It has been a challenge to establish the accurate diagnosis of developmental tooth anomalies based on periapical radiographs. Recently, three-dimensional imaging by cone beam computed tomography has provided useful information to investigate the complex anatomy of and establish the proper management for tooth anomalies. The most severe variant of dens invaginatus, known as dilated odontome, is a rare occurrence, and the cone beam computed tomographic findings of this anomaly have never been reported for an erupted permanent maxillary central incisor. The occurrence of talon cusp occurring along with dens invaginatus is also unusual. The aim of this report was to show the importance of cone beam computed tomography in contributing to the accurate diagnosis and evaluation of the complex anatomy of this rare anomaly.
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