J Korean Acad Conserv Dent.  2007 Nov;32(6):483-490.

The palato-gingival groove - anatomical anomaly occurred in maxillary lateral incisors: case reports

• Kim HI
• Noh YS
• Chang HS
• Ryu HW
• Min KS

Abstract

This report describes clinical cases of a palato-gingival groove on a maxillary lateral incisor with associated localized periodontal disease and pulp necrosis. The tooth of the first case was extracted because of severe bone destruction. The palato-gingival groove of the second case was eliminated using a round bur, and the resulting defect was filled with synthetic graft and covered by an absorbable membrane. Both diagnosis and treatment of palato-gingival groove were very difficult and usually extraction of the involved tooth is the treatment of choice, but combined endodontic-periodontic treatment allowed the tooth to be saved.

Keyword

Palato-gingival groove; Pulp necrosis; Anatomical anomaly; Endodontic-periodontic

MeSH Terms

Dental Pulp Necrosis
Diagnosis
Incisor*
Membranes
Periodontal Diseases
Tooth
Transplants

Figure

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  Figure 1 Pretreatment images. (A) Photograph demonstrating the facial sinus tract. (B) Probing depth (8 mm) at the cingulum. (C) Periapical radiograph showing a gutta-percha cone tracing the facial sinus tract.

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  Figure 2 (A) and (B) The osseous defect associated with the palato-gingival groove (arrow). (C) Lingual side of extracted tooth shows palato-gingival groove running along entire length of root. (D) Cross sectional view of extracted tooth at 5 mm level from CEJ shows the communication between the root canal system and the groove.

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  Figure 3 (A) Preoperative clinical view demonstrating the facial sinus tract (arrow) and discoloration of lateral incisor. (B) Periapical radiograph showing a gutta-percha cone tracing the facial sinus tract to the periradicular radiolucency associated with the right maxillary lateral incisor. Three vertically oriented radiolucent lines are also evident within lateral incisor (arrows). (C) Nonsurgical endodontic treatment; gutta-percha on apical one-third and resin core on middle and coronal one-third.

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  Figure 4 (A) The fenestration of the cortical plate on the facial aspect. (B) The palatal bony defect associated with the palatal groove (arrow). (C) The palatal groove after odontoblasty and filling of the bony defect with freeze-dried bone allograft.

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  Figure 5 Periapical radiograph of tooth 6 months after treatment.

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