Nonsurgical management of type II dens invaginatus with cone beam computed tomography: a rare case

Abstract

Dens invaginatus is a progressive abnormality resulting from invagination of the crown or root before calcification. This case report presents nonsurgical endodontic treatment and nine-year follow-up results of a right maxillary canine tooth with type II dens invaginatus. A 40-year-old female patient was referred to the clinic for treatment of her maxillary right canine tooth. The invagination was managed on a two-visit appointment. On the first visit, the invagination area, which was disconnected, was completely removed from the root canal. The invagination area was instrumented, and the root canal was dressed with calcium hydroxide. At the second appointment, apexification was done using mineral trioxide aggregate compacted to the apical 3mm. Finally, the invaginated area and the root canal were obturated with a warm vertical compaction technique. At a nine-year follow-up, the invaginated tooth was asymptomatic, and the periradicular lesion showed satisfactory healing radiographically.

Treatment opinions for dens invaginatus: A case series

“…The indicators for efficacy of DI treatment in the Department of Endodontics of Liaocheng People's Hospital include: i) No conscious symptoms, such as pain and swelling; ii) no discomfort during chewing; iii) normal periapical mucosal soft tissue without redness or abscess; iv) fistula disappearance without tenderness and percussion; v) healthy gingiva without redness, swelling or pus discharge and vi) radiographical findings of intact tooth, tightly filled canal and periapical lesions reduced or missed. In the present cases, lack of symptoms and the aforementioned radiograph manifestations were considered indicators for the efficacy of DI treatment, as previously reported (16,30,50,51). The complications of DI management methods are mainly secondary pulpitis, periapical periodontitis and periodontal disease.…”

Dens Invaginatus of Mandibular Premolars and Maxillary Anterior Teeth: A Case Report in Three Brothers

“…We found this anomaly through routine radiographic imaging. Treatment for DI [30][31][32][33] includes preventive treatment, restoration after removing the affected portion of the tooth, root canal treatment, extraction, or intentional replantation depending upon severity. Recently, successfully treated immature DI cases by pulp revascularization were reported [34][35][36].…”