Cervical Enamel Projections and Associated Pouch‐Like Opening in Mandibular Furcations

Abstract

This study reports on the presence of a pouch-like opening between the enamel and cementum in mandibular molars with Grade III CEPs. The clinical significance of these cementum pouches has yet to be determined but bacterial contamination of these pouch-like structures in areas of furcation periodontal breakdown may serve as a nidus for recolonization and disease recurrence or for the development of furcation caries if exposed to the oral cavity after surgical procedures.

The Possible Effect of an Accessory Root‐Like Structure on Periodontitis: A Clinical and Histologic Case Report

“…Bacterial plaque is the primary etiologic factor for the initiation and progression of periodontal diseases. Anatomic factors, such as enamel pearls, 10 cervical enamel projections, 11,12 cemental tears, 13,14 and radicular grooves, 15 are often associated with advanced localized periodontal destruction and considered as the coetiologic factors. In the present case report, the accessory root‐like structure was sharp, small in size, and located in the coronal half of the root, which resulted in early exposure of this abnormal structure into the periodontal pocket when the patient developed periodontal disease.…”

Unanswered Questions

“…[19][20][21] Recent electron microscopic studies show that there is even greater complexity to cervical enamel projections than previously thought. 22 Pouchlike openings ( Fig. 1) have recently been described in association with cervical enamel projections.…”

Anatomical, microbiological, and genetic considerations in treatment of Chinese periodontal patients

“…Similar to coronal enamel, connective tissues are unable to attach to CEP, and therefore they have been implicated as a risk factor for the development of localized periodontitis. Furthermore, a pouch‐like opening was found between the cementum and apex of CEP when examined under scanning electron microscope (SEM) . This might serve as an ecological niche for periodontal pathogens.…”

“…Furthermore, a pouch-like opening was found between the cementum and apex of CEP when examined under scanning electron microscope (SEM). 32 This might serve as an ecological niche for periodontal pathogens. A significant association between molars with CEs and furcation involvement has been found in dry skulls 30 and in clinical examinations 33,34 when compared to molars without CEP.…”