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

Abstract

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.

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

“…In contrast to this, some researchers observed a lower prevalence of enamel pearls (0.74%) using micro CT [11]. In our study enamel pearls were seen only on molar teeth not in premolar and anterior teeth, this was consistent with the findings of previous studies, which did not find enamel pearls in premolars [15], but found enamel pearls in 0.22% of premolars and without occurrence in incisors [12].…”

“…Previously, the prevalence of EP has been estimated in vivo and ex vivo in conventional radiographs, cone beam computed tomography (CBCT) and extracted teeth [11]. To the best of our knowledge, no studies were carried out to assess the prevalence of enamel pearls in Saudi Arabian population.…”

Bi̇ri̇nci̇ Ve İki̇nci̇ Molar Di̇şleri̇n Furkasyon Bölgeleri̇ndeki̇ Mi̇ne İnci̇si̇ Prevelansinin İncelenmesi̇

“…Köklerde görülen şekil anomalilerinden biri olan mine incileri, bağ dokusu ataçmanına girerek sadece hemidezmozal birleşime müsaade ettikleri için periodontitis nedeni olarak görülmüşlerdir. Ek olarak, bu tür oluşumların yapısı ve konumu, plağın mekanik olarak tutulmasına izin verir ve hem hastalar hem de hekimler tarafından etkili bir şekilde uzaklaştırılmasını engelleyerek periodontal hastalıklara yol açabilir 6,[8][9][10] .…”

Bi̇ri̇nci̇ Ve İki̇nci̇ Molar Di̇şleri̇n Furkasyon Bölgeleri̇ndeki̇ Mi̇ne İnci̇si̇ Prevelansinin İncelenmesi̇

“…Günümüze kadar mine incileri in vivo ve ex vivo olarak konvansiyonel radyografi 6,13,14 ve konik ışınlı bilgisayarlı tomografi (KIBT) 15,16 kullanılarak değerlendirilmiştir. Bununla birlikte son on yılda mikro-BT, diş sert dokularının üç boyutlu değerlendirilmesi için invaziv olmayan tekrarlanabilir bir yöntem 8,17 Tespit edilen mine incilerinin 1 tanesinin su damlası şeklinde, 10 tanesinin ise küre şeklinde olduğu görülmüştür. Küre şeklindeki incilerin çapları 0.3 mm ile 1.7 mm arasında değişiklik göstermektedir (ortalama 1.12 mm) (Tablo 3).…”