Isolated periodontal pockets: a clinical review

Abstract

An isolated periodontal pocket is a perplexing clinical entity that usually poses a diagnostic challenge to the oral health professional. Although periodontal pockets are easy to detect, they can be easily missed during a routine clinical examination. The broad range of aetiological factors that can result in an isolated periodontal pocket makes identifying the cause difficult. The aetiology can be as simple as an overhanging restoration or food impaction due to open interproximal contacts, to more complex and uncommonly occurring presentations, such a palato-radicular groove or cemental tears. Although previous classifications proposed by the American Academy of Periodontology and European Federation of Periodontology have discussed this topic under different headings, an explicit classification on isolated periodontal pockets based on aetiology is currently missing. Isolated periodontal pockets are easily undiagnosed, with associated cases presenting with substantial destruction necessitating complex multidisciplinary treatment. This article highlights the various causes of an isolated periodontal pocket, and provides a systematic and easy clinical aetiology-based classification. The proposed classification categorizes isolated periodontal pockets into those occurring due to: (1) developmental anomalies of the teeth; (2) iatrogenic causes; and (3) pathological conditions. Further studies are essential to validate this classification. CPD/Clinical Relevance: Early detection of easily missed isolated periodontal pockets is of clinical value during initial screening to avoid delayed diagnosis and treatment.