Int J Stomatol

Int J Stomatol ›› 2026, Vol. 53 ›› Issue (2): 230-238.doi: 10.7518/gjkq.2026009

• Reviews • Previous Articles    

Research status and clinical management of enamel pearls

Manyao Hong(),Mijia Guo,Ting Zhou,Zilong Deng()   

  1. Dept. of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
  • Received:2025-01-17 Revised:2025-03-09 Online:2026-03-01 Published:2026-02-13
  • Contact: Zilong Deng E-mail:906602467@qq.com;zldeng@yeah.net
  • Supported by:
    Grants from Clinical Research Program of Nanfang Hospital, Southern Medical University(2021CR011);National Natural Science Foundation of China(82100997)

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Abstract:

Enamel pearls (EPs) are the most common ectopic enamel. The etiology of EPs remains obscure. Clinically, EPs are mainly detected through radiographic examinations or when they elicit associated clinical symptoms. A hemidesmosomal junction exists between EP and periodontal tissue, which weakens the ability of periodontium to defend against infection. Furthermore, the presence of EPs facilitates plaque retention by shielding plaque from salivary enzymes and routine oral hygiene measures, which leads to endodontic and periodontal diseases. Therefore, early diagnosis, assessment, and management of EPs are of clinical importance. This article reviews the literature on EPs; it encompasses their nomenclature, prevalence, diagnosis and differential diagnosis, classification, morphological and distribution characteristics, physicochemical properties, histological features, histogenesis and pathogenesis, clinical implications, and management strategies, to provide a reference for their clinical diagnosis and management and further investigation.

Key words: enamel pearl, classification, prevalence, diagnosis, treatment

CLC Number: 

  • R780.2

TrendMD: 

Tab 1

Enamel pearl prevalence based on extracted teeth"

研究者（年份）研究人群样本牙发生率/%磨牙发生率/%
Risnes[5]（1974）挪威人8 854颗磨牙2.28
Negra等[9]（1974）巴西人30 726颗牙0.49
Loh[10]（1980）亚洲人5 674颗牙1.132.60
Sutalo等[7]（1986）克罗地亚人3 370颗磨牙0.541.13
沙继春等[11]（1986）中国人10 000颗牙3.0
解危[12]（1991）中国人12 379颗牙1.012.49
Chrcanovic等[6]（2010）巴西人45 785颗牙0.821.71
Kaminagakura等[13]（2011）巴西人2 201颗磨牙2.86
Versiani等[14]（2013）巴西人2 532颗牙0.74

Tab 2

Enamel pearl prevalence based on radiographic examinations"

研究者（年份）研究方法研究人群样本人发生率/%牙发生率/%磨牙发生率/%
Darwazeh等[3]（2000）根尖X线片约旦人

2 986颗牙齿

1 032张根尖X线片

819份牙科记录

4.51.62.32
Akgül等[4]（2012）CBCT土耳其人

15 185颗牙

768人

4.690.240.83
?olak等[15]（2014）全景片土耳其人

6 912张全景片

97 362颗牙

5.10.85
Al-Zoubi等[16]（2018）全景片沙特阿拉伯人642张全景片4.820.962.49
Zengin等[17]（2022）CBCT土耳其人1 003份CBCT4.290.71

Fig 1

CBCT images of multiple enamel pearls in bilateral maxillary second molars of the same patient"

Fig 2

Classification diagrams of enamel pearls"

Tab 3

Research results on the size of enamel pearls"

研究者（年份）研究方法研究人群釉珠数目/个平均直径/mm标准差/mm尺寸范围/mm
Risnes[5]（1974）离体牙、放大镜挪威人2190.960.430.3~4
Loh[10]（1980）离体牙亚洲人640.2~2.6（多为1~1.9）
Sutalo等[7]（1986）离体牙欧洲人381.600.5~2.7
沙继春等[11]（1986）离体牙、放大镜中国人1831.060.3~3.0
解危[12]（1991）离体牙、放大镜中国人1391.560.5~3.2
Versiani等[14]（2013）离体牙、micro-CT巴西人231.980.85多为1.15~4.48
Zengin等[17]（2022）CBCT土耳其人720.5~2.95（多为1~2）

Fig 3

Diagrams of structural relationship between cementum and enamel pearl"

Fig 4

Management strategies of enamel pearl"

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