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Wang Y, Su S, Chen X, Jia X. CBCT analysis of the incidence of maxillary lateral incisor dens invaginatus and its impact on periodontal supporting tissues. BMC Oral Health 2024; 24:1569. [PMID: 39734211 DOI: 10.1186/s12903-024-05376-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2024] [Accepted: 12/23/2024] [Indexed: 12/31/2024] Open
Abstract
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.
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Affiliation(s)
- Yanhua Wang
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Sha Su
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xing Chen
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xueting Jia
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
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Fajrianti H, Karimah F, Dewi SK, Ratih DN, Devitaningtyas N, Karina VM, Diba SF. Regenerative Surgical Management of an Endodontic Periodontic Lesion of the Mandibular Molar Combined With External Inflammation Root Resorption. Case Rep Dent 2024; 2024:1048933. [PMID: 39239239 PMCID: PMC11377115 DOI: 10.1155/2024/1048933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 07/17/2024] [Accepted: 08/10/2024] [Indexed: 09/07/2024] Open
Abstract
Endo-perio lesions are lesions involving pulp tissue with periodontal tissue. The bacterial infection of the pulp can spread to the furcation area through the accessory canal, causing damage to the furcation area. Regeneration therapy has good success when performed with flap surgery and is performed in cases of Grades I and II furcation involvement. Demineralized freeze-dried bone allograft (DFDBA) is a regenerating material that has osteoinductive and osteoconductive abilities. It has the advantage of successful treatment of bone defects. Biodentine is an agent used for direct pulp capping, root perforation and furcation repair, and apexification. It can bind and enter the dentinal tubules and create interlocking crystals with dentin. This case report presents the treatment of furcation involvement Grade II originating from endo-perio lesions by using DFDBA and Biodentine as regeneration materials with 6 months of follow-up.
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Affiliation(s)
- Henytaria Fajrianti
- Department of Conservative Dentistry Faculty of Dentistry Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Fauziah Karimah
- Department of Conservative Dentistry Faculty of Dentistry Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Safitri Kusuma Dewi
- Department of Conservative Dentistry Faculty of Dentistry Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Diatri Nari Ratih
- Department of Conservative Dentistry Faculty of Dentistry Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Nungky Devitaningtyas
- Department of Periodontics Faculty of Dentistry Brawijaya University, Malang, Indonesia
| | - Vincensia Maria Karina
- Department of Periodontics Faculty of Dentistry Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Silviana Farrah Diba
- Department of Dentomaxillofacial Radiology Faculty of Dentistry Universitas Gadjah Mada, Yogyakarta, Indonesia
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Li T, He W, Jiang W, Wang X, Nie M, Wang S. Interdisciplinary management of combined periodontal-endodontic lesions with palatogingival grooves of the maxillary lateral incisors: a case report. Br Dent J 2023; 234:27-33. [PMID: 36639473 DOI: 10.1038/s41415-022-5370-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 07/26/2022] [Indexed: 01/15/2023]
Abstract
A palatogingival groove of the maxillary lateral incisor is an anatomic malformation, which always predisposes the tooth to pulpal and periodontal disease. The diagnosis and treatment planning become complicated, with uncertain prognosis. Herein, we present an effective interdisciplinary management of a case of combined periodontal-endodontic lesions caused by palatogingival grooves. A series of treatment modalities were undertaken to preserve the two teeth, including root canal treatment, periodontal initial therapy, splinting the mobile teeth, occlusal adjustment, apical microsurgery, grinding and sealing grooves, and guided tissue regeneration. An apparent healing of the lesions was visible after 12 months. Therefore, interdisciplinary management of combined periodontal-endodontic lesions with palatogingival grooves of the maxillary lateral incisors is necessary for a favourable long-term outcome.
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Affiliation(s)
- Tong Li
- State Key Laboratory of Military Stomatology and National Clinical Research Centre for Oral Diseases and Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, 145 West Chang-le Road, Xi´an 710032, Shaanxi, People's Republic Of China
| | - Wenxi He
- State Key Laboratory of Military Stomatology and National Clinical Research Centre for Oral Diseases and Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, 145 West Chang-le Road, Xi´an 710032, Shaanxi, People's Republic Of China
| | - Wenkai Jiang
- State Key Laboratory of Military Stomatology and National Clinical Research Centre for Oral Diseases and Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, 145 West Chang-le Road, Xi´an 710032, Shaanxi, People's Republic Of China
| | - Xiaoli Wang
- State Key Laboratory of Military Stomatology and National Clinical Research Centre for Oral Diseases and Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, 145 West Chang-le Road, Xi´an 710032, Shaanxi, People's Republic Of China
| | - Min Nie
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, Department of Endodontics, School and Hospital of Stomatology, Wuhan University, 237 Luo-yu Road, Wuhan, 430079, Hubei, People's Republic Of China
| | - Shengchao Wang
- State Key Laboratory of Military Stomatology and National Clinical Research Centre for Oral Diseases and Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, 145 West Chang-le Road, Xi´an 710032, Shaanxi, People's Republic Of China.
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Tan D, Li ST, Feng H, Wang ZC, Wen C, Nie MH. Intentional replantation combined root resection therapy for the treatment of type III radicular groove with two roots: A case report. World J Clin Cases 2022; 10:6991-6998. [PMID: 36051153 PMCID: PMC9297402 DOI: 10.12998/wjcc.v10.i20.6991] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 03/29/2022] [Accepted: 05/22/2022] [Indexed: 02/06/2023] Open
Abstract
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.
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Affiliation(s)
- Dan Tan
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Shi-Ting Li
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Hao Feng
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Zhong-Chao Wang
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Cai Wen
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Min-Hai Nie
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
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Tan XL, Chen X, Fu YJ, Ye L, Zhang L, Huang DM. Diverse microbiota in palatal radicular groove analyzed by Illumina sequencing: Four case reports. World J Clin Cases 2021; 9:6846-6857. [PMID: 34447834 PMCID: PMC8362521 DOI: 10.12998/wjcc.v9.i23.6846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/24/2021] [Accepted: 06/04/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND A palatal radicular groove is an unusual developmental deformity of the tooth, which may serve as a channel linking the periodontal and periapical inflammation, and yet no literature could be obtained analyzing microbiota within the palatal radicular grooves.
CASE SUMMARY Four patients diagnosed with palatal radicular groove and concomitant periodontal-endodontic deformity in permanent maxillary lateral incisors were enrolled in this work. Twelve bacterial samples from 4 patients were collected from different parts of the palatal radicular groove during intentional replantation surgery. Illumina sequencing was performed to analyze the taxonomical composition and microbiome structure inside the palatal grooves, and 1162 operational taxonomic units were obtained. The phyla of Firmicutes and Proteobacteria predominated in most of the samples. An unknown genus from the Bacillaceae family, Lactococcus, and Porphyromonas were the most abundant genera identified. There was no difference in the microbiota richness and diversity in three sections of the groove.
CONCLUSION The unique ecological niches inside the palatal grooves harbored bacterial communities that shared some component features of both the endodontic and periodontal infections. The existence of palatal groove may play an interaction bridge between the root apex and tooth cervix and thus impair the outcome of traditional therapeutic methods such as root canal treatment and periodontal management.
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Affiliation(s)
- Xue-Lian Tan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xuan Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yu-Jie Fu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Ling Ye
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Lan Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Ding-Ming Huang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
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