Palatal radicular groove is a developmental malformation of maxillary incisors, lateral incisors in particular, which often causes periodontal destruction. This paper reports a case of combined periodontal-endodontic lesions induced by palatal radicular groove, which was initially misdiagnosed as a simple periapical cyst. After root canal therapy and periapical cyst curettage, the course of disease was prolonged, resulting in the absence of buccal and maxillary bone plates in the affected tooth area. After the etiology was determined, the affected tooth was extracted and guide bone tissue regeneration was performed at the same time, followed by implantation and restoration at the later stage, leading to clinical cure. The palatal radicular groove is highly occult, and the clinical symptoms are not typical. If the abscess of the maxillary lateral incisor occurs repeatedly, and the abscess of the maxillary lateral incisor has not been cured after periodontal and root canal treatment, cone-beam computed tomographic and periodontal flap surgery should be considered.
Humans ; Incisor ; Radicular Cyst ; Abscess ; Tooth Root/abnormalities* ; Root Canal Therapy ; Maxilla ; Cysts

Enamel pearl is an ectopic enamel, which usually occurs in the root bifurcate or approaching enamel-cementum site of the first maxillary molar. A case of multiple enamel pearls on the left maxillary third molar is reported in this paper, and relevant literature was reviewed.
Dental Cementum ; Dental Enamel ; abnormalities ; Humans ; Molar ; Molar, Third ; Tooth Root

OBJECTIVETo evaluate the incidence of two-rooted mandibular premolar morphology using full-mouth periapical film series in a Chinese population, with particular emphasis on bilateral incidence, so as to provide a clinical anatomical basis for root canal treatment in mandibular premolars.

METHODSA total of 2015 patients who underwent dental treatment and had full mouth periapical radiographs at the Peking University School of Stomatology from April 2011 to April 2012 were enrolled in this study. Three experienced dentists reviewed the patients' periapical films and classified the root morphology of mandibular premolars bilaterally. The incidence of unilateral and bilateral double roots were recorded and calculated, including confirmed and suspected bucco-lingual root types.

RESULTSIn terms of the morphology of two-rooted mandibular first premolars, of the 2015 cases with complete root formation, two-rooted first premolars were detected in 120 cases, with a total number of 159 teeth. According to the number of teeth, the overall incidence of double roots was 4.03% (159/3972). In terms of the morphology of two-rooted mandibular second premolars, of the 2015 cases with complete root formation, two-rooted second premolars were detected in 24 cases, with a total number of 33 teeth. According to the number of teeth, the overall incidence of double roots was 0.85% (33/3880).

CONCLUSIONSThe roots of mandibular premolars display specific morphological patterns. Based on a large sample, we observed and calculated not only the occurrence rate of bucco-lingual and mesio-distal double roots in first and second mandibular premolars, but also the incidence of unilateral or bilateral double roots within the same mandible. These findings could provide useful information on the anatomical structure of mandibular premolars for endodontic, prosthodontic and surgical procedures, and could improve the quality of treatment and reduce complications.

Adolescent ; Adult ; Aged ; Bicuspid ; abnormalities ; Child ; Humans ; Mandible ; Middle Aged ; Periapical Tissue ; diagnostic imaging ; Radiography ; Tooth Root ; abnormalities

Although the purpose of orthodontic treatment is to increase the function and esthetics of the jaws along with increasing stability, there are many side effects during the treatment itself, such as root resorption and alveolar bone resorption. Such resorption of the apical root is unpredictable, and may even proceed into the dentin layer. Once the process has begun, it is irreversible. By evaluating the effect of many oral habits, especially that of nail biting, in correlation with the root and the periodontal tissues, the appropriate biomechanics for orthodontic treatment can be taken into consideration, along with the possibility of root resorption and alveolar bone loss during orthodontic treatment, and any legal problems that might occur. Among the male and female patients of the ages 10~15 without skeletal deformity, 63 were chosen as the experiment group with known nail biting habits at time of examination, and within the same age group without nail biting habits as the control. After the orthodontic treatment, number of the experiment group was 31 and the control group was 22. The periapical radiographies of anterior teeth were taken and the assesment of the root length and alveolar bone level were taken before(T1) and after(T2) the orthodontic treatment. The results from this study were as follows : 1. Before the orthodontic treatment, average crown-to-root ratio of the experimental group showed noticeably high values in 4 maxillary incisors and mandibular right central incisor. 2. Before the orthodontic treatment, comparing the root length, maxillary and mandibular right central incisors and both mandibular incisors had a smaller value in the experimental group. 3. Before the orthodontic treatment, comparing and evaluating the alveolar bone loss measured from the cemento-enamel junction to the alveolar bone crest, some crestal bone of the experiment group showed greater loss than the control. 4. After the orthodontic treatment, there was shortening of the root length and loss of the crestal bone in both groups. 5. After the orthodontic treatment, the changes of C/R ratio and the shortening of root length were significantly high in the experimental group. 6. After the orthodontic treatment, the level of alveolar crestal bone showed greater loss in the experimental group.
Alveolar Bone Loss ; Bone Resorption ; Congenital Abnormalities ; Dentin ; Equidae ; Esthetics ; Female ; Humans ; Incisor ; Jaw ; Male ; Nail Biting* ; Root Resorption ; Tooth

PURPOSE: The aim of this study was to explore root shape abnormalities, to investigate the influence of root form abnormalities on periodontal attachment loss, and to gather basic data to assist in the diagnosis and treatment of aggressive periodontitis. METHODS: From January 2010 to June 2012, a survey was conducted of all 3,284 periodontitis patients who visited the Department of Periodontology, Daejeon Dental Hospital, Wonkwang University School of Dentistry. Clinical parameters (probing depth, periodontal attachment loss, missing teeth) were measured and a radiographic examination was performed at the baseline. We classified the root shape abnormality of bicuspids and molars based on Meng classification. RESULTS: The periodontal attachment loss was the highest at the maxillary first molar (6.03 mm). The loss of the second molar was prominent. Type V deformity was shown to be the most common in the second maxillary and mandibular molars (P<0.05). Type V root shape was associated with the highest attachment loss (P=0.01). CONCLUSIONS: Considering the small population and limited design of this study, definitive conclusions cannot be drawn. We suggest larger scale, methodologically more sophisticated studies that include normal controls and chronic periodontitis patients to clarify whether root form abnormalities are a potential risk factor for aggressive periodontitis.
Aggressive Periodontitis ; Bicuspid ; Chronic Periodontitis ; Classification ; Congenital Abnormalities ; Dentistry ; Diagnosis ; Humans ; Methods ; Molar ; Periodontal Attachment Loss* ; Periodontitis ; Risk Factors ; Tooth Loss ; Tooth Root

This case report describes the diagnosis and endodontic therapy of maxillary fused second and third molars, using cone-beam computed tomography (CBCT). A 31-year-old Chinese male, with no contributory medical or family/social history, presented with throbbing pain in the maxillary right molar area following an unsuccessful attempted tooth extraction. Clinical examination revealed what appeared initially to be a damaged large extra cusp on the buccal aspect of the distobuccal cusp of the second molar. However, CBCT revealed that a third molar was fused to the second molar. Unexpectedly, the maxillary left third molar also was fused to the second molar, and the crown of an unerupted supernumerary fourth molar was possibly also fused to the apical root region of the second molar. Operative procedures should not be attempted without adequate radiographic investigation. CBCT allowed the precise location of the root canals of the right maxillary fused molar teeth to permit successful endodontic therapy, confirmed after 6 months.
Adult ; Cone-Beam Computed Tomography ; methods ; Follow-Up Studies ; Fused Teeth ; diagnostic imaging ; Humans ; Image Processing, Computer-Assisted ; methods ; Imaging, Three-Dimensional ; methods ; Male ; Maxilla ; Molar ; abnormalities ; Molar, Third ; abnormalities ; Pulpitis ; diagnostic imaging ; Root Canal Therapy ; Tooth Root ; abnormalities ; Tooth, Supernumerary ; diagnostic imaging ; Tooth, Unerupted ; diagnostic imaging

This paper reported a case of fusion between an impacted third molar and a supernumerary tooth, in which a surgical intervention was carried out, with the objective of removing the dental elements. The panoramic radiography was complemented by the Donovan's radiographic technique; but because of the proximity of the dental element to the mandibular ramus, it was not possible to have a final fusion diagnosis. Hence, the Cone-Beam Computed Tomography-which provides precise three-dimensional information-was used to determinate the fusion diagnosis and also to help in the surgical planning. In this case report we observed that the periapical, occlusal and panoramic were not able to show details which could only be examined through the cone-beam computed tomography.
Adult ; Cone-Beam Computed Tomography ; methods ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Fused Teeth ; diagnostic imaging ; Humans ; Imaging, Three-Dimensional ; methods ; Molar, Third ; abnormalities ; diagnostic imaging ; Patient Care Planning ; Radiography, Bitewing ; Radiography, Panoramic ; Tooth Root ; abnormalities ; diagnostic imaging ; Tooth, Impacted ; diagnostic imaging ; Tooth, Supernumerary ; diagnostic imaging