Diverse microbiota in palatal radicular groove analyzed by Illumina sequencing: Four case reports

CBCT analysis of the incidence of maxillary lateral incisor dens invaginatus and its impact on periodontal supporting tissues

BACKGROUND

Dens invaginatus is a developmental abnormality originating from tooth development, including coronal invaginatus and radicular invaginatus. The reported incidence varies greatly due to diagnostic techniques, classification criteria and race. The incidence of dens invaginatus in China was not clear, and the impact of dens invaginatus on periodontal support tissue were rarely reported. This study aims to clarify the incidence of maxillary lateral incisor dens invaginatus and its impact on periodontal supporting tissues.

METHODS

From the cone-beam computed tomography database, images of 212 maxillary lateral incisors from 106 Chinese patients were selected. Teeth that met the Oehlers classification criteria for coronal invaginatus were recorded as coronal invaginatus, and teeth with radicular cystoid invaginatus or radicular groove were classified as radicular dens invaginatus. The complexity of radicular groove was determined by Gu's classification standard. Both of coronal invaginatus and radicular dens invaginatus were recorded as dens invaginatus. For 15 patients with unilateral radicular dens invaginatus, the periodontal ligament area of the affected teeth and the corresponding natural teeth in the same jaw were measured and compared.

RESULTS

The overall incidence of maxillary lateral incisor invaginatus in China is 25.0%. The incidence of coronal invaginatus is 12.3%, and the incidence of radicular dens invaginatus is 14.6%. No significant differences were observed between genders or sides. In this study, all radicular dens invaginatus exhibited as radicular groove, of which 87.1% were Gu type I, 9.7% were Gu type II, and 3.2% were Gu type III. Although the difference was not statistically significant, the average periodontal ligament area of the maxillary lateral incisor with radicular dens invaginatus was 148.93 ± 35.62mm2, smaller than that of the control teeth (152.28 ± 40.22mm2).

CONCLUSIONS

The dens invaginatus of the maxillary lateral incisor is common. There is no significant difference in the incidence between genders or between sides. The main manifestation of the radicular dens invaginatus is the radicular groove (Gu's type I). This anatomical abnormality may reduce the periodontal ligament area. The presence of the additional root of the maxillary lateral incisor is not rare and was supposed to be highly concerned by dentists.

Intentional replantation combined root resection therapy for the treatment of type III radicular groove with two roots: A case report

BACKGROUND

A radicular groove is an anatomic malformation that usually initiates at the central fossa, extending along the root at varying lengths and depths and predisposes the involved tooth to a severe periodontal defect. Severe grooves that extend to the root apex often lead to complex combined periodontal-endodontic lesions. They are a serious challenge for doctors to diagnose and treat.

CASE SUMMARY

In this report, we described a patient with a maxillary lateral incisor with a deep palatogingival groove with two roots, which led to complex combined periodontal-endodontic lesions. Suggested treatment modalities included curettage of the affected tissues, elimination of the groove by grinding and/or sealing with a variety of filling materials, and surgical procedures. In this case, a combination of endodontic therapy, intentional replantation, and root resection were used, which resulted in periodontal/periradicular healing after 12 mo.

CONCLUSION

Intentional replantation and root resection offer a predictable procedure and should be considered a viable treatment modality for the management of palatogingival grooves, especially for two-rooted teeth.