AIM: To present the rare localization of a radicular groove on the buccal aspect of a tooth and to discuss the pathology and management of the concomitant endo-periodontal defect. SUMMARY: Bilateral buccal radicular grooves were found on the maxillary central incisors of a 60-year-old female Caucasian. One groove was associated with deep local pocketing resulting in pulp necrosis and the formation of a periodontal-endodontic lesion. After endodontic treatment of the affected tooth, periodontal surgery was performed during which an apicoectomy was carried out on the root-filled tooth. Both the buccal grooves were removed by grinding, the roots were planed with curettes and a guided-tissue regeneration technique applied using amelogenin (Emdogain, Biora, Sweden). Following a period of 2 years, re-examination showed excellent healing with the complete elimination of the periodontal pocket on both incisors and significant radiographic evidence of bone regeneration. KEY LEARNING POINTS: Deep radicular grooves can predispose to pulp necrosis and the establishment of combined periodontal-endodontic lesions. Evaluation of clinical signs and appropriate diagnostic tests are of paramount importance in order to prevent incorrect diagnosis and treatment. Endodontists must be capable of performing advanced periodontal regeneration techniques during endodontic surgery.
AIM: To present the rare localization of a radicular groove on the buccal aspect of a tooth and to discuss the pathology and management of the concomitant endo-periodontal defect. SUMMARY: Bilateral buccal radicular grooves were found on the maxillary central incisors of a 60-year-old female Caucasian. One groove was associated with deep local pocketing resulting in pulp necrosis and the formation of a periodontal-endodontic lesion. After endodontic treatment of the affected tooth, periodontal surgery was performed during which an apicoectomy was carried out on the root-filled tooth. Both the buccal grooves were removed by grinding, the roots were planed with curettes and a guided-tissue regeneration technique applied using amelogenin (Emdogain, Biora, Sweden). Following a period of 2 years, re-examination showed excellent healing with the complete elimination of the periodontal pocket on both incisors and significant radiographic evidence of bone regeneration. KEY LEARNING POINTS: Deep radicular grooves can predispose to pulp necrosis and the establishment of combined periodontal-endodontic lesions. Evaluation of clinical signs and appropriate diagnostic tests are of paramount importance in order to prevent incorrect diagnosis and treatment. Endodontists must be capable of performing advanced periodontal regeneration techniques during endodontic surgery.