Enamel pearls are tiny nodules of ectopic enamel that occur most typically on the root surface of permanent maxillary molar teeth, although mandibular molars can be affected.7,10 These projections typically consist of enamel, but dentin and pulp tissue may be present underneath the enamel layer posing a potential risk for pulp exposure. Radiographically, enamel pearls are singular, well-defined circular radiopacities located near the cervical aspect of the tooth (Figure 35) or in the root furcation area (Figure 36).7-10 The prevalence of enamel pearls ranges from ≈ 1% to 10% with Asians demonstrating the greatest incidence.7,10 In most circumstances, enamel pearls are asymptomatic, but their presence may impact oral hygiene care and periodontal health.9,10
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