This paper presents a rare case of bilateral talon cusp in permanent maxillary central incisors, one on the labial and another on the lingual surface of each tooth. The condition was associated with dens invaginatus in a maxillary permanent lateral incisor, but no developmental syndrome was identified. The left central incisor required no treatment because the aesthetic appearance was satisfactory and neither occlusal interferences nor caries were present. After careful investigation of the right lateral incisor, a sealant was applied. Root canal treatment was indicated for the right central incisor that had a wide open apex with thin, weak, divergent walls, and an apical radiolucency.

A case of dens invaginatus in a mandibular first premolar with periapical lesion is presented in which it was possible to perform non-surgical endodontic therapy. Dens invaginatus is a developmental malformation of teeth which results from abnormal morphodifferentiation. Due to their abnormal anatomical configuration, invaginated teeth present technical difficulties in their clinical management. The treatment modalities available to the clinician include: endodontic therapy, endodontic surgery, combined treatment, or extraction. In this case the treatment of choice, selected according to clinical and radiographic considerations, was endodontic therapy of the main root canal.

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