Successful management of a case of true radicular dens invaginatus using platelet‐rich fibrin and guided tissue regeneration

Abstract

A radicular variant of dens invaginatus (DI) is a rare form of dens invaginatus which develops in the root of the tooth after the crown development is completed. This report involves successful management of a case with guided tissue regeneration and describes the cone beam computed tomography (CBCT) characteristics of true radicular DI. A 20-year-old woman reported with recurrent swelling and pus discharge associated with her maxillary left central incisor (#21). Cone beam computed tomography (CBCT) of the region revealed #21 had an invagination in the mesial aspect of the coronal third of the root with a para radicular low-density region perforating both the cortices. A diagnosis of true radicular variant of DI was made by exclusion. The case was managed with Biodentine ® , platelet-rich fibrin and freeze-dried demineralised bone graft. A 2-year review showed that the tooth was functional with normal periodontal parameters and normal response to electric pulp sensibility test.

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

“…• diagnostic and therapeutic approaches for dens in dente in form of case report with or without associated literature review [16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,35,36, 37] -18 articles;…”

“…Also, platelet-rich brin has been used as apical barrier during Oehlers Type II dens invaginatus treatment, while root canal was lled with Biodentine after invaginated hard tissue mass removal [27]. Mohan et al expand such protocol by adding freeze-dried demineralized bone graft to ll bone defect at the periapical area of tooth with radicular dens invaginatus associated complications [28].…”

Investigation of dens invaginatus in a Chinese subpopulation using Cone‐beam computed tomography

“…Most case reports of DI in recent years are unilateral (Abu et al, 2019;Lee et al, 2019Lee et al, , 2020Liu et al, 2019;Mohan et al, 2019).…”

Management of a Type II Dens Invaginatus with Regenerative Endodontic Therapy

“…Dens invaginatus (DI) is a developmental anomaly resulting from an invagination of the enamel organ into the dental papilla prior to the mineralization phase. [1] Maxillary lateral incisors are the most commonly affected teeth, [2] followed by maxillary central incisors, premolars, canines, and less often molars. [3] Prevalence of DI varies depending on the invagination type.…”

“…Type I is the most common, reaching a prevalence of 11.3%, while types II and III are uncommon, accounting for 0.7% and 0.8% of cases, respectively, [4] with a 3:1 female predilection. [1] The purpose of this paper was to detail the management of type II dens invaginatus in an immature necrotic permanent tooth using the revascularization approach with platelet-rich fibrin (PRF) as a scaffold material, and to discuss the clinical and radiological outcomes of this technique.…”