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Interdisciplinary management of combined periodontal-endodontic lesions with palatogingival grooves of the maxillary lateral incisors: a case report

British Dental Journal volume 234, pages 27–33 (2023)Cite this article

Abstract

A palatogingival groove of the maxillary lateral incisor is an anatomic malformation, which always predisposes the tooth to pulpal and periodontal disease. The diagnosis and treatment planning become complicated, with uncertain prognosis. Herein, we present an effective interdisciplinary management of a case of combined periodontal-endodontic lesions caused by palatogingival grooves. A series of treatment modalities were undertaken to preserve the two teeth, including root canal treatment, periodontal initial therapy, splinting the mobile teeth, occlusal adjustment, apical microsurgery, grinding and sealing grooves, and guided tissue regeneration. An apparent healing of the lesions was visible after 12 months. Therefore, interdisciplinary management of combined periodontal-endodontic lesions with palatogingival grooves of the maxillary lateral incisors is necessary for a favourable long-term outcome.

Key points

  • Cone-beam computed tomography enables three-dimensional visualisation of the morphological variations in teeth, which aids practitioners in diagnosing, treatment planning and evaluating prognosis.

  • This report highlights the importance of interdisciplinary management for combined periodontal-endodontic lesions with palatogingival grooves.

  • Although teeth with Grade III mobility are conventionally extracted, preservation of natural teeth should be prioritised in treatment.

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Funding

The study was supported by FMMU Science and technology development fund (2020JZ047) and FMMU Clinical Research Program (2021LC2223, 2021KYBJ01).

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Authors and Affiliations

  1. State Key Laboratory of Military Stomatology and National Clinical Research Centre for Oral Diseases and Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, 145 West Chang-le Road, Xi´an 710032, Shaanxi, People’s Republic Of China

    Tong Li, Wenxi He, Wenkai Jiang, Xiaoli Wang & Shengchao Wang

  2. The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, Department of Endodontics, School and Hospital of Stomatology, Wuhan University, 237 Luo-yu Road, Wuhan, 430079, Hubei, People’s Republic Of China

    Min Nie

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  1. Tong Li
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Contributions

Tong Li collected cases and wrote the article; Wenxi He, Wenkai Jiang, Xiaoli Wang and Min Nie provided guidance in treatment planning; Shengchao Wang supervised and made a final review of the article to be published.

Corresponding author

Correspondence to Shengchao Wang.

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The authors declare that there are no conflicts of interest.

Written informed consent was obtained from the participant for the publication of their details and images.

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Cite this article

Li, T., He, W., Jiang, W. et al. Interdisciplinary management of combined periodontal-endodontic lesions with palatogingival grooves of the maxillary lateral incisors: a case report. Br Dent J 234, 27–33 (2023). https://doi.org/10.1038/s41415-022-5370-8

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  • DOI: https://doi.org/10.1038/s41415-022-5370-8

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