Multi-disciplinary treatment of severe palatal radicular groove of maxillary lateral incisor: A case report and literature review

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2023 Feb 28;48(2):302-310. doi: 10.11817/j.issn.1672-7347.2023.220104.
[Article in English, Chinese]

Abstract

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.

畸形舌侧沟是上颌切牙尤其是侧切牙常见的发育畸形,常引起牙周组织的破坏。本文报告1例畸形舌侧沟引发的牙周-牙髓联合病变误诊为单纯的根尖周囊肿的病例,经完善根管治疗及根尖周囊肿刮除术后病程迁延不愈,造成患牙区域颊、颚侧骨板缺如,后通过拔除患牙同期行位点保存术,后期配合种植修复,得到临床治愈。畸形舌侧沟隐匿性强、临床表现往往不典型,如有上颌侧切牙脓包反复发作或深牙周袋持续存在,应完善影像学检查,必要时行牙周翻瓣术探查牙根面形态。.

Keywords: combined periodontal-endodontic lesions; dental implant; guide bone tissue regeneration; palatal radicular groove; periapical cysts; periodontal abscess.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Abscess
  • Cysts*
  • Humans
  • Incisor
  • Maxilla
  • Radicular Cyst*
  • Root Canal Therapy
  • Tooth Root / abnormalities
  • Tooth Root / surgery