Management of a deep palatogingival groove using Guided Tissue Regeneration

Palatoradicular groove is a developmental anomaly which has been implicated as an initiating factor in localized gingivitis and periodontitis. Palatal radicular groove or radicular lingual groove represents an infolding of the enamel organ and epithelial sheath of hertwig. Groove is a locus for plaque accumulation, which destroys sulcular epithelium and later deeper parts of periodontium, finally resulting in formation of severe localized periodontal defect. A 28 year old male patient presented to department of periodontics and oral implantology with chief complaint of forwardly placed and mobile tooth with bleeding gums in left upper front region. On examination a groove running from cingulum towards root was found on the palatal aspect of 22. Probing depth was 8mm in mid palatal region. Radiographically, extensive bone loss was present. After completion of non-surgical therapy, flap reflection was done. Scaling and debridement was done followed by restoration with glass inomer cement. Guided tissue regeneration was placed over localized bone defect and flaps were approximated and sutured. Keywords: developmental anomaly, palatal groove, GTR membrane, localized periodontitis