Groove associated periodontitis: classification proposal and clinical. Case report.
The presence of a palatoradicular groove (PRG), more frequently observed at the level of the upper lateral incisors, may compromise both the radicular pulp and the periodontium leading to endodontic-periodontal lesions. Frequently, the prognosis of these elements is compromised because of the missed diagnosis or because of the complex therapeutic approach that is necessary to cure the associated pathologies. A histopathological and clinical classification is proposed showing according to the degree of the affected tooth involvement. Preventive measures are also discussed and a clinical case is reported. A 49-year-old woman presented with a PRG at the superior left lateral incisor, endodontically treated years before, associated with probing pocket depths of 10 mm and 7 mm, clinical attachment loss of 11 mm and first degree mobility. The tooth was treated with splinting, periodontal surgery with radiculoplasty, root surface conditioning, guided tissue regeneration and with a prosthetic crown for esthetic rehabilitation. Six years later, the operated site showed probing pocket depths of 3 mm, gains in clinical attachment level of 4 mm and 7 mm and reduction of tooth mobility. The ceramic crown re-established an acceptable esthetics for the patient. Even in the presence of a 3(rd) degree PRG, according to the classification presented, the prognosis of the tooth may be positive through the association of root canal treatment, periodontal and prosthetic therapy. The classification presented shows the clinician the best therapeutic approach.