Palatogingival Oluklarda Tanı ve Tedavi: Multidisipliner Yaklaşım
Özet
Bu bölüm, özellikle maksiller lateral kesici dişlerde lokalize periodontal yıkım, pulpal etkilenim ve kombine endodontik-periodontal lezyonlara zemin hazırlayabilen gelişimsel anatomik anomalilerden biri olan palatogingival oluklara güncel bir bakış sunmaktadır. Bölümde etiyopatogenez, oluğun derinliği ve uzanımına göre sınıflandırılması, klinik önemi ve doğru tanının gerekliliği ayrıntılı biçimde ele alınmaktadır. Özellikle konik ışınlı bilgisayarlı tomografinin (KIBT), oluk morfolojisinin belirlenmesi, eşlik eden kemik defektlerinin değerlendirilmesi ve komplike vakalarda tedavi planlamasının iyileştirilmesindeki rolü vurgulanmaktadır. Ayrıca konservatif oluk düzenlemesi ve kapatılmasından kök kanal tedavisine, rejeneratif periodontal uygulamalardan endodontik mikrocerrahiye ve seçilmiş ileri vakalarda kasıtlı reimplantasyona kadar güncel tedavi seçenekleri gözden geçirilmektedir. Bölüm, mevcut kanıt boşluklarını ve gelecekteki araştırma alanlarını da değerlendirerek başarılı tedavinin morfoloji temelli risk analizi, doğru görüntüleme ve endodonti ile periodontolojiyi birleştiren multidisipliner yaklaşımla mümkün olduğunu ortaya koymaktadır.
This chapter provides an up-to-date overview of palatogingival grooves. These are developmental anatomical anomalies that may predispose teeth, especially maxillary lateral incisors, to localised periodontal destruction, pulpal involvement and combined endodontic–periodontal lesions. It discusses current understanding of the aetiology and pathogenesis, classification according to groove depth and extension, and the clinical significance of accurate diagnosis. Particular focus is given to the role of cone-beam computed tomography (CBCT) in identifying groove morphology, evaluating associated bone defects and enhancing treatment planning in complex cases. The chapter also reviews contemporary treatment strategies, ranging from conservative groove sealing and root canal treatment to periodontal regenerative procedures and endodontic microsurgery. In selected severe cases, the option of intentional replantation is considered. Additionally, it highlights current evidence gaps and future research priorities. Overall, the chapter emphasises that successful management depends on morphology-based risk assessment, precise imaging, and a multidisciplinary approach integrating endodontic and periodontal perspectives.
Referanslar
Schwartz SA, Koch MA, Deas DE, Powell CA. Combined Endodontic-Periodontic Treatment of a Palatal Groove: A Case Report. J Endod. 2006 Jun 1;32(6):573–8.
Simon J, Glick D. Predictable endodontic and periodontic failures as a result of radicular anomalies. Oral Surg Oral Med Oral Patho. 31 (1971), pp. 823-826
Everett F. The disto‐lingual groove in the maxillary lateral incisor; a periodontal hazard. 1972 Jun ;43(6):352–61.
D.S. August The radicular lingual groove: an overlooked differential diagnosis. J Am Dent Assoc, 96 (1978), pp. 1037-1039
Kogon S L. The prevalence, location and conformation of palato‐radicular grooves in maxillary incisors. 1986 Apr;57(4):231–4.
Pecora J D. Study of the Incidence of Radicular Grooves in Maxillary. Braz Dent J. 1992;3(1):11-6.
Assaf M. The cingulo-radicular groove: its significance and management--two case report. https://pubmed.ncbi.nlm.nih.gov/1521267/
Aksoy U, Kermeoğlu F, Kalender A, Eren H, Kolsuz ME, Orhan K. Cone-beam computed tomography evaluation of palatogingival grooves: a retrospective study with literature review. Oral Radiology 2017 33:3. 2017 May 3;33(3):193–8.
Arslan H, Ertas ET, Topçuoǧlu HS, Şekerci AE, Atici MY, Ertas H, et al. Radicular grooves of maxillary anterior teeth in a Turkish population: A cone-beam computed tomographic study. Arch Oral Biol. 2014 Mar 1;59(3):297–301.
Kim HJ, Choi Y, Yu MK, Lee KW, Min KS. Recognition and management of palatogingival groove for tooth survival: a literature review. Restor Dent Endod. 2017;42(2):77.
Zhang R, Xiong J, Haapasalo M, Shen Y, Meng L. Palatogingival grooves associated with periodontal bone Loss of maxillary incisors in a Chinese population. Aust Endod J. 2022 Aug 1;48(2):313–21
Gu YC. A Micro–Computed Tomographic Analysis of Maxillary Lateral Incisors with Radicular Grooves. J Endod. 2011 Jun 1 ;37(6):789–92.
Withers JA, Brunsvold MA, Killoy WJ, Rahe AJ. The relationship of palato‐gingival grooves to localized periodontal disease. Wiley Online LibraryJA Withers, MA Brunsvold, WJ Killoy, AJ Rahe. Journal of Periodontology. 1981 Jan;52(1):41–4.
Mazzi-Chaves, GB Leoni, JS Oliveira, YTC Silva-Sousa, RG Silva, R Pauwels. Brazilian oral research, Braz Oral Res. 2022 Jan 14:36:e005.
Aljuailan AI, Aljuailan R, Gaikwad RN, Kolarkodi SH, Alamri NR. Prevalence of palatogingival groove affecting maxillary anterior teeth in Saudi subpopulation: A cone-beam computed tomographic study with literature review. Saudi Dent J. 2023 Dec 1;35(8):1039–47.
Lekshmi MS, Sharma S, Gupta SR, Sharma S, Kumar V, Chawla A, et al. Prevalence and radiological characteristics of palatogingival groove: A retrospective cone-beam computed tomography study in an Indian cohort. Journal of Conservative Dentistry. 2021 Jul 1;24(4):359–63.
Yildirim DP, Goker Kamali S. Prevalence of palatogingival groove and its association with periapical lesions and periodontal bone loss: a cone beam computed tomography study. BMC Oral Health. 2025 Dec 1;25(1).
Alkahtany SM, Alrwais F, Altamimi A, Bukhary SM, Mirdad A. The incidence of radicular groove on maxillary lateral incisors of Saudi population: CBCT evaluation. BMC Oral Health. 2022 Dec 1;22(1).
Li H, Tai Z, Dong J, Song Z. A classification of radicular grooves from the perspective of periodontology. BMC Oral Health 2025 25:1. 2025 Oct 6;25(1):1530-.
Leuke Bandara D, Gunasena C, Jayasinghe RD. Cone-beam CT evaluation of palato-gingival grooves and associated periodontal bone loss in maxillary anterior teeth: Evidence from a Sri Lankan cohort. Ceylon Journal of Science. 2026 Jan 5;55(1):55–61.
Sharma S, Deepak P, Vivek S, Dutta SR. Palatogingival Groove: Recognizing and Managing the Hidden Tract in a Maxillary Incisor: A Case Report. J Int Oral Health. 2015 Jun;7(6):110.
Pinheiro TN, Cintra LTA, Azuma MM, Benetti F, Silva CC, Consolaro A. Palatogingival groove and root canal instrumentation. Int Endod J. 2020 May;53(5):660–70.
Gaudex Y, Gandillot V, Fontanille I, Bouchard P, Kerner S, Carra MC. Palatal groove associated with periodontal lesions: a systematic review illustrated by a decisional tree for management. BMC Oral Health 2024 24:1. 2024 Sep 4;24(1):1037-.
Ansari I, Miglani S, Yadav V, Hasan S. Management of Palatogingival Groove in Maxillary Lateral Incisor: A Report of a Rare Case With a Brief Review of Literature. Cureus. 2023 Oct 4 ;15(10).
Ghahramani Y, Haghighi BS, Abbaszadegan A, Shahidi S. Cone-beam computed tomographic evaluation of radicular grooves in maxillary anterior teeth in a selected Iranian population. Iran Endod J. 2018;13(4):503–7.
Reddy R, Venkatesha G, Mohan KR, Fenn M, Gokulraj S, Appusamy K. A Three-Dimensional Assessment of a Type I Shallow Palatogingival Groove by Cone Beam Computed Tomography: A Case Report. Cureus. 2024 May 7;16(5):e59835.
Tan X, Zhang L, Zhou W, Li Y, Ning J, Chen X, et al. Palatal Radicular Groove Morphology of the Maxillary Incisors: A Case Series Report. J Endod. 2017 May 1;43(5):827–33.
Giner-Lluesma T, Micó-Muñoz P, Prada I, Micó-Martínez P, Collado-Castellanos N, Manzano-Saiz A, et al. Role of cone-beam computed tomography (CBCT) in diagnosis and treatment planning of two-rooted maxillary lateral incisor with palatogingival groove. Case report. J Clin Exp Dent. 2020;12(7): e704–7.
González OL, Salas Orozco MF, Marín NP, Abbott P V., Garcia-Font M, Sans FA. Prevalence of Palatal Grooves on Maxillary Anterior Teeth Using Cone-beam Computed Tomography: A Systematic Review and Meta-Analysis. J Endod. 2026 Jan 1.2026;52(1):14-23. e3.
Patel S, Brown J, Semper M, Abella F, Mannocci F. European Society of Endodontology position statement: Use of cone beam computed tomography in Endodontics: European Society of Endodontology (ESE) developed by: Int Endod J. 2019 Dec 1 ;52(12):1675–8.
Attam K, Tiwary R, Talwar S. Palatogingival groove: endodontic-periodontal management—case report. Journal of endodontics. J Endod. 2010 Oct;36(10):1717-20.
Anderegg CR, Metzler DG. Treatment of the Palato‐Gingival Groove with Guided Tissue Regeneration. Report of 10 Cases. J Periodontol 1993 Jan 1;64(1):72–4.
Johns D, Shivashankar V, Shobha K, Johns M. An innovative approach in the management of palatogingival groove using BiodentineTM and platelet-rich fibrin membrane. J Conserv Dent. 2014 Jan;17(1):75–9.
Yan H, Xu N, Wang H, Yu Q. Intentional Replantation with a 2-segment Restoration Method to Treat Severe Palatogingival Grooves in the Maxillary Lateral Incisor: A Report of 3 Cases. J Endod. 2019 Dec 1;45(12):1543–9.
Referanslar
Schwartz SA, Koch MA, Deas DE, Powell CA. Combined Endodontic-Periodontic Treatment of a Palatal Groove: A Case Report. J Endod. 2006 Jun 1;32(6):573–8.
Simon J, Glick D. Predictable endodontic and periodontic failures as a result of radicular anomalies. Oral Surg Oral Med Oral Patho. 31 (1971), pp. 823-826
Everett F. The disto‐lingual groove in the maxillary lateral incisor; a periodontal hazard. 1972 Jun ;43(6):352–61.
D.S. August The radicular lingual groove: an overlooked differential diagnosis. J Am Dent Assoc, 96 (1978), pp. 1037-1039
Kogon S L. The prevalence, location and conformation of palato‐radicular grooves in maxillary incisors. 1986 Apr;57(4):231–4.
Pecora J D. Study of the Incidence of Radicular Grooves in Maxillary. Braz Dent J. 1992;3(1):11-6.
Assaf M. The cingulo-radicular groove: its significance and management--two case report. https://pubmed.ncbi.nlm.nih.gov/1521267/
Aksoy U, Kermeoğlu F, Kalender A, Eren H, Kolsuz ME, Orhan K. Cone-beam computed tomography evaluation of palatogingival grooves: a retrospective study with literature review. Oral Radiology 2017 33:3. 2017 May 3;33(3):193–8.
Arslan H, Ertas ET, Topçuoǧlu HS, Şekerci AE, Atici MY, Ertas H, et al. Radicular grooves of maxillary anterior teeth in a Turkish population: A cone-beam computed tomographic study. Arch Oral Biol. 2014 Mar 1;59(3):297–301.
Kim HJ, Choi Y, Yu MK, Lee KW, Min KS. Recognition and management of palatogingival groove for tooth survival: a literature review. Restor Dent Endod. 2017;42(2):77.
Zhang R, Xiong J, Haapasalo M, Shen Y, Meng L. Palatogingival grooves associated with periodontal bone Loss of maxillary incisors in a Chinese population. Aust Endod J. 2022 Aug 1;48(2):313–21
Gu YC. A Micro–Computed Tomographic Analysis of Maxillary Lateral Incisors with Radicular Grooves. J Endod. 2011 Jun 1 ;37(6):789–92.
Withers JA, Brunsvold MA, Killoy WJ, Rahe AJ. The relationship of palato‐gingival grooves to localized periodontal disease. Wiley Online LibraryJA Withers, MA Brunsvold, WJ Killoy, AJ Rahe. Journal of Periodontology. 1981 Jan;52(1):41–4.
Mazzi-Chaves, GB Leoni, JS Oliveira, YTC Silva-Sousa, RG Silva, R Pauwels. Brazilian oral research, Braz Oral Res. 2022 Jan 14:36:e005.
Aljuailan AI, Aljuailan R, Gaikwad RN, Kolarkodi SH, Alamri NR. Prevalence of palatogingival groove affecting maxillary anterior teeth in Saudi subpopulation: A cone-beam computed tomographic study with literature review. Saudi Dent J. 2023 Dec 1;35(8):1039–47.
Lekshmi MS, Sharma S, Gupta SR, Sharma S, Kumar V, Chawla A, et al. Prevalence and radiological characteristics of palatogingival groove: A retrospective cone-beam computed tomography study in an Indian cohort. Journal of Conservative Dentistry. 2021 Jul 1;24(4):359–63.
Yildirim DP, Goker Kamali S. Prevalence of palatogingival groove and its association with periapical lesions and periodontal bone loss: a cone beam computed tomography study. BMC Oral Health. 2025 Dec 1;25(1).
Alkahtany SM, Alrwais F, Altamimi A, Bukhary SM, Mirdad A. The incidence of radicular groove on maxillary lateral incisors of Saudi population: CBCT evaluation. BMC Oral Health. 2022 Dec 1;22(1).
Li H, Tai Z, Dong J, Song Z. A classification of radicular grooves from the perspective of periodontology. BMC Oral Health 2025 25:1. 2025 Oct 6;25(1):1530-.
Leuke Bandara D, Gunasena C, Jayasinghe RD. Cone-beam CT evaluation of palato-gingival grooves and associated periodontal bone loss in maxillary anterior teeth: Evidence from a Sri Lankan cohort. Ceylon Journal of Science. 2026 Jan 5;55(1):55–61.
Sharma S, Deepak P, Vivek S, Dutta SR. Palatogingival Groove: Recognizing and Managing the Hidden Tract in a Maxillary Incisor: A Case Report. J Int Oral Health. 2015 Jun;7(6):110.
Pinheiro TN, Cintra LTA, Azuma MM, Benetti F, Silva CC, Consolaro A. Palatogingival groove and root canal instrumentation. Int Endod J. 2020 May;53(5):660–70.
Gaudex Y, Gandillot V, Fontanille I, Bouchard P, Kerner S, Carra MC. Palatal groove associated with periodontal lesions: a systematic review illustrated by a decisional tree for management. BMC Oral Health 2024 24:1. 2024 Sep 4;24(1):1037-.
Ansari I, Miglani S, Yadav V, Hasan S. Management of Palatogingival Groove in Maxillary Lateral Incisor: A Report of a Rare Case With a Brief Review of Literature. Cureus. 2023 Oct 4 ;15(10).
Ghahramani Y, Haghighi BS, Abbaszadegan A, Shahidi S. Cone-beam computed tomographic evaluation of radicular grooves in maxillary anterior teeth in a selected Iranian population. Iran Endod J. 2018;13(4):503–7.
Reddy R, Venkatesha G, Mohan KR, Fenn M, Gokulraj S, Appusamy K. A Three-Dimensional Assessment of a Type I Shallow Palatogingival Groove by Cone Beam Computed Tomography: A Case Report. Cureus. 2024 May 7;16(5):e59835.
Tan X, Zhang L, Zhou W, Li Y, Ning J, Chen X, et al. Palatal Radicular Groove Morphology of the Maxillary Incisors: A Case Series Report. J Endod. 2017 May 1;43(5):827–33.
Giner-Lluesma T, Micó-Muñoz P, Prada I, Micó-Martínez P, Collado-Castellanos N, Manzano-Saiz A, et al. Role of cone-beam computed tomography (CBCT) in diagnosis and treatment planning of two-rooted maxillary lateral incisor with palatogingival groove. Case report. J Clin Exp Dent. 2020;12(7): e704–7.
González OL, Salas Orozco MF, Marín NP, Abbott P V., Garcia-Font M, Sans FA. Prevalence of Palatal Grooves on Maxillary Anterior Teeth Using Cone-beam Computed Tomography: A Systematic Review and Meta-Analysis. J Endod. 2026 Jan 1.2026;52(1):14-23. e3.
Patel S, Brown J, Semper M, Abella F, Mannocci F. European Society of Endodontology position statement: Use of cone beam computed tomography in Endodontics: European Society of Endodontology (ESE) developed by: Int Endod J. 2019 Dec 1 ;52(12):1675–8.
Attam K, Tiwary R, Talwar S. Palatogingival groove: endodontic-periodontal management—case report. Journal of endodontics. J Endod. 2010 Oct;36(10):1717-20.
Anderegg CR, Metzler DG. Treatment of the Palato‐Gingival Groove with Guided Tissue Regeneration. Report of 10 Cases. J Periodontol 1993 Jan 1;64(1):72–4.
Johns D, Shivashankar V, Shobha K, Johns M. An innovative approach in the management of palatogingival groove using BiodentineTM and platelet-rich fibrin membrane. J Conserv Dent. 2014 Jan;17(1):75–9.
Yan H, Xu N, Wang H, Yu Q. Intentional Replantation with a 2-segment Restoration Method to Treat Severe Palatogingival Grooves in the Maxillary Lateral Incisor: A Report of 3 Cases. J Endod. 2019 Dec 1;45(12):1543–9.
