SHOVEL-SHAPED INCISORS

 This alteration occurs predominantly in Asians, with a prevalence of approximately 15% in whites but close to 100% in native Americans and Alaskans. Affected incisors demonstrate prominent lateral margins, creating a hollowed lingual surface that resembles the scoop of a shovel (figure 1-1). Typically, the thickened marginal ridges converge at the cingulum; not uncommonly there is a deep pit, fissure, or dens invaginatus at this junction. Maxillary lateral and central incisors most frequently are affected, with mandibular incisors and canines less commonly reported. Frequently, shovel-shaped incisors is seen in association with another variation of coronal anatomy, dens evaginatus.

Figure 1-1 Maxillary central incisors exhibiting prominent lateral margins.

   If shovel-shaped incisors are present, the affected teeth should be inspected for surface defects at the point where the marginal ridges converge. Any deep fissures or invaginations should be restored shortly after eruption to prevent carious exposure of the adjacent pulp.