Skip to main content

Advertisement

SpringerLink
Log in

Imaging characteristics of enamel pearls on CBCT and their co-relation with supernumerary tooth

  • Original Article
  • Published:
Oral Radiology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Kupietzky A, Rozenfarb N. Enamel pearls in the primary dentition: report of two cases. ASDC J Dent Child. 1993;60:63–6.

    PubMed  Google Scholar 

  2. Risnes S, Segura JJ, Casado A, Jimenez-Rubio A. Enamel pearls and cervical enamel projections on 2 maxillary molars with localized periodontal disease: case report and histologic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;89:493–7.

    Article  Google Scholar 

  3. Saini T, Ogunleye A, Levering N, Norton NS, Edwards P. Multiple enamel pearls in two siblings detected by volumetric computed tomography. Dentomaxillofac Radiol. 2008;37:240–4.

    Article  Google Scholar 

  4. Versiani MA, Cristescu RC, Saquy PC, Ṕecora JD, de Sousa-Neto MD. Enamel pearls in permanent dentition: case report and micro-CT evaluation. Dentomaxillofac Radiol. 2013;42:20120332.

    Article  Google Scholar 

  5. Pederson P. The East Greenland Eskimo dentition. Numerical variations and anatomy. Medd Grönl. 1949;142:149–55.

    Google Scholar 

  6. Moskow BS, Canut PM. Studies on root enamel (2). Enamel pearls. A review of their morphology, localization, nomenclature, occurrence, classification, histogenesis and incidence. J Clin Periodontol. 1990;17:275–81.

    Article  Google Scholar 

  7. Darwazeh A, Hamasha AA. Radiographic evidence of enamel pearls in jordanian dental patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;89:255–8.

    Article  Google Scholar 

  8. Cavanha AO. Enamel pearls. Oral Surg Oral Med Oral Pathol. 1965;19:373–82.

    Article  Google Scholar 

  9. Risnes S. The prevalence, location, and size of enamel pearls on human molars. Scand J Dent Res. 1974;82:403–12.

    PubMed  Google Scholar 

  10. Kaugars GE. Internal enamel pearls: report of case. J Am Dent Assoc. 1983;107:941–3.

    Article  Google Scholar 

  11. White SC, Pharoah MJ. Dental Anomalies. In: White SC, Pharoah MJ, editors. Oral radiology principles and interpretation. Missouri: Elsevier Mosby; 2014. p. 582.

    Google Scholar 

  12. Rajab LD, Hamdan MAM. Supernumerary teeth: review of the literatüre and a survey of 152 cases. Int J Paediatr Dent. 2002;12:244–54.

    Article  Google Scholar 

  13. Díaz A, Orozco J, Fonseca M. Multiple hyperodontia: report of a case with 17 supernumerary teeth with non-syndromic association. Med Oral Patol Oral Cir Bucal. 2009;14:E229–31.

    PubMed  Google Scholar 

  14. Rao PV, Chidzonga MM. Supernumerary teeth: literature review. Cent Afr J Med. 2001;47:22–6.

    PubMed  Google Scholar 

  15. Chaudhry A, Sobti G. Imaging characteristics of Gubernacular Tract on CBCT- A pictorial review. Oral Radiol. 2021;37:355–65.

    Article  Google Scholar 

  16. Akgul N, Caglayan F, Durna N, Sumbullu MA, Akgul HM, Durna D. Evaluation of enamel pearls by cone-beam computed tomography (CBCT). Med Oral Patol Oral Cir Bucal. 2012;17:e218–22.

    Article  Google Scholar 

  17. Chrcanovic BR, Abreu MH, Custodio AL. Prevalence of enamel pearls in teeth from a human teeth bank. J Oral Sci. 2010;52:257–60.

    Article  Google Scholar 

  18. Sutalo J, Ciglar I, Njemirovskij V. Incidence of enamel pearls in our population. Acta Stomatol Croat. 1986;20:123–9.

    PubMed  Google Scholar 

  19. Goldstein AR. Enamel pearls as contributing factor in periodontal breakdown. J Am Dent Assoc. 1979;99:210–1.

    Article  Google Scholar 

  20. Loh HS. A local study on enamel pearls. Singapore Dent J. 1980;5:55–9.

    PubMed  Google Scholar 

  21. Garvey MT, Barry HJ, Blake M. Supernumerary teeth–an over view of classification, diagnosis and management. J Can Dent Assoc. 1999;65:612–6.

    PubMed  Google Scholar 

  22. Mahabob MN, Anbuselvan GJ, Kumar BS, Raja S, Kothari S. Pre valence rate of supernumerary teeth among non-syndromic South In dian population: an analysis. J Pharm Bioallied Sci. 2012;4:S373–5.

    Article  Google Scholar 

  23. Nishida I, Oda M, Tanaka T, Kito S, Seta Y, Yada N, et al. Detection and imaging characteristics of the gubernacular tract in children on cone beam and multidetector computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;120:e109–17.

    Article  Google Scholar 

  24. Oda M, Nishida I, Miyamoto I, Habu M, Yoshiga D, Kodama M, et al. Characteristics of the gubernaculum tracts in mesiodens and maxillary anterior teeth with delayed eruption on MDCT and CBCT. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016;122(4):511.

    Article  Google Scholar 

  25. Oda M, Nishida I, Miyamoto I, Saeki K, Tanaka T, Kito S, et al. Significance and usefulness of imaging characteristics of gubernaculum tracts for the diagnosis odontogenic tumors or cysts. PLoS ONE. 2018;13:e0199285.

    Article  Google Scholar 

  26. Skinner MA, Shiloah J. The role of enamel pearls in localized severe periodontitis. Quintessence Int. 1989;20:181–3.

    PubMed  Google Scholar 

  27. Lin HJ, Chan CP, Yang CY, Wu CT, Tsai YL, Huang CC, et al. Cemental tear: clinical characteristics and its predisposing factors. J Endod. 2011;37:611–8.

    Article  Google Scholar 

  28. Romeo U, Palaia G, Botti R, Nardi A, Del Vecchio A, Tenore G, et al. Enamel pearls as a predisposing factor to localized periodontitis. Quintessence Int. 2011;42:69–71.

    PubMed  Google Scholar 

  29. Pauwels R, Beinsberger J, Collaert B, Theodorakou C, Rogers J, Walker A, et al. Effective dose range for dental cone beam computed tomography scanners. Eur J Radiol. 2012;81:267–71.

    Article  Google Scholar 

  30. AAE/AAOMR. Use of cone-beam computed tomography in endodontics Joint Position Statement of the American Association of Endodontists and the American Academy of Oral and Maxillofacial Radiology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;111:234–7.

    Article  Google Scholar 

  31. Matthews DC, Tabesh M. Detection of localized tooth-related factors that predispose to periodontal infections. Periodontol. 2000;2004(34):136–50.

    Google Scholar 

Download references

Funding

Authors declare that there is no source of funding or financial interest.

Author information

Authors and Affiliations

  1. Oral and Maxillofacial Radiology, Faculty of Dentistry, University of Ondokuzmayis, Atakum, 55139, Samsun, Turkey

    Ayse Zeynep Zengin, Ayse Pinar Sumer & Gunay Ozturk

  2. Advanced Imaging Diagnostics, Private Practice, San Antonio, USA

    Marcel Noujeim

Authors
  1. Ayse Zeynep Zengin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ayse Pinar Sumer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gunay Ozturk
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marcel Noujeim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ayse Zeynep Zengin.

Ethics declarations

Conflict of interest

Authors declare that there is no conflict of interest.

Ethics

This study was reviewed and approved by the Institutional Review Board of the University (OMU KAEK 2020/591). All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).

Informed consent

Informed consent was obtained from all patients for being included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zengin, A.Z., Sumer, A.P., Ozturk, G. et al. Imaging characteristics of enamel pearls on CBCT and their co-relation with supernumerary tooth. Oral Radiol 38, 370–377 (2022). https://doi.org/10.1007/s11282-021-00567-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11282-021-00567-x

Keywords

Search

Navigation