Anatomical prevalence of the cervical enamel projection: a narrative review
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Keywords

Dental anatomy
Developmental defects of enamel
Review

How to Cite

Anatomical prevalence of the cervical enamel projection: a narrative review. (2026). Odontoestomatología, 28(48). https://doi.org/10.22592/ode2026n48e346

Abstract

Atypical dental anatomy or, more precisely, some morphological defects in the dental structure should be considered predisposing factors for the onset and progression of periodontal disease since they favor biofilm accumulation and may be related to the onset and progression of periodontal disease. This paper aims to analyze the prevalence of the cervical enamel projection (CEP) through a narrative review. We analyzed articles relating to cervical enamel projections published in Portuguese, English, or Spanish without restriction on the year of publication in databases such as EMBASE, Google Scholar, Scopus, PubMed, and Web of Science using the MESH descriptors "anatomy" and "cervical enamel projection". 134 studies were found; however, only 37 of these articles met all the inclusion criteria and were added to the complete qualitative analysis. The publications were made between the years 1964 and 2019, and in vitro studies (20), literature review (10), and clinical cases (7) were identified. The presence of cervical projection of enamel, both in upper and lower molars, is a frequent finding in all anatomical studies, with a prevalence observed in the literature of 5.86 to 85% in molar teeth.

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PDF (Inglés) (Spanish)

References

Cecília MS, Rocha RM, Corrêa PBM. Projeção cervical de esmalte: uma causa do insucesso do tratamento endodôntico. Rev Assoc Paul Cirur Dent. 1998; 52(4):299-301.

Melo N, Consolaro A. Projeção cervical do esmalte: aspectos morfológicos e suas implicações clínicas. Rev Dental Press Biol Oral. 2000; 1(2):29-49.

Bower RC. Furcation development of human mandibular first molar teeth: a histologic graphic reconstrucional study. J Period Res. 1983; 18(4):412-19.

Gaspersic D. Histogenetic aspects of the composition and structure of human ectopic enamel, studied by scanning electron microscopy. Arch Oral Biol. 1992; 37(8):603-11.

Hou GL, Tsai CC. Cervical enamel projection and intermediate bifurcational ridge correlated with molar furcation involvements. J Periodontol. 1997; 68(7):687-93.

Masters DH, Hoskins SW. Projection of cervical enamel into molar furcations. J. Periodontol. 1964; 35(1):49-53.

Campbell M, et al. Synthesis without meta-analysis (SWiM) in systematic reviews: reporting guideline. BMJ. 2020; 16,368:l6890.

Grewe JM, Meskin LH, Miller T. Cervical enamel projections: prevalence, location, and extent; with associated periodontal implications. J Periodontol. 1965; 36(6):460-5.

Bissada NF, Abdelmalek RG. Incidence of cervical enamel projections and its relationship to furcation involvement in Egyptian skulls. J Periodontol. 1973; 44(9):583-5.

Leib AM, Berdon JK, Sabes WR. Furcation involvements correlated with enamel projections from the cementoenamel junction. J Periodontol. 1967; 38(4):330-4.

Tsatsas B, Mandi F, Kerani S. Cervical enamel projections in the molar teeth. J Periodontol. 1973; 44(5):312-14.

Swan RH, Hurt WC. Cervical enamel projections as an etiologic factor in furcation involvement. J Am Dent Assoc. 1976; 93(2):342-5.

Zee KY, Chiu ML, Holmgren CJ, Walker RT, Corbet EF. Cervical enamel projections in Chinese first permanent molars. Aust Dent J. 1991; 36(5):356-60.

Swerts M, Oliveira A, Swerts M. Projeção cervical do esmalte em molares permanentes. Rev PerioNews. 2008; 2(2):117-20.

Bhusari P, Sugandhi A, Belludi SA, Khan S. Prevalence of enamel projections and its co-relation with furcation involvement in maxillary and mandibular molars: A study on dry skull. J Indian Soc Periodontol. 2013; 17(5):601-4.

de Souza ML, Marques AF, Sponchiado EC, de Vargas TA, Garcia LR. Prevalence of cervical enamel projection in human molars. Dent Hypotheses. 2014; 5(1):21-4.

Hou GL, Tsai CC. Relationship between periodontal furcation involvement and molar cervical enamel projections. J Periodontol. 1987; 58(10):715-21.

Risnes S. The prevalence and distribution of cervical enamel projections reaching into the bifurcation on human molars. Scand J Dent Res. 1974; 82(6):413-9.

Leite AP, Silva RG, da Cruz Filho AM, Pécora JD. In vitro study of cervical enamel projection in human molars. Braz Dent J. 1995; 6(1):25-8.

Risnes S, Segura JJ, Casado A, Jiménez-Rubio A. Enamel pearls and cervical enamel projections on 2 maxillary molars with localized periodontal disease: case report and histologic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000; 89(4):493-7.

Lim HC, Jeon SK, Cha JK, Lee JS, Choi SH, Jung UW. Prevalence of cervical enamel projection and its impact on furcation involvement in mandibular molars: A cone-beam computed tomography study in Koreans. Anat Rec. 2016; 299(3):379-84.

Soto J, Moreno S, Moreno F. Antropología dental y periodoncia: relación entre los rasgos morfológicos dentales y la enfermedad periodontal. Acta Odontol Venez. 2010; 48(3):1-13.

Sponchiado Jr EC, Fonseca TS, Pereira JV, Alfredo E, Sousa YTCS, Sousa Neto MD. Prevalência de projeção cervical de esmalte em molares inferiores: avaliação da possibilidade de diagnóstico utilizando RX convencional e digital. Rev Odonto Ciênc. 2004; 19(46):342-7.

Ercoli C, Caton JG. Dental prostheses and tooth-related factors. J Clin Periodontol. 2018 Jun;45 Suppl 20:S207-S218.

Storrer CLM, Sanchez PRL, Pustiglioni FE. Anatomia radicular de interesse periodontal em dentes de humanos: concavidades e sulcos. Rev Pós-Grad USP. 2001;8(4):372-7.

Martos J, Leonetti ACM, Godinho Neto MS, César Neto JB, Nova Cruz LER. Anatomical evaluation of some morphological abnormalities related to periodontal diseases. Braz J Morphol Sci. 2009; 26(2):77-80.

Pereira A. Projeção cervical do esmalte: anomalia anatômica como fator predisponente à instalação de problemas periodontais localizados. Rev Bras Odontol. 1997; 54(6):329-31.

Roussa E. Anatomic characteristics of the furcation and root surfaces of molar teeth and their significance in the clinical management of marginal periodontitis. Clin Anat. 1998; 11(3):177-86.

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Copyright (c) 2026 Rafaela Corrêa Martins, Gabrielle Ferreira Cardoso, Josiane Dias Pinz, Laura Lourenço Morel, Josué Martos