Diagnostic and therapeutic approach in dens in dente

Lejri, Walid; Kallel, Ines; Marwen, Omar; Douki, Nabiha

doi:10.4103/0970-7212.195432

Cited by 9 publications

(21 citation statements)

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“…However, the overriding objective must preserve pulp vitality as much as possible. This can be achieved by early diagnosis and prophylactic treatment [3]. If endodontic treatment is feasible, and given the complexity of the root canal system of an invaginated tooth, the practitioner should use modern cone beam sectional imaging, which has low irradiance and compensates for the shortcomings of a conventional twodimensional imaging protocol that is too imprecise [11].…”

Section: Discussionmentioning

confidence: 99%

“…The exact etiology of dens invaginatus remains unknown; several theories have been proposed [2][3][4][5][6]: External factors: Atkinson (1943) suggested that dental invagination is the result of external forces exerting an effect on the dental germ during development, trauma, infections... [2,3,[5][6][7] Developmental anomalies: Twin theory: suggested the fusion of two tooth germs. [2] Delay theory: it reports a failure of the internal adamantin epithelium growth, while the cells of the external adamantin epithelium continue to proliferate.…”

Section: Etiologymentioning

confidence: 99%

“…Nevertheless, endodontic treatment is mandatory in cases where the tooth presents a negative response to the pulp vitality test. [2][3][4][5][6] For dens invaginatus type II, the invagination is deeper than in type I. Treatment of the invagination alone and its filling are recommended if the tooth is vital.…”

Section: Clinical Guideline For Diagnosis and Treatment Of Dens Invaginatusmentioning

confidence: 99%

“…[2][3][4][5][6] For dens invaginatus type III, the main challenge is to highlight the pulpal vitality which will guide our therapeutic approach towards two choices: treating the root canal as a separate entity without affecting the vitality of the tooth (prophylactic treatment). [2][3][4][5][6] In the other hand, the invagination and the root canal should be combined in the treatment, If the pulp was necrotic. Ultrasonic instruments or long-shanked round burs are preferably used working from the root canal side to the invagination.…”

Section: Clinical Guideline For Diagnosis and Treatment Of Dens Invaginatusmentioning

confidence: 99%

“…Dens invaginatus (DI) is a developmental anomaly resulting from the invaginations of the enamel organ into the dental papilla before calcification of the dental tissues [1][2][3][4][5][6][7][8][9][10]. This creates a pocket of organic material underneath the enamel surface [6].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Guideline for Diagnosis and Treatment of Dens Invaginatus

2021

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Etiologymentioning

confidence: 99%

Section: Clinical Guideline For Diagnosis and Treatment Of Dens Invaginatusmentioning

confidence: 99%

Section: Clinical Guideline For Diagnosis and Treatment Of Dens Invaginatusmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Guideline for Diagnosis and Treatment of Dens Invaginatus

2021

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Dens invaginatus: a review and orthodontic implications

et al. 2021

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Abnormality in the Morphogenesis of Tooth Development and Relationship with Orthodontic Deformities and Treatment Approaches

Yordanova

Grancharov

Gurgurova

2021

Case Reports in Dentistry

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In the process of odontogenesis, a disturbance in the formation of the epithelium and mesenchyme can be observed and this can be manifested by atypical forms of dental development. Such biological phenomena with altered morphology are as follows: dens invaginatus (DI), dens evaginatus (DE), talon cusps, and double teeth (DT) or connate teeth (fusion and gemination). Patients with orthodontic anomalies who also exhibit teeth with morphogenetic disorders are presented in this article. Dens evaginatus and talon cusps pose orthodontic challenges in the treatment finishing phase. These reduce the possibility of achieving maximum intercuspidation between the lower and upper front teeth as well as poor incisor guidance. Other orthodontic challenges are as follows: the risk of occlusal trauma and periodontal loading of the antagonists and the possibility of accessory cusps to play the role of the inclined plane and lead to deviations in the closure of the lower jaw. The fused teeth can cause aesthetic and occlusal disturbances in the anterior segment. Furthermore, double teeth can lead to ectopic eruption or noneruption of adjacent teeth due to their increased crown size as is the case with one of the presented patients. This is because a double tooth occupies more space in the dental arch. If not diagnosed early, impaction of the adjacent tooth, violation of the occlusal ratios (Bolton/anterior), and exacerbation of the orthodontic deformity can be observed. The modern CBCT imaging is the best diagnostic method for identifying problems related to tooth positions or tooth germs.

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Diagnostic and therapeutic approach in dens in dente

Cited by 9 publications

References 0 publications

Clinical Guideline for Diagnosis and Treatment of Dens Invaginatus

Clinical Guideline for Diagnosis and Treatment of Dens Invaginatus

Dens invaginatus: a review and orthodontic implications

Abnormality in the Morphogenesis of Tooth Development and Relationship with Orthodontic Deformities and Treatment Approaches

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