GUBERNACULUM DENTIS IN A TRANSMIGRATING CANINE: CASE REPORT AND LITERATURE REVIEW

Publication date: January 2019

Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 127, Issue 1

Author(s): L. ALMUFLEH, S. GHORI, R. VYAS, K. VAGISHA, M. MUPPARAPU, A.G. CREANGA, M. STRICKLAND, S.R. SINGER

Background

Gubernaculum dentis (GD) is an anatomic structure, described in the literature as an eruption pathway from the dental follicle to the gingiva for permanent teeth.¹ This is the first reported case of a GD associated with a transmigrating canine.²

Clinical and Radiologic Findings

A 60-year-old female of Indian origin presented for evaluation for implant placement to replace a clinically missing lower canine tooth. Her medical history was unremarkable. Cone beam computed tomography (CBCT) of the mandible was performed, and the image demonstrated the presence of a corticated tract of low density, contiguous with the dental follicle of the horizontally displaced and impacted mandibular left canine. The tract extended from the pericoronal space around the impacted tooth toward the alveolar crest. The structure measured 2 cm long and 2 mm wide.

Differential or Definitive Interpretation

On the basis of the clinical and radiographic findings, this structure was diagnosed as GD and had to be differentiated from bone trabeculae, medullary spaces, neurovascular bundles, or sinus tracts. Because this is considered a normal anatomic structure, no biopsy was indicated.¹

Discussion

Histologically, GD consists of a fibrous band running in the bony channel that connects the pericoronal follicular tissue of the successional tooth with the overlying gingiva. Typically, GD opens on the alveolar bone crest behind the deciduous teeth. Radiographically, GD appears as a corticated tract of low density, contiguous with the dental follicle of an unerupted tooth on CBCT.³ It would be difficult to visualize the very thin and round radiolucent structures with a diameter of only 1 to 3 mm on 2-dimensional radiographs. In addition, the structure lies in the spongy bone of the maxilla and the mandible. Therefore, GD has not received adequate attention in dental fields, including oral and maxillofacial radiology.

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