title: Cervical enamel projections in unusual locations: a case report and mini-review.
abstract: BACKGROUND
  Periodontitis is primarily a bacteria-induced disease that can be modified by tooth-related local factors. Cervical enamel projections (CEPs) are a common tooth anomaly that can act as contributing factors in the development of periodontitis. They are most commonly found at the buccal surfaces of mandibular molars.
  
  
  METHODS
  A 57-year-old female was referred to our clinic for treatment of chronic periodontitis. A clinical examination revealed moderate attachment loss that was localized to the palatal side of the maxillary second molars. The rest of the dentition was less affected, with a diagnosis of generalized slight chronic periodontitis. An initial non-surgical periodontal treatment was provided followed by apically positioned flap surgery in the maxillary right and left posterior areas. At the time of surgery, CEPs were found where the periodontium was most affected.
  
  
  RESULTS
  Because surgical intervention exposed the CEPs, they were not removed. After the active therapy, which resulted in inflammation resolution and maintainable probing depths, the patient was placed on a 3-month recall for periodontal maintenance.
  
  
  CONCLUSIONS
  CEPs were found in an unusual location on the palatal roots of maxillary second molars. The findings of this case report confirm the role of CEPs as a local contributing factor in localized chronic periodontitis.
authors.affiliation: Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Hsun-Liang
authors.initials: HL
authors.lastname: Chan
authors.forename: Tae-Ju
authors.initials: TJ
authors.lastname: Oh
authors.forename: Jill
authors.initials: J
authors.lastname: Bashutski
authors.forename: Jia-Hui
authors.initials: JH
authors.lastname: Fu
authors.forename: Hom-Lay
authors.initials: HL
authors.lastname: Wang
mesh_terms: D055113:Chronic Periodontitis / Q000209:etiology*; D003743:Dental Enamel / Q000002:abnormalities*; D012534:Dental Scaling; D005260:Female; D005889:Gingival Recession / Q000209:etiology; D006801:Humans; D008437:Maxilla; D008875:Middle Aged; D008963:Molar / Q000002:abnormalities*; D017622:Periodontal Attachment Loss / Q000209:etiology; D010514:Periodontal Pocket / Q000209:etiology; D016745:Root Planing; D013524:Surgical Flaps; D019237:Tooth Cervix / Q000002:abnormalities*; D014092:Tooth Root / Q000002:abnormalities