Interdisciplinary approach for diagnosis and management of the tooth with type III palatogingival groove

Abstract

Palatogingival grooves (PGGs) are developmental anomalies well known for causing endodontic and periodontal diseases to the teeth that have no evidence of caries or trauma. It is a rare developmental defect that frequently exhibits the palatal aspect of maxillary anterior teeth. The aim of this case report is to diagnose PGG using cone-beam computed tomography (CBCT) and manage it with an interdisciplinary approach by endodontic and periodontic intervention. A 20-year-old healthy female patient came with a chief complaint of foul smell and discharge of pus from the gum region. During clinical examination, a sinus opening and deep periodontal pocket were noticed with respect to the maxillary left lateral incisor. The tooth showed mild tenderness to percussion and a negative response to thermal and electric pulp testing. The intraoral periapical radiograph showed a vertical radiolucent line with periapical radiolucency, giving suspicion of PGG, which was confirmed by CBCT investigation. The diagnosis of pulp necrosis with chronic periapical abscess was made. After root canal treatment, surgical intervention was done and sealed the groove with Biodentine. This case report shows the successful outcome of a tooth associated with PGG after a 9-month follow-up. The tooth associated with this anomaly can be correctly diagnosed and planned with CBCT, and successfully treated using an interdisciplinary approach with a bioactive restorative material.