enamel pearl

Definition: An "enamel pearl" is an ectopic globule of enamel that is adherent to the tooth root surface. Such an anomaly may facilitate the progression of periodontal breakdown.

Information on the prevalence of enamel pearls is sparse, and ethnic variations are thought to occur.

The pathogenesis of ectopic enamel formation is not known.

The radiographic presentation of enamel pearls and its clinical significance is also discussed.

The observation of multiple enamel pearls in siblings raises the possibility of a hereditary association in the formation of enamel pearls.

Internal enamel pearl formation may be a continuation of formation of external enamel pearl.

Enamel pearls are detected in 4.76% of the subjects and on 1.6% of the molars. No significant difference between sexes was observed. First molar teeth were the most commonly affected, whereas the third molars were the least affected with the condition.

A histological resemblance between the tissues of the enamel pearls and those of the carrier teeth was found. The resemblance was more pronounced in larger pearls, which showed a variability of the enamel microhardness and structure in the occlusal-cervical direction typical of the tooth crown. (7783004)

Large pearls also exhibite a root and a pulp. (7783004)

Some histological features of the enamel pearls were probably caused by pressures exerted on the developing pearl by its surroundings. (7783004)

It is suggested that the histogenesis of small and large pearls is based on the ability of the developing root of the carrier tooth to behave in part as a new tooth germ. (7783004)

References

 Multiple enamel pearls in two siblings detected by volumetric computed tomography. Saini T, Ogunleye A, Levering N, Norton NS, Edwards P. Dentomaxillofac Radiol. 2008 May;37(4):240-4. PMID: 18460580

 An association of external and internal enamel pearls. Mahajan S, Charan CR. Indian J Dent Res. 2005 Jan-Mar;16(1):17-8.PMID: 16375232

 Radiographic evidence of enamel pearls in jordanian dental patients. Darwazeh A, Hamasha AA. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000 Feb;89(2):255-8. PMID: 10673666

 Enamel microhardness and histological features of composite enamel pearls of different size. Gaspersic D. J Oral Pathol Med. 1995 Apr;24(4):153-8. PMID: 7783004

 Enamel pearls in the primary dentition: report of two cases. Kupietzky A, Rozenfarb N. ASDC J Dent Child. 1993 Jan-Feb;60(1):63-6.PMID: 8432951

 Ectopic tooth enamel. An SEM study of the structure of enamel in enamel pearls. Risnes S. Adv Dent Res. 1989 Sep;3(2):258-64. PMID: 2640436