor (93.8%). Palatoradicular groove may present as a radiolucent para pulpal line, radiographically. Treatment of radicular groove presents a clinical challenge to the operator. Removal of local predisposing factor is of prime importance. This case report presents the management of the periodontal defect associated with palatoradicular groove incorporating periodontal flap surgery with bone graft and GTR.

The palato-radicular groove: In diagnosis, think easy first

Palato-radicular grooves (PRGs) are developmental anomalies of maxillary incisors that are a site for plaque accumulation and periodontal infection, contributing to localized periodontitis. Here a case of PRG that was initially thought to be root fracture or cemento-dentinal tear is presented, along with a discussion of the importance of a systematic approach to diagnosis.

Strategic management of periodontic and periodontic-endodontic lesion associated with palato-radicular groove – Report of three cases

Strategic management of periodontic and periodontic-endodontic lesion associated with palato-radicular groove – Report of three cases

Palato-Radicular Groove: A Rare Entity in Maxillary Central Incisor Leading To Endo-Perio Lesion

A 35-year-old female patient reported with chief complaint of discoloration and pus drainage from the upper right central incisor. On examination, brownish discoloration of teeth 11 was seen and a draining sinus tract was present on the labial alveolar mucosa [Table/Fig-1a]. A deep periodontal pocket of 13mm was found on the palatal aspect of 11 and a Palato Radicular Groove (PRG) extending into the gingival sulcus was identified [Table/Fig-1b,​,1c].1c]. Periapical radiographs revealed an extensive peri-radicular radiolucency involving the apical and middle one-third of the mesial aspect of root [Table/Fig-1d]. The tooth tested negative to pulp vitality. The facial sinus tract was traceable with a gutta-percha cone to the periapical radiolucency [Table/Fig-1e]. Based on clinical and radiographic findings, it was concluded that tooth 11 having a PRG predisposed to the development of localized periodontitis with secondary endodontic involvement.

Palatoradicular Groove Associated Defect Resolved with GIC, Alloplastic Graft and GTR Membrane

ABSTRACT The region of maxillary lateral incisor is an area of embryological importance with major and minor malformations like, gemination, fusion, cysts, dens in dente, peg-shaped laterals, talon cusps, supernumerary roots, and palatogingival groove (PGG). Palatogingival groove is a developmental groove usually found on the lingual aspect of maxillary incisors. It can be simple or complex on the basis of its connection to the pulp. These grooves act as a nidus for plaque accumulation which destroys the sulcular epithelium and later deeper parts of the periodontium. Since proper cleaning of this region is difficult by patient himself, it can lead to serious localized periodontal lesion or can communicate with endodontic lesion. Suggested treatment modalities are curettage of the affected tissues, elimination of the groove by grinding (saucerization), or by sealing with a variety of filling materials. If the groove extends beyond the middle-third of the root apex, surgical procedures are required, including use of barriers and intraosseous alloplastic graft to correct the defect. How to cite this article Devaraj CG, Yadav A, Sharma S, Meena M, Mishra P, Godara S, Kapoor R. PalatoRadicular Groove Associated Defect Resolved with GIC, Alloplastic Graft and GTR Membrane. J Mahatma Gandhi Univ Med Sci Tech 2016;1(2):75-78.

The role of clinical examination in the detection of permanent maxillary molars with two palatal roots.

The aim of the study was to determine whether the presence of two palatal roots (2PR) in permanent maxillary molars (PMMs) could be predicted by observing dental morphological traits during the clinical examination. A total of 18 second and 26 third PMMs with 2PR were examined from the collection of extracted teeth. The reference sample of 44 extracted PMMs with one palatal root was selected such that pairs of morphologically matching PMMs with one and 2PR were formed. The external morphology of these tooth pairs was examined under a stereomicroscope and distinguishing traits were registered. The Fisher's exact test was applied to examine differences between second and third PMMs. Additionally, the external morphology of 17 PMM with 2PR in 15 patients was analysed retrospectively. Extracted PMMs with 2PR possessed the following distinguishing morphological traits: crown wider on the palatal half (55.3%), double Carabelli cusps (23.7%), pronounced palatal indentation of the crown (20.5%), thick palatal enamel extension (16.3%), palato-radicular groove (11.6%) and palatal enamel pearl (2.3%). Differences between second and third PMMs were not statistically significant (p > 0.05). At least one distinguishing trait was present in 63.4% and 94.1% of extracted and clinically evaluated PMMs with 2PR, respectively. Omega-shaped deformation of the dental arch may be the first clinically observable clue to this root constellation. Clinical examination of tooth morphology and shape of the dental arch is essential for the detection PMMs with 2PR.

Palatogingival Groove - an Endodontic Enigma

Palatoradicular groove is a developmental anomaly which has been implicated as an initiating factor in localized gingivitis and periodontitis. These grooves when further complicated by pulp necrosis can present a diagnostic and treatment planning challenge to the operator. This case report presents a successful management of a case of a maxillary lateral incisor with an associated radicular lingual groove and severe periapical osseous destruction. A combination of endodontic treatment, radiculoplasty to eliminate the radicular lingual groove, and periapical surgery to eliminate the periapical osseous defect was used.

Elimination of palatoradicular groove: a combined endo-perio effort

Palatoradicular groove is an anomaly which is found more frequently in upper lateral and central incisors. This condition may lead to endo-perio lesions. A 19- year- old female presented with chief complaint of swelling and pus discharge from the gums of the right side of the upper front teeth and she also complained of loose tooth and intermittent pain. On clinical examination, probing pocket depth of 10 mm, grade II mobility and extrusion of the tooth was found. A combined endo-perio treatment was performed and elimination of the groove, pain and reduction in probing pocket depth and mobility was achieved. The purpose of this case is to highlight an interdisciplinary approach towards the management of an anomaly which may affect the endodontic status of the tooth and periodontal health of the patient. DOI: http://dx.doi.org/10.3329/bjms.v13i3.15216 Bangladesh Journal of Medical Science Vol.13(3) 2014 p.345-349

Combined treatment of a lateral incisor with palato-radicular groove: 1 year follow-up

AbstractPeriodontic - endodontic lesion with a palato-radicular groove as a contributing factor for periodontitis is the most important diagnostic and therapeutic challenges faced by periodontists and the maxillary lateral incisors are the most frequently affected teeth. These developmental grooves promotes the accumulation of plaque and calculus, which destroys the sulcular epithelium and later deeper parts of the periodontium, finally resulting in the formation of a severe localized periodontal lesion since proper cleaning of that site is difficult, if not impossible, for the patient. There are different types of treatment such as scaling and root planning, odontoplasty, amalgam restoration, and extraction of the tooth to treat palatogingival groove and associated periodontal bone defects. In this case, a successful management of an endodontic-periodontal combined lesion by combined treatment and guided tissue regeneration was presented.

Management of endodontic-periodontic lesion of a maxillary lateral incisor with palatoradicular groove

Presence of palatal radicular grooves are considered to be an important contributing factor to the development of localized periodontitis, as it favored the accumulation and proliferation of bacterial plaque deep into the periodontium. Pulp involvement could result due to the introduction of bacterial toxins through channels that existed between the root canal system and the groove. Early diagnosis, elimination of infl ammation and correction of anatomic complications are the key to a favorable outcome for managing palatoradicular groove. Present report describes successful management with an interdisciplinary approach of maxillary lateral incisor with combined endodontic periodontic lesion associated with palatoradicular groove.

Management of palato radicular groove in a maxillary lateral incisor

This study is to report the rare localization of a radicular groove on the palatal aspect of the maxillary lateral incisor and to discuss the pathology and management of the concomitant endo-periodontal defect. Unilateral palato-radicular groove was located on the Maxillary right lateral incisor of an 18-year-old female patient. The groove was associated with deep local periodontal pocket resulting in pulp necrosis and the formation of a large periapical lesion. A collaborative management was carried out using a combination of endodontic therapy, surgical enucleation, odontoplasty, and periodontal regenerative procedure resulting the successful healing of the periapical lesion.

Syndesmocorono-radicular tooth: An endo-perio challenge

Syndesmocorono-radicular tooth consist of palatoradicular groove that represents anomalous morphology and is the predisposing factor for developing localized chronic periodontitis and pulpal necrosis. This clinical report discusses diagnosis and endodontic-periodontal treatment of maxillary central incisor with palatoradicular groove that begins in the central fossa, crosses cingulum and extends a variable distance onto the root. Both endodontic and periodontal surgical therapy is required for treatment of pulpal pathosis, correction of osseous defect, pocket elimination and groove correction depending on the extent and depth of the radicular groove.Clinical Relevance to Interdisciplinary DentistryEndodontic failure may occur due to communication of palatal groove with pulp cavity. Such anomaly often predisposes to periodontal defects, severe bone destruction or combined endodontic-periodontal lesions. Interdisciplinary treatment modalities used in the present case reports emphasizes on the team approach management consisting of both endodontist and periodontist.

Effective Management of a Perio-endo Lesion associated with Palatoradicular Groove

ABSTRACT This case report highlights the effective management of a maxillary lateral incisor with perio-endo lesion precipitated and complicated by the presence of a deep palatoradicular groove extending up to the root apex. Despite an apparently poor prognosis, the tooth was successfully managed by a collaborative endodontic and surgical periodontal therapy. The periodontal ligament attachment and periradicular healing were appreciated both clinically and radiographically at 3-month follow-up. How to cite this article Krishnan DR, Haridas N, Singh VPP, Balakrishnan B. Effective Management of a Perio-endo Lesion associated with Palatoradicular Groove. Cons Dent Endod J 2017;2(1):16-23.

Treatment of an intrabony osseous lesion associated with a palatoradicular groove

Various root developmental anomalies like palatoradicular groove (PRG) have been associated with worsening of periodontal condition. The aim of the present case report is to describe the regenerative surgical treatment of periodontal and osseous lesion associated with the subgingival extension of PRG. A 23-year-old female patient reported with pain in upper incisor teeth region. On clinical and radiological examination, a deep endosseous defect was found distal to maxillary right lateral incisor that was etiologically associated with the presence of a PRG. Treatment procedures consisted of: Regenerative periodontal therapy using Guided tissue regeneration (GTR) and hydroxyapatite (HA) bone graft and 2) flattening of the radicular portion of the palatal groove. The clinical examination at 1 year revealed shallow residual probing depth (3 mm) and no increase in gingival recession. The radiographic examination showed reduction in the radiolucency suggesting bone fill. A PRG may serve as a pathway for the development of a periodontal osseous defect. The combination of GTR and HA may be clinically and radiographically efficacious in the treatment of such a defect.

Development anomaly and non-vitality: Two case reports

Anatomic aberrations are seen in human dentition. The maxillary incisor region of the permanent dentition where these anatomical aberrations are commonly seen is considered an area of embryonic hazard. Aberrations affecting the internal and external morphology can at times be the cause of complex pathological conditions involving the pulpal and periodontal tissues and can pose a challenge to the clinician for the diagnosis and clinical management. Detecting and treating the anomalies at an early phase is essential as it poses a threat for the loss of vitality of the concerned teeth. The aim of this paper is to highlight the fact two different developmental anomalies of maxillary incisors, namely palatoradicular groove and Turner's hypoplasia, led to the loss of vitality of the same.

Successful treatment of osseous lesion associated with palatoradicular groove using local drug delivery and guided tissue regeneration: A report of two cases

Developmental grooves are not rare and often appear on maxillary lateral and central incisors and are an important predisposing factor to localized periodontal disease. Various techniques have been adopted to eliminate the groove and regenerate lost periodontium. This report of two cases describes the technique of using the local drug delivery system with chlorehexidine and the guided tissue regeneration (GTR) to control the disease progression and regeneration.

Palato-radicular groove, diagnosis and management—a case report

Palato-radicular groove (PRG) is one of the rare developmental anomalies of maxillary incisor teeth, primarily maxillary lateral incisor. It usually begins in the central fossa, crosses the cingulum and extends to varying distance apically, possibly reaching the root apex. Its clinical relevance comes into picture once there is associated lack of epithelial closure which makes it an important niche for microbes. The accurate diagnosis of groove as an initiator of pathology, along with its depth and relation to pulp cavity is the pre-requisite for successful management. This report describes an unusual case of mesially oriented PRG on maxillary lateral incisor and an interdisciplinary approach towards the decision making process and successful management.

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

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.

PERAWATAN ENDODONTIK KONVENSIONAL PADA GIGI INSISIF LATERAL ATAS DENGAN KISTA RADIKULAR (LAPORAN KASUS)

It has been shown that more than 40 percent of the apical radiolucencies are radicular cyst, numerous endodontist claims that from 85 to 90 percent of apical lesions disappear or become reduced in size following conservative endodontic treatment and do not require surgical intervention. Maxillary teeth are more frequently susceptible to trauma and there are numerous morphologic anomalies associated with maxillary incisors especially lateral incisors its call palato-radicular groove (PRG), its caused non vital have been implicated in formation of periapical lesions. Periapical lesions can be cured by conventional endodontic treatment used Ca(OH)2 as an intracanal medication. One case with radicular cyst on the maxillary lateral incisors because of trauma 2 years ago will be presented. Fiffteenth months during treatment showed that the cyst reduced in size and symptomless.