{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:55:15Z","timestamp":1791273315279,"version":"4.1.0"},"reference-count":17,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Cone\u2010beam computed tomography (CBCT) is routinely used before mandibular wisdom tooth extraction to determine its three\u2010dimensional relationship with the mandibular canal. In contrast, the extraction of a maxillary third molar is often planned based on panoramic radiographs alone. Enamel pearls are common at the maxillary molar sites, with prevalence varying by ethnicity; however, their detection based on panoramic radiographs alone is challenging. We herein present the novel case of a 27\u2010year\u2010old woman whose maxillary sinus floor was being elevated and partially perforated by enamel pearls, thereby increasing the risk of sinus perforation area spread, enamel pearl fracture, and displacement into the sinus cavity during extraction as well as postoperative complications. This case illustrates the clinical implications for the surgical management of impacted maxillary third molars located close to the maxillary sinus floor and also emphasizes the value of CBCT imaging for accurate preoperative assessment and surgical planning in such cases.<\/jats:p>","DOI":"10.1002\/ccr3.73400","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T11:11:42Z","timestamp":1787742702000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Precautions When Extracting Impacted Third Molars With Impacted Enamel Pearls in the Maxillary Sinus Floor: A Case Report"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3059-2700","authenticated-orcid":false,"given":"Hideki","family":"Suito","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical Sciences Tokushima University  Tokushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4381-9403","authenticated-orcid":false,"given":"Yuuri","family":"Oku","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical Sciences Tokushima University  Tokushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9633-259X","authenticated-orcid":false,"given":"Tomoyuki","family":"Kondo","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical Sciences Tokushima University  Tokushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kumiko","family":"Kamada","sequence":"additional","affiliation":[{"name":"Department of Oral Surgery, Graduate School of Biomedical Sciences Tokushima University  Tokushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9354-5071","authenticated-orcid":false,"given":"Naito","family":"Kurio","sequence":"additional","affiliation":[{"name":"Department of Oral Surgery, Graduate School of Biomedical Sciences Tokushima University  Tokushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6293-3409","authenticated-orcid":false,"given":"Naoki","family":"Maeda","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical Sciences Tokushima University  Tokushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"268","article-title":"Prevalence and Microscopic Features of Enamel Pearls From Permanent Human Molars","volume":"10","author":"Kaminagakura E.","year":"2011","journal-title":"Brazilian Journal of Oral Sciences"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/dvdy.10404"},{"key":"e_1_2_11_4_1","first-page":"69","article-title":"Enamel Pearls as a Predisposing Factor to Localized Periodontitis","volume":"10","author":"Romeo U.","year":"2011","journal-title":"Quintessence International"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/236462"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.4103\/0972\u2010124X.124520"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100714.1995.tb01157.x"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u2010051x.1990.tb01043.x"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1259\/dmfr.20120332"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100722.1974.tb00394.x"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100722.1974.tb00395.x"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.4034\/PBOCI.2018.181.09"},{"key":"e_1_2_11_13_1","first-page":"621","article-title":"Role of the Intermediate Cementum in the Formation of Enamel Pearls in Deciduous Dentition","volume":"68","author":"Arys A.","year":"1989","journal-title":"Journal of Dental Research"},{"key":"e_1_2_11_14_1","first-page":"62","article-title":"Enamel Pearl Associated With Localized Periodontitis in Hellenistic Age Woman","volume":"11","author":"Tomov G.","year":"2017","journal-title":"Bulletin Of The International Association For Paleodontology"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.2334\/josnusd.52.257"},{"key":"e_1_2_11_16_1","first-page":"45","article-title":"Morphologic Study of Enamel Pearls in Human Teeth","volume":"2","author":"Bernaba J. M.","year":"1973","journal-title":"Revista da Faculdade de Odontologia de Ara\u00e7atuba"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmbbm.2020.103711"},{"key":"e_1_2_11_18_1","first-page":"870","volume-title":"Contemporary Implant Dentistry","author":"Misch C. E.","year":"2008"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73400","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.73400","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73400","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:40:21Z","timestamp":1791272421000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.73400"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,26]]},"references-count":17,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/ccr3.73400"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.73400","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,26]]},"assertion":[{"value":"2025-10-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e73400"}}