Cervical Enamel Projections and Enamel Pearls in a Collection of Australian Extracted Molars

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Dimitra Lekkas
Grant Townsend


Cervical enamel pearls (CEPs) and enamel pearls (EPs) are generally located on permanent molars. They are detected less frequently in Caucasian than in Mongoloid teeth. No data are available documenting these features in teeth collected in Australia. The aim of this study was to determine the frequency and degree of expression of CEPs and EPs in a large sample of Caucasian deciduous and permanent extracted dried molars. The molars were scored for CEPs and EPs. Scoring of CEPs was based on the classification system of Zee et al. (1991). Genuine CEPs were observed in 19.1% of the 282 deciduous molars and 44.0% of 2827 permanent molars examined. In deciduous molars, CEPs were regularly seen on the lingual surface of mandibular second molars, with the Grade I type being most common. In permanent molars, CEPs were generally seen on the buccal surface of mandibular second molars, with the Grade III being the most frequent. External composite EPs were observed in 1.1% of deciduous molars and 3.3% of permanent molars being examined. EPs in permanent molars were frequently detected in maxillary third molars on the distal or mesial surfaces. The results obtained in this study are in broad agreement with previous investigations of Caucasian extracted molars. However, we noted a higher frequency of CEPs in permanent molars than did other studies and found that the Grade III type of CEP occurred most frequently. A modification is proposed to the Zee et al. (1991) scoring system: inclusion of Grade IIIc being a CEP consisting of droplets of enamel streaming toward the furcation. CEPs and EPs are of clinical importance, as they have been implicated as contributing factors in localized periodontal lesions.