Enamel pearls as a contributing factor in periodontal breakdown

Goldstein, Avrum R.

doi:10.14219/jada.archive.1979.0258

Cited by 47 publications

(49 citation statements)

References 5 publications

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“…EP's have been appeared to encourage the advancement of periodontal breakdown, regarding that the enamel housing of the EP can avert a connective tissue coupling and the anatomy of EP's takes into account the confinement of dental plaque [18,19]. It may be noted that the limited separation between the cervical line of the enamel and the furcation vertex, the possibility of periodontal pathologies will be more, even with the existence of minor EP [20].…”

Section: Discussionmentioning

confidence: 99%

A Radiographic Study of Prevalence and Location of Enamel Pearls in a Saudi Arabian Adolescent Population

Al-Zoubi

Patil

Alam

et al. 2018

Pesqui. bras. odontopediatria clín. integr.

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Objective: To determine the prevalence of enamel pearls on panoramic radiographs and to explore any potential correlation between the occurrences of enamel pearls with gender, jaw and tooth involved. Material and Methods: Digital panoramic radiographs of 642 adolescents aging 12-19 years were examined for the presence of enamel pearls. The location of involved tooth in terms of jaw and side and gender were recorded. Statistical analysis was carried out by applying Chi-square tests with the Yates correction. The level of significance was set at 5%. Results: The person prevalence of enamel pearls was 4.82% of patients and tooth prevalence was 0.96%. No statistical significant difference was observed between maxillary and mandibular arches and no gender and side predilection was observed. Most of the enamel pearls were seen in maxillary third molars (4.76%) and mandibular third molars (2.68%), followed by maxillary first molars (2.68%) and mandibular second molars (1.95%). No enamel pearl was observed in any of the anterior teeth or in any of the deciduous teeth. Conclusion: The prevalence of enamel pearls was observed in 4.28% of patients and 0.96% of teeth. They were most frequently seen on molars with no predilection for gender, jaw and side.

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Section: Discussionmentioning

confidence: 99%

A Radiographic Study of Prevalence and Location of Enamel Pearls in a Saudi Arabian Adolescent Population

Al-Zoubi

Patil

Alam

et al. 2018

Pesqui. bras. odontopediatria clín. integr.

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“…[1][2][3][4][5][6][7][8][9] The EP-associated lesion often presents as a periapical or a periodontal lesion with angular bone loss along the root surface on the radiograph. 3,5,[9][10][11] In some cases, its clinical features may result in drainage in the sulcus area, swelling, sinus tract, simulating an endodontic-periodontic lesion. 11,12 A thorough examination including pulp vitality tests and careful radiographic examination is necessary to aid in the diagnosis and treatment options.…”

Section: Introductionmentioning

confidence: 99%

“…The most acceptable theory is that the pearl develops because of a localized developmental activity of the Hertwig's epithelial root sheath cells that remained adherent to the root surface during root development differentiating into functioning ameloblasts. 1,3,6,15,16 The EP has been evaluated in vivo and ex vivo using conventional radiography 2,6,17 and cone beam CT (CBCT). 10 In the last decade, micro-CT (mCT) has gained increasing significance as a non-invasive reproducible method for three-dimensional (3D) assessment of dental hard tissues.…”

Section: Introductionmentioning

confidence: 99%

Enamel pearls in permanent dentition: case report and micro-CT evaluation

Versiani

Cristescu²,

Saquy³

et al. 2013

Dentomaxillofacial Radiology

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Objectives: To investigate the frequency, position, number and morphology of enamel pearls (EPs) using micro-CT (mCT) and to report a case of an EP mimicking an endodonticperiodontic lesion. Methods: Cone beam CT (CBCT) was performed in a patient to evaluate a radio-opaque nodule observed on the left maxillary first molar during the radiographic examination. Additionally, 23 EPs were evaluated regarding frequency, position, number and morphology by means of mCT. The results were statistically compared using the Student's t-test for independent samples. Results: 1 pearl was presented in 13 specimens, while 5 specimens presented 2 pearls. The most frequent location of the EPs was the furcation between the disto-buccal and the palatal roots of the maxillary molars. Overall, the mean major diameter, volume and surface area were 1.98 6 0.85 mm, 1.76 6 1.36 mm 3 and 11.40 6 7.59 mm 2 , respectively, with no statistical difference between maxillary second and third molars (p . 0.05). In the case report, CBCT revealed an EP between the disto-buccal and the palatal roots of the maxillary first left molar associated with advanced localized periodontitis. The tooth was referred for extraction. Conclusions: EPs, located generally in the furcation area, were observed in 0.74% of the sample. The majority was an enamel-dentin pearl type and no difference was found in maxillary second and third molars regarding diameter, volume and surface area of the pearls. In this report, the EP mimicked an endodontic-periodontic lesion and was a secondary aetiological factor in the periodontal breakdown.

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“…Calculus or enamel pearls may be contributing factors in periodontal disease as they may promote plaque retention. Goldstein (8) reported that once breakdown occurs in these regions, more rapid progression of the disease is likely, as the anatomy of the pearl allows retention of plaque. SEM observation showed rod-shaped bacteria on the particle surfaces.…”

Section: Discussionmentioning

confidence: 99%