Clinical Guideline for Diagnosis and Treatment of Dens Invaginatus

Abstract

The invaginated tooth, also called dens invaginatus or dens in dente, is a rare anomaly affecting human dentition, resulting from invagination of enamel organ into the dental papilla.Maxillary lateral incisors are the most commonly affected teeth. The accentuated pit within the DI accumulates debris causing prompt initiation and progression of dental caries with subsequent involvement of the pulp, resulting in periapical pathology. Invagination depth varies from a slight enlargement of the cingulum to an extended invagination into the apex. This anatomic variation means a true clinical challenge because of its complex anatomy. Early diagnosis is then essential to avoid any periodontal complications.This study aims to review: etiopathogenics, classification, elements of the diagnosis and provides guidelines for the management of dens invaginatus cases in clinic that provide hope for teeth that could not be saved before.

Treatment options for dens in dente: state-of-art literature review

“…• diagnostic and treatment guidelines of dens invaginatus for practicing dentists in form of literature review [3,5,32,33, 34] -5 articles;…”

“…It is worth to mention that extraction was considered as preferred method for dens invaginatus treatment until 1970's due to the challenges associated with prognosis of endodontic treatment [17; 32]. In clinical guidelines for dens invaginatus treatment extraction as targeted intervention option could be considered for mesiodens, non-restorable tooth, excessively wide apex cases, and also when provided endodontic and/or surgical treatment has failed [32].…”