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Kim HJ, Kim SY. Cervical enamel projections from a periodontal perspective: A scoping review. Clin Anat 2024; 37:353-365. [PMID: 38348736 DOI: 10.1002/ca.24141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/16/2023] [Accepted: 01/29/2024] [Indexed: 03/16/2024]
Abstract
Cervical enamel projections (CEPs) represent a unique developmental and anatomical anomaly wherein the enamel structure extends apically beyond the cemento-enamel junction of the tooth. In this scoping review, the existing literature on CEPs was evaluated to delineate their characteristics, prevalence, predilection for specific teeth and surfaces, clinical significance, and management approaches. Searches were conducted on MEDLINE (PubMed), Cochrane Library, and Embase databases using the keywords "enamel projection(s)" or "ectopic enamel." In total, 24 studies meeting inclusion criteria were included in the review. The prevalence of CEPs varied widely (8.3%-85.1%), predominantly manifesting as grade I or grade III. Mandibular first and second molars exhibited a higher incidence of CEPs, with a notable predilection for buccal surfaces. The consensus in most studies was that CEPs are associated with localized periodontal diseases. Recommendations inclined toward the removal of ectopic enamel during periodontal surgery to enhance periodontal attachment formation. However, decision-making should involve careful consideration of the benefits and drawbacks based on individual circumstances.
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Affiliation(s)
- Hyun Ju Kim
- Department of Periodontics, Seoul National University Dental Hospital, Seoul, Republic of Korea
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Sun-Young Kim
- Department of Conservative Dentistry and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
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Kurosaka H, Yamamoto S, Hirasawa K, Yanagishita T, Fujioka K, Yagasaki H, Nagata M, Ishihara Y, Yonei A, Asano Y, Nagata N, Tsujimoto T, Inubushi T, Yamamoto T, Sakai N, Yamashiro T. Craniofacial and dental characteristics of three Japanese individuals with genetically diagnosed SATB2-associated syndrome. Am J Med Genet A 2023. [PMID: 37141439 DOI: 10.1002/ajmg.a.63225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 04/12/2023] [Accepted: 04/20/2023] [Indexed: 05/06/2023]
Abstract
Craniofacial defects are one of the most frequent phenotypes in syndromic diseases. More than 30% of syndromic diseases are associated with craniofacial defects, which are important for the precise diagnosis of systemic diseases. Special AT-rich sequence-binding protein 2 (SATB2)-associated syndrome (SAS) is a rare syndromic disease associated with a wide variety of phenotypes, including intellectual disability and craniofacial defects. Among them, dental anomalies are the most frequently observed phenotype and thus becomes an important diagnostic criterion for SAS. In this report, we demonstrate three Japanese cases of genetically diagnosed SAS with detailed craniofacial phenotypes. The cases showed multiple dental problems, which have been previously reported to be linked to SAS, including abnormal crown morphologies and pulp stones. One case showed a characteristic enamel pearl at the root furcation. These phenotypes add new insights for differentiating SAS from other disorders.
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Affiliation(s)
- Hiroshi Kurosaka
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Sayuri Yamamoto
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Kyoko Hirasawa
- Department of Pediatrics, Tokyo Women's Medical University, Tokyo, Japan
| | - Tomoe Yanagishita
- Institute of Medical Genetics, Tokyo Women's Medical University, Tokyo, Japan
| | - Kaoru Fujioka
- Department of Pediatrics, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Hideaki Yagasaki
- Department of Pediatrics, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Miho Nagata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yasuki Ishihara
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Ayumi Yonei
- Department of Genetic Counseling Osaka University Hospital, Osaka, Japan
| | - Yoshihiro Asano
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Namiki Nagata
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Takayuki Tsujimoto
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Toshihiro Inubushi
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Toshiyuki Yamamoto
- Institute of Medical Genetics, Tokyo Women's Medical University, Tokyo, Japan
| | - Norio Sakai
- Department of Genetic Counseling Osaka University Hospital, Osaka, Japan
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Health Science, Child Healthcare and Genetic Science, Osaka University Graduate School of Medicine, Suita, Japan
| | - Takashi Yamashiro
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Suita, Japan
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Madi M, Elakel A, Aly N, Al Mansour R, Al Mansour A, Zakaria O. Assessment of Mandibular Molar Root Morphology Using Cone‑Beam Computed Tomography in Periodontitis Patients From Eastern Province: A Cross-Sectional Study. Cureus 2021; 13:e20804. [PMID: 35111476 PMCID: PMC8794416 DOI: 10.7759/cureus.20804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2021] [Indexed: 11/05/2022] Open
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Zengin AZ, Sumer AP, Ozturk G, Noujeim M. Imaging characteristics of enamel pearls on CBCT and their co-relation with supernumerary tooth. Oral Radiol 2021; 38:370-377. [PMID: 34609699 DOI: 10.1007/s11282-021-00567-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 09/08/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Enamel pearl (EP) is an ectopic growth of enamel that is generally round and white and it firmly adheres to the external root surface of tooth. The aim of this study was to assess the prevalence and imaging features of enamel pearls (EPs) and to investigate the potential relationship between EP and supernumerary tooth. METHODS Cone beam computed tomography (CBCT) images of 1003 patients were evaluated for the presence of EP. Descriptive characteristics of gender and age of patients and imaging features of EPs and presence of supernumerary tooth were recorded. RESULTS In this study, 72 EPs were radiographically detected in 63 molars in 43 patients, with a person prevalence of 4.29% and tooth prevalence of 0.71%. Most of the EPs (95.83%) were detected in maxillary molars especially in third (n = 42, 58.33%) and second molars (n = 18, 25%). They were more frequently located at mesial (n: = 21; 29.16%); distal (n = 16; 22.22%) proximal surface of roots and the furcation between the disto-buccal and the palatal roots (n = 12; 16.67%) respectively. CBCT images of 109 (10.87%) patients showed supernumerary tooth/teeth and 13 of these also presented EP. A statistical significant relationship between supernumerary tooth and EP was found (p = 0.001). Additionally, CBCT images of four EPs showed corticated hypodens tracts similar to gubernaculum dentis (GD). CONCLUSIONS Clinicians and radiologists should be aware that EPs are most frequently observed in maxilla especially in third and second molars. Presence of supernumerary tooth might be associated with higher presence of EPs.
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Affiliation(s)
- Ayse Zeynep Zengin
- Oral and Maxillofacial Radiology, Faculty of Dentistry, University of Ondokuzmayis, Atakum, 55139, Samsun, Turkey.
| | - Ayse Pinar Sumer
- Oral and Maxillofacial Radiology, Faculty of Dentistry, University of Ondokuzmayis, Atakum, 55139, Samsun, Turkey
| | - Gunay Ozturk
- Oral and Maxillofacial Radiology, Faculty of Dentistry, University of Ondokuzmayis, Atakum, 55139, Samsun, Turkey
| | - Marcel Noujeim
- Advanced Imaging Diagnostics, Private Practice, San Antonio, USA
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Enamel pearls: Their occurrence in recent human populations and earliest manifestation in the modern human lineage. Arch Oral Biol 2019; 101:147-155. [PMID: 30939297 DOI: 10.1016/j.archoralbio.2019.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 02/22/2019] [Accepted: 03/04/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To document and describe the occurrence of an enamel pearl on the distal root surface of the maxillary M3 of the fossil hominin specimen from Florisbad, South Africa that is dated to ca. 259,000 years B.P., and is an early representative of Homo sapiens or as a member of the evolutionary line that was directly ancestral to modern humans. DESIGN The molar was examined macroscopically and by micro-computed tomography (μCT) to enable accurate measurement and visualization of the structure of the enamel pearl. RESULTS The single pearl has a diameter of 0.97 mm; it is a Type 2 "composite" pearl comprising an enamel cap and dentine core without pulp chamber involvement. The size of the Florisbad pearl falls within or just below the size ranges of this anomaly in modern human samples. Type 2 pearls are most commonly encountered in recent human populations, and the location of the pearl on the distal root surface of the Florisbad M3 is consistent with its most frequent location in recent humans. Pearls in recent human populations affect between 0.2-4.8% of individuals, and 1.7-6.8% of permanent molars. Pearls have been documented in several prehistoric human dentitions, and all examples are less than 4000 years old. CONCLUSIONS Enamel pearls have been associated with periodontal disease, but it is not possible to relate its presence to the advanced periodontal inflammation and alveolar bone loss in the Florisbad fossil. Florisbad presents the earliest evidence of this anomaly in the fossil record pertaining to modern humans.
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Enamel Pearls Implications on Periodontal Disease. Case Rep Dent 2015; 2015:236462. [PMID: 26491574 PMCID: PMC4600495 DOI: 10.1155/2015/236462] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Revised: 08/24/2015] [Accepted: 08/26/2015] [Indexed: 11/17/2022] Open
Abstract
Dental anatomy is quite complex and diverse factors must be taken into account in its analysis. Teeth with anatomical variations present an increase in the rate of severity periodontal tissue destruction and therefore a higher risk of developing periodontal disease. In this context, this paper reviews the literature regarding enamel pearls and their implications in the development of severe localized periodontal disease as well as in the prognosis of periodontal therapy. Radiographic examination of a patient complaining of pain in the right side of the mandible revealed the presence of a radiopaque structure around the cervical region of lower right first premolar. Periodontal examination revealed extensive bone loss since probing depths ranged from 7.0 mm to 9.0 mm and additionally intense bleeding and suppuration. Surgical exploration detected the presence of an enamel pearl, which was removed. Assessment of the remaining supporting tissues led to the extraction of tooth 44. Local factors such as enamel pearls can lead to inadequate removal of the subgingival biofilm, thus favoring the establishment and progression of periodontal diseases.
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Castro-Silva II, Azevedo FLD, Otero D. Pérola de esmalte: epidemiologia, morfopatogênese e relevância na clínica odontológica. REVISTA DE ODONTOLOGIA DA UNESP 2013. [DOI: 10.1590/s1807-25772013000300012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUÇÃO: Distúrbios da odontogênese geram anomalias dentárias com relevância diagnóstica e terapêutica. OBJETIVO: O presente artigo teve como objetivos fazer uma revisão sistemática sobre a pérola de esmalte e discutir seu processo formativo, bem como a sua significância na clínica odontológica. MATERIAL E MÉTODO: Três bancos de dados eletrônicos (Pubmed, Cochrane e Biblioteca Virtual em Saúde) foram usados para recuperar artigos científicos dos últimos 30 anos, usando o descritor enamel pearls. RESULTADO: O Brasil ocupa posição de destaque nas publicações temáticas existentes (18%). A etiopatogênese desta anomalia ainda permanece obscura, sendo necessários mais estudos acerca da contribuição de fatores envolvidos com amelogênese ectópica e cementogênese deficiente in situ. Dados epidemiológicos apontam uma frequência variável na população brasileira (0,8 a 8%) e mundial (0,2 a 6,2%), sendo os molares os dentes mais acometidos. Análise morfológica das pérolas de esmalte mostra que esta anomalia de forma e volume pode ser de dois tipos: simples (pérola verdadeira externa ou interna) ou composta (esmalte-dentina ou esmalte-dentina-polpa). É importante o diagnóstico clínico-radiológico diferencial de pérolas de esmalte para permitir o tratamento odontológico adequado, que inclui a ameloplastia como conduta eficaz para minimizar o acúmulo de biofilme oral e a exarcerbação da doença periodontal. CONCLUSÃO: Faz-se necessária a publicação de pesquisas pormenorizadas sobre pérolas de esmalte, a fim de gerar evidências científicas no fazer profissional da Odontologia.
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Versiani MA, Cristescu RC, Saquy PC, Pécora JD, de Sousa-Neto MD. Enamel pearls in permanent dentition: case report and micro-CT evaluation. Dentomaxillofac Radiol 2013; 42:20120332. [PMID: 23520396 DOI: 10.1259/dmfr.20120332] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To investigate the frequency, position, number and morphology of enamel pearls (EPs) using micro-CT (µCT) and to report a case of an EP mimicking an endodontic-periodontic 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 µCT. 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 ± 0.85 mm, 1.76 ± 1.36 mm³ and 11.40 ± 7.59 mm², 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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Affiliation(s)
- M A Versiani
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, Ribeirão Preto, Brasil
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Akgül N, Caglayan F, Durna N, Sümbüllü MA, Akgül HM, Durna D. Evaluation of enamel pearls by cone-beam computed tomography (CBCT). Med Oral Patol Oral Cir Bucal 2012; 17:e218-22. [PMID: 22143707 PMCID: PMC3448323 DOI: 10.4317/medoral.17475] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Accepted: 05/12/2011] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the frequency of enamel pearls according to population, sex and tooth groups on Cone-Beam Computed Tomography (CBCT) or Dental Volumetric Tomography (DVT) scans of patients, retrospectively. STUDY DESIGN In this study, 15185 teeth belonging to 768 patients, 430 female and 338 male, was performed cross-sectional examination by CBCT. The volumetric Computed Tomography used in the study is Newton FP based on flat-panel. The data were analyzed with Pearson chi-squared test. RESULTS Enamel pearls were detected in 36 subjects (4.69%). Of these enamel pearls, 19 were detected in male and 17 were in male. There was no statistically a significant association between prevalence of enamel pearls and sex. All of enamel pearls were detected in molar teeth, for prevalence 0.83%. CONCLUSION All of enamel pearls are found upper and lower molar teeth, especially the most commonly in maxillary second and third molars.
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Affiliation(s)
- N Akgül
- Department of Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Atatürk University, Erzurum, 25240, Turkey.
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Jekl V, Krejcirova L, Buchtova M, Knotek Z. Effect of high phosphorus diet on tooth microstructure of rodent incisors. Bone 2011; 49:479-84. [PMID: 21571111 DOI: 10.1016/j.bone.2011.04.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2011] [Revised: 04/05/2011] [Accepted: 04/26/2011] [Indexed: 01/02/2023]
Abstract
Enamel hypoplasia and disruption of dentinogenesis are the most common abnormalities of development and mineralization of human teeth. Several reports are available in the literature on the influence of dietary calcium on the formation of human and rodent tooth; however, the information about the influence of dietary phosphorus on the tooth formation is scarce. The aim of the present investigation was to examine the chronic effect of high phosphorus diet and improper dietary calcium to phosphorus ratio on the mandibular incisor microstructure in a hystricomorph rodent--Octodon degu--using macroscopic observation, histopathological examination, transmission and scanning electron microscopy. The present study shows that enamel and dentin development is disturbed under high phosphorus diet and improper calcium to phosphorus ratio. Disturbed mineral metabolism resulted in enamel depigmentation, enamel hypoplasia, enamel pitting and altered dentin morphology. The results suggest that more attention should be focused on dietary phosphorus content when facing altered tooth structure in young patients with deciduous or permanent dentition. Furthermore, we showed that degus can be used as an experimental animal model for the study of the developmental teeth disturbances.
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Affiliation(s)
- Vladimir Jekl
- Avian and Exotic Animal Clinic, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic.
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Chrcanovic BR, Abreu MHNG, Custódio ALN. Prevalence of enamel pearls in teeth from a human teeth bank. J Oral Sci 2010; 52:257-60. [PMID: 20587950 DOI: 10.2334/josnusd.52.257] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Enamel pearls are anatomical structures that can bring about clinical implications if associated with the retention of plaque, in turn resulting in periodontal disease. In an attempt to avoid periodontal disease, the removal and treatment of these enamel pearls, may be a necessity in some circumstances. A total of 45,785 extracted teeth from a human teeth bank were analyzed for the presence of enamel pearls. The most prevalent anatomical location of enamel pearls was the permanent maxillary first and second molar region. An association between the prevalence of enamel pearls and dental class (P < 0.001) was observed, most frequently in the maxillary molars. In the maxillary molars, the most prevalent anatomical location of enamel pearls in the first and second molars was the furcation between the distobuccal and palatal roots. Enamel pearls are a common observation in molars in general, but are most commonly found in maxillary molars.
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Affiliation(s)
- Bruno R Chrcanovic
- Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Borizonte, MG, Brazil.
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Chan HL, Oh TJ, Bashutski J, Fu JH, Wang HL. Cervical enamel projections in unusual locations: a case report and mini-review. J Periodontol 2010; 81:789-95. [PMID: 20429658 DOI: 10.1902/jop.2010.090654] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Periodontitis is primarily a bacteria-induced disease that can be modified by tooth-related local factors. Cervical enamel projections (CEPs) are a common tooth anomaly that can act as contributing factors in the development of periodontitis. They are most commonly found at the buccal surfaces of mandibular molars. METHODS A 57-year-old female was referred to our clinic for treatment of chronic periodontitis. A clinical examination revealed moderate attachment loss that was localized to the palatal side of the maxillary second molars. The rest of the dentition was less affected, with a diagnosis of generalized slight chronic periodontitis. An initial non-surgical periodontal treatment was provided followed by apically positioned flap surgery in the maxillary right and left posterior areas. At the time of surgery, CEPs were found where the periodontium was most affected. RESULTS Because surgical intervention exposed the CEPs, they were not removed. After the active therapy, which resulted in inflammation resolution and maintainable probing depths, the patient was placed on a 3-month recall for periodontal maintenance. CONCLUSIONS CEPs were found in an unusual location on the palatal roots of maxillary second molars. The findings of this case report confirm the role of CEPs as a local contributing factor in localized chronic periodontitis.
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Affiliation(s)
- Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
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Chan HL, Oh TJ, Bashutski J, Fu JH, Wang HL. Cervical enamel projections in unusual locations: A case report and mini-review. J Periodontol 2010:1-11. [PMID: 20450356 DOI: 10.1902/jop.2009.090654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Periodontitis is primarily a bacteria-induced disease that can be modified by tooth-related local factors. Cervical enamel projections (CEPs) are a common tooth anomaly that can act as a contributing factor in the development of periodontitis. They are most commonly found at the buccal surfaces of mandibular molars. Methods: A 57-year-old female was referred to our clinic for treatment of chronic periodontitis. Clinical examination revealed moderate attachment loss that was localized to the palatal side of the maxillary secondary molars. The rest of the dentition was less affected, with a diagnosis of generalized slight chronic periodontitis. Initial non-surgical periodontal treatment was provided, followed by apically positioned flap surgery in the maxillary right and left posterior areas. At the time of surgery, CEPs were found where the periodontium was most affected. Results: Due to the fact that surgical intervention exposed the CEPs, they were not removed. After the active therapy, which resulted in inflammation resolution and maintainable probing depth, the patient was placed on a three-month recall for periodontal maintenance. Conclusions: This case report presents CEPs in an unusual location in the palatal roots of maxillary secondary molars. CEPs confirm their role as a local contributing factor in localized chronic periodontitis.
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Affiliation(s)
- Hsun-Liang Chan
- Resident, Graduate Periodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
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Bosshardt DD, Nanci A. Immunocytochemical characterization of ectopic enamel deposits and cementicles in human teeth. Eur J Oral Sci 2003; 111:51-9. [PMID: 12558808 DOI: 10.1034/j.1600-0722.2003.00015.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Despite the relative frequency and clinical relevance of radicular enamel deposits and cementicles, their etiology and nature are unknown. The purpose of the present study was therefore to evaluate the presence and distribution of mineralization-associated non-collagenous matrix proteins (NCPs) in various types of root-associated ectopic mineralizations. Human teeth were processed for embedding in epoxy or acrylic resins. Tissue sections were incubated with antibodies to amelogenins (AMEL), bone sialoprotein (BSP), and osteopontin (OPN). Radicular enamel deposits contained residual organic matrix that labeled for AMEL. In contrast, BSP and OPN were not detected in the residual enamel matrix, they were found in the cementum deposited on its surface as well as in collagen-free cementicle-like structures in the adjacent periodontal ligament. True cementicles consisted of a collagenous matrix intermixed with a non-collagenous ground substance. Labeling for BSP and OPN was mainly associated with the interfibrillar ground substance. No immunoreactivity for AMEL was detected in cementicles. These data indicate that ectopic enamel deposits on the root retain a high amount of AMEL, whereas cementicles contain BSP and OPN, two NCPs typically found in bone and cementum. These NCPs may, like in their normal tissue counterparts, play a role in the mineralization process.
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Affiliation(s)
- Dieter D Bosshardt
- Department of Periodontology and Fixed Prosthodontics, School of Dental Medicine, University of Berne, Berne, Switzerland.
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