Prevalence of enamel projections and its co-relation with furcation involvement in maxillary and mandibular molars: A study on dry skull

Abstract

Background:The objectives of this study were to investigate the incidence of cervical enamel projection (CEP) in molars of Indian dry human skulls and to evaluate its relationship with furcation involvement (FI).Materials and Methods:The material consisted of 944 upper and lower first, second and third permanent molars from 89 Indian dry human skulls. CEPs were investigated from the buccal aspect of the tooth and classified according to a system describeddescribed by Masters and Hoskins. FI was measured horizontally from the buccal aspect into the furcation with a graduated probe to the nearest millimeter. Any measurement ≥2 mm was considered to have positive FI.Results:The results showed that CEPs was found more frequently in the mandibular than in the maxillary molars (2:1). The highest incidence of CEP was found in the mandibular second molar (14.7%) followed by the maxillary second molar (14.6%). The mandibular third molar showed the lowest incidence (5.5%). The association between CEP and FI (87.5%) was statistically significant. This favors the view of the possible role played by such anomalies in the progression of periodontal diseases. CEP in male skulls (77.4%) was significantly more prevalent than in female skulls (20.4%). No significant difference was found between the right and left side of maxillary and mandibular teeth with CEP and FI.Conclusion:The findings suggested the role of CEPs as a local contributing factor in localized chronic periodontitis and FI in molars. Detailed examination as well as early diagnosis of periodontal disease at the region of furcation is clinically very important.

Prevalence of Cervical Enamel Projection and Its Impact on Furcation Involvement in Mandibular Molars: A Cone‐Beam Computed Tomography Study in Koreans

“…These factors increase the likelihood that the presence of lingual CEPs will be underestimated. The prevalence rate of CEPs on the lingual surface was 26.6% in the present study, which is similar to or much greater than the prevalence rates reported for Americans, Indians, and Egyptians (Bhusari et al, ; Bissada and Abdelmalek, ; Grewe et al, ; Leib et al, ). Mandibular molars anatomically have a lingual inclination, which leads to a more‐apical position of the furcal entrance compared to the buccal entrance.…”

“…In previous studies, the influence of CEP in the subjects without information about their periodontal conditions was inconsistent. Most studies have found CEP to be associated with FI (Grewe et al, ; Bissada and Abdelmalek, ; Hou and Tsai, ; Zee and Bratthall, ; Bhusari et al, ), but other studies—including the present one—found no such relation (Leib et al, ; Zee et al, ). When confining targets to periodontally‐involved teeth, a significant relationship between CEP and FI was found (Hou and Tsai, ; Machtei et al, ).…”

“…Reich et al () demonstrated that Indians can be classified into two groups on a basis of genotypes: (1) “Ancestral North Indian,” who are genetically close to Middle Eastern, Central Asian, and European populations (39%–71% in Indian substructural populations), and (2) “Ancestral South Indian.” Such findings may explain the difference in the prevalence of CEPs among Asian countries. Studies investigating the prevalence of CEPs in Egyptians (a Middle Eastern population) found a similar prevalence rate to that in Indians (Bhusari et al, ; Bissada and Abdelmalek, ).…”

“…Interestingly, the prevalence of CEPs in mandibular molars appears to vary geographically among Asians. A recent study involving Indians found very low prevalence rates of 10% and 14% in the first and second mandibular molars, respectively (Bhusari et al, ). The prevalence in Asia increases when moving to East Asia, as demonstrated for Chinese (Zee et al, ), Taiwanese (Hou and Tsai, ), and the Koreans in the present study.…”

“…Previous studies on CEPs have been performed by observations in extracted teeth or cadavers, using macroscopy during periodontal surgery, or by probing in the region of the cementoenamel junction (Bhusari et al, ; Hou and Tsai, ; Leib et al, ; Swan and Hurt, ; Zee and Bratthall, ). However, these methods can be subject to limitations such as the inconvenience of performing cadaver examinations, the limited number of samples, the need for invasive surgery, and the possibility of inaccurate assessments.…”