Recognition and management of palatogingival groove for tooth survival: a literature review

Abstract

Palatogingival groove (PGG) is an anomaly in the maxillary anterior teeth, often accompanied by the area of bony destruction adjacent to the teeth with no carious or traumatic history. The hidden trap in the tooth can harbor plaque and bacteria, resulting in periodontal destruction with or without pulpal pathologic change. Related diseases can involve periodontal destruction, combined endodontic-periodontal lesions, or separate endodontic and periodontal lesions. Disease severity and prognosis related to PGG depend on several factors, including location, range, depth, and type of the groove. Several materials have been used and recommended for cases of extensive periodontal destruction from PGG to remove and block the inflammatory source and recover the health of surrounding periodontal tissues. Even in cases of severe periodontal destruction, several studies have reported favorable treatment outcomes with proper management. With new options in diagnosis and treatment, clinicians need a detailed understanding of the characteristics, treatment, and prognosis of PGG to successfully manage the condition.

Successful Multidisciplinary Management of an Endodontic‐Periodontal Lesion Associated With a Palato‐Radicular Groove: A Case Report

“…Its effectiveness in lesions related to the PRG has been reported previously . Other regenerative materials that have been reported for this purpose include platelet‐rich fibrins and enamel matrix derivatives . Although the prognosis was guarded in this case, the patient requested that an attempt be made to save her tooth.…”

“…In a Type III case, the groove might be eliminated with a combination of odontoplasty and other sealing materials such as glass ionomer cement, and mineral trioxide aggregate. The complexity of the root canal system may even require root resection or intentional extraction/replantation . A Type III PRG may also communicate with an invagination into the canal resulting in increased complexity of the canal system .…”

“…They are often associated with increased probing depths, and endodontic‐periodontal lesions in severe cases with pulpal involvement mainly via accessory canals . The prognosis of a tooth with a PRG is affected by several major factors, including the features (groove extension and invagination) of the PRG, complexity of the root canal system, severity of the concurrent periodontal disease, and accessibility to the osseous defect area . While several case reports have reported promising results with treatment of extensive lesions associated with a PRG that were deemed hopeless in the past, detailed examinations involving cone‐beam computed tomography (CBCT) imaging and comprehensive understanding of the PRG are critical for clinical success .…”

“…5,6 The prognosis of a tooth with a PRG is affected by several major factors, including the features (groove extension and invagination) of the PRG, complexity of the root canal system, severity of the concurrent periodontal disease, and accessibility to the osseous defect area. 7 While several case reports have reported promising results with treatment of extensive lesions associated with a PRG that were deemed hopeless in the past, detailed examinations involving cone-beam computed tomography (CBCT) imaging and comprehensive understanding of the PRG are critical for clinical success. 5 This case report describes multidisciplinary management of an endodontic-periodontal lesion associated with a PRG on a maxillary lateral incisor.…”

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

“…The treatment proposed for management of palatal groove depends on several factors, including depth and extension of groove, severity of periodontal disease, and pulpal status of the affected tooth. Management strategies reported range from access flap to smoothen the root surface, sealing the groove with restorative materials, use of various regenerative materials, combined periodontal‐endodontic approach, and the extraction of unsalvageable teeth . There has been no large cohort study reporting on the treatment of palatal grooves to date, most likely due to difficulty in recruitment, and the treatment reported has mostly been in the form of case reports or case series …”