Enamel Pearls

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.^5,10 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 44) or in the root furcation area (Figure 45).^5,8-10 The prevalence of enamel pearls ranges from ≈ 1% to 10% with Asians demonstrating the greatest incidence.^5,10 In most circumstances, enamel pearls are asymptomatic, but their presence may impact oral hygiene care and periodontal health.^9,10

Figure 44.

Figure 44.

Periapical radiograph of a distal enamel pearl on mandibular left third molar tooth #17.

Figure 45.

Figure 45.

Periapical radiograph of a furcal enamel pearl on mandibular right third molar tooth #32.