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The palatal groove is a developmental, anomalous groove usually found on the palatal aspect of maxillary central and lateral incisors. It is also known as palatogingival groove or palatoradicular groove.¹ These structures are considered a funnel-like anomaly predisposing to the accumulation of biofilm and calculus formation.^125–132 The prevalence of this condition ranges from 1.9% to 18%, affecting primarily maxillary lateral incisors and central incisors with a possible predilection for individuals of Asian descent (Table 5-10).^{70,127,128,131,133–135}

TABLE 5-10 Prevalence of palatoradicular grooves

Authors	Population	Affected teeth	Prevalence
Everett and Kramer133	American	Lateral incisors	1.9%
Gher and Vernino70	American	Lateral incisors	3%
Withers131	American	Lateral and central incisors	Overall: 2.33%Bilateral: 0.75%Lateral incisors: 4.4%Central incisors: 0.28%
Kogon127	Canadian	Lateral and central incisors	4.6%
Bačić et al128	Croatian	Lateral and central incisors	1.01%
Hou and Tsai134	Taiwanese	Lateral and central incisors	18.06%
Albaricci et al135	Brazilian	Lateral and central incisors	Overall: 9.3%Lateral incisors: 11.1%Central incisors: 7%

Embryologically, these anomalies arise as a mild form of invagination from the folding of the enamel epithelium and are closely related to dens in dente.¹³³ As a result, a clinically detectable hollow groove can be observed proceeding apically for a variable distance along the length of the root. Hou and Tsai noted an increased predilection of these grooves for midpalatal areas (42.5%) when compared with mesial (27.4%) and distal (30.1%) surfaces.¹³⁴ Moreover, it has been reported that 58% of the grooves extended more than 5 mm from the CEJ,¹²⁷ whereas 8.6% can reach the root apex.¹³⁵ Radiographically, these might be detected as radiolucent, parapulpal lines representing a radicular extension of the palatal groove.^126,130

Localized forms of periodontitis have also been associated with the presence of palatoradicular grooves.^{128,130–132} Teeth with palatoradicular grooves revealed worse periodontal health as evidenced by higher gingival index, plaque index, and periodontal disease index scores when compared to teeth without grooves.¹³¹ Similarly, Bačić et al reported significantly greater probing depths (mean: 8.8 mm) at sites with palatoradicular grooves among periodontal patients.¹²⁸ Hou and Tsai also noted deeper pocket depths when palatoradicular grooves were present.¹³⁴