## 4 Discussion
### Ethnic and Geographic Differences
While no significant association between groove type and tooth type was observed in our study (\(p\) = 0.182, Bonferroni-corrected), the predominance of Type 1 grooves may have masked subtle relationships. Localization analysis in our study revealed a significant predominance of midpalatal grooves (54.07%), followed by mesial (42.11%) and distal grooves (3.83%). This finding aligns with previous research, including [PERSON] et al. and [PERSON] et al., who both reported midpalatal grooves to be the most common with significant positional variation [21; 37]. Midpalatal grooves consistently emerge as the most frequent localization in PRG morphology, as highlighted by [PERSON] et al. (2023), [PERSON] et al. (2021), and [PERSON] et al. (1992) [19; 23; 34]. Studies like [PERSON] et al. (2008) and [PERSON] et al. (1993) further reinforce their centrality, emphasizing their diagnostic and biomechanical significance [38; 40]. In this study, midpalatal grooves were most common, with a significant difference in central teeth (\(p\) < 0.001), no difference in lateral incisors (\(p\) = 0.152), and even distribution in canines (\(p\) = 1.0), reflecting their overall lower prevalence of PRGs. These findings highlight the variability in groove localization and its potential clinical implications for diagnosis and treatment planning. The findings of this study underscore the importance of early detection and management of palatoradicular grooves (PRGs) in clinical practice. The predominance of Type 1 grooves highlights the necessity for heightened diagnostic awareness, as these grooves, despite their relative simplicity, can harbor plaque and calculus, leading to localized periodontal destruction. Rarer groove types, such as Type 3B, pose additional challenges due to their association with severe periodontal bone loss and complex root anatomy, complicating endodontic treatment, as emphasized by [PERSON] et al. (2011) and [PERSON] et al. (2022) [19; 23]. PRG detection plays a vital role in guiding treatment decisions. Simple cases may only require routine care, such as cleaning and monitoring, whereas severe grooves, particularly Type 3B, often necessitate specialized procedures, including root-surface surgery, regenerative therapies, or even combined periodontal and endodontic approaches. CBCT imaging proved instrumental in this study, offering the detailed visualization needed to craft precise and individualized treatment solutions. Treatment considerations by PRG-type CBCT visualization is invaluable for tailoring therapy to groove depth and complexity. Type 1 PRGs can usually be managed with odontoplasty or shallow saucerization followed by sealing with glass-ionomer composite or a calcium-silicate cement to eliminate the plaque niche [41]. Type 2 PRGs benefit from a papilla-preserving or apically positioned flap for thorough debridement; the groove is smoothed or filled and a regenerative aid such as bone graft, enamel matrix derivative, PRP, or membrane is added to re-establish attachment [42; 43; 44]. Type 3A/3B PRGs require combined endodontic therapy plus surgical access to clean and seal the groove; in extensive lesions, intentional replantation or orthodontic extrusion allows extra-oral sealing, with \(\approx\)88% two-year survival [45]. Successful outcomes in severe (especially Type 3B) cases also depend on concurrent periodontal treatment to eradicate external biofilm [46; 47]. Thus, while simple grooves may need only routine cleaning and monitoring, complex forms often demand root-surface surgery and advanced regenerative or combined perio-endo approaches; CBCT is essential for planning these individualized interventions. This study provides a comprehensive evaluation of PRGs using a large dataset and advanced CBCT imaging. The inclusion of maxillary amines, often overlooked in previous studies, offers a more complete analysis of PRG prevalence across anterior teeth.