Cone-beam CT evaluation of palato-gingival grooves and associated periodontal bone loss in maxillary anterior teeth: Evidence from a Sri Lankan cohort

The palato-gingival groove (PGG) is a developmental anomaly that predisposes maxillary anterior teeth to localized periodontal and endodontic complications. Cone-beam computed tomography (CBCT) enables precise three-dimensional visualization of these grooves and their associated bone changes, overcoming the diagnostic limitations of conventional imaging. This study aimed to determine the prevalence, morphological characteristics, and periodontal bone loss associated with PGGs in maxillary anterior teeth using CBCT imaging in a Sri Lankan cohort. A retrospective review of 676 CBCT scans encompassing 4,021 maxillary anterior teeth was conducted, and each tooth was examined for the presence, location, and extent of PGGs as well as for associated periodontal and endodontic changes. Statistical analysis was performed using the Chi-square test with a significance level of p < .05. PGGs were identified in 11 teeth from nine individuals, corresponding to a prevalence of 1.33% at the patient level and 0.27% at the tooth level. Lateral incisors were most frequently affected (81.8%), predominantly on the mesial surface (72.7%). All grooves were of mild or moderate extent, with no complex types observed. Periodontal bone loss was evident in 81.8% of affected teeth, and one case showed combined endodontic involvement. A significant association was found between PGG presence and tooth type (p = 0.03), but not with sex or groove extent. Although uncommon, PGGs were strongly associated with localized periodontal bone loss detectable on CBCT. The mesial predominance and low prevalence observed suggest possible population-specific morphological patterns. These findings highlight CBCT as a valuable diagnostic tool for early identification of PGG-related bone defects and prevention of progressive periodontal destruction.