Nonsurgical endodontic management of dens invaginatus: a report of two cases

Abstract

Dens invaginatus is a malformation affecting mainly the superior lateral incisors. It is defined as an infolding of the crown hard tissues, including the enamel and dentin, and can extend up to the root apex. Root canal treatment of this abnormality is considered difficult due to the complex anatomy presented by these teeth. This case series presents nonsurgical endodontic treatment in two cases of dens invaginatus (type II and III) in maxillary lateral incisors. This nonsurgical or conventional endodontic treatment results in healing of the periapical lesions associated with both cases, with no need for extra intervention e.g. surgical or invasive management. The manual instrumentation associated with sodium hypochlorite and calcium hydroxide were able to completely heal the lesions. Radiographic exams were carried out to control and asses the healing. Nonsurgical treatment was successful in both cases with adequate repair after a 6-year follow-up with radiographic and tomographic assessments.

Etiological factors commonly related to the need of endodontic treatment in individuals with orofacial clefts

“…Regardless of the type of orofacial cleft and etiological factor involved, a high percentage of success was observed (Tables 1,2 and Fig. 2 ), which can be assigned to the knowledge of professionals and the technological and scientific advances in Endodontics in recent years, such as the use of digital radiography, cone-beam computed tomography, foraminal locators, engine-driven mechanic systems, use of ultrasound to enhance the properties of irrigants, intracanal medication and use of resin and bioceramic materials for root canal obturation ( 6 , 15 , 18 , 19 , 21 ). Therefore, this retrospective study revealed relevant data regarding the type of cleft and the most prevalent etiological factors that lead to the need for endodontic treatment.…”

“…Thus, clinical and radiographic follow-up is important for the longevity of therapy; if any change is detected, endodontic reintervention is indicated, provided it can be performed. The European Society of Endodontics (2006) suggests the achievement of control radiographs for at least 1 year after completion of endodontic treatment ( 6 , 15 , 18 , 19 ). In cases of pulp necrosis with radiographically visible apical bone resorption, clinical and radiographic follow-up should be encouraged by the professional for a period of 2 to 4 years, due to the difficulty of performing histopathological analysis of the periapical lesion ( 6 , 20 ).…”

Analysis of the Association of Foramen Cecum and Dens in Dente in Maxillary Lateral Incisor

“…Surgical treatment is indicated in cases of conventional endodontic failure and the impossibility of access to the root canal system due to dental anatomy. 24 However, due to the failure or inability to treat the root canal system, extraction is eventually necessary. Given the importance of early diagnosis for prevention, treatment, and preservation, it is important to observe anatomical structures such as the foramen cecum that may indicate the presence of dens in dente.…”

“…Surgical treatment is indicated in cases of conventional endodontic failure and the impossibility of access to the root canal system due to dental anatomy. 24 …”

Apicoectomy of Perforated Root Canal Using Bioceramic Cement and Photodynamic Therapy

“…The symptomatic periapical periodontitis is an endodontic disease of the necrosed pulp and its management depends mainly on root canal disinfection [ 1 ] in which the manual/automated instruments remove the microorganisms mechanically and the auxiliary chemical substances act chemically [ 2 – 4 ]. However, in some cases, additional complementary techniques are indicated to provide more favorable decontamination using photodynamic therapy (PDT) [ 5 , 6 ] and passive ultrasonic irrigation (PUI) [ 7 , 8 ].…”