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Wilson's disease (WD) is a rare autosomal recessive genetic disease that affects copper metabolism. Anomalies can be seen in the dento‐maxillofacial structures of WD patients. Dens invaginatus (DI) is an uncommon tooth anomaly, and its incidence in decidious and permanent molars is even lower. This case report primarily explored the multiple DI of a patient with WD. A 9‐year‐old boy was admitted to our clinic with complaints of pain and swelling in the right lower molar area. It was learnt that the patient was diagnosed with WD after he was born. Fistula, submandibular lymphadenopathy and diffuse swelling were detected. Using cone‐beam computed tomography (CBCT), multiple DIs were observed in bilateral bimaxillary four first molars and deciduous molars. When the patient's systemic condition was considered, extraction was planned under oral antibiotic therapy and was performed. During the 6‐month follow‐up, uneventful healing was observed. [ABSTRACT FROM AUTHOR]

Dens invaginatus (dens in dente) is a frequent malformation of the hard tissues of the tooth the maxilar permanent lateral incisors. This anomaly is often not identified by the dentist during examinations and are not correctly diagnosed in the treatment. On the basis of a clinical case of chronic periodontitis of the tooth 1.2, which was specified malformation in combination with the wrong early diagnosis, developed perspective of the phenomenon in relation to the upper second incisors. Recommended x-ray diagnostics of all lateral upper incisors, visually discovered a blind fissure. Also discusses the use of the material Biodentine as an alternative to endodontic treatment in the case of extensive destruction of dens invaginatus malformation.

Abstract Background To report a case of type III dens invaginatus associated with peri-invagination periodontitis in an immature permanent mandibular central incisor with open apex, in which only the invagination area was treated and vitality was preserved. Case presentation A 9-year-old boy was referred complaining of pain in the mandibular left central incisor. After radiographic examination, an invagination into the pulp chamber of the tooth associated with periapical radiolucency was detected. Endodontic access was performed and the orifice was identified under a dental operating microscope. The invagination area was chemo-mechanically cleaned. After 1 week, the invagination was obturated with mineral trioxide aggregate. During the 2-year follow up period, the tooth was asymptomatic. Radiographic examination revealed significant progression of periapical healing and root development in the main root canal of the tooth. Conclusion Non-surgical root canal treatment of the invagination may preserve pulp vitality, and continuous root development of the tooth.

This is a case of swelling originating from dens invaginatus associated with lateral incisor, misdiagnosed as a globulomaxillary cyst. The initial diagnosis of globulomaxillary cyst was made solely from radiographs by observing a reverse pear-shaped radiolucency between the lateral incisor and cuspid. The results following pulp testing and Cone Beam Computed Tomography (CBCT) evaluation revealed the endodontic origin of the lesion, which entailed the treatment carried out by surgical enucleation and apicoectomy. This also details the clinical and diagnostic dilemma as well as conflicts associated with the diagnosis and management of the cystic lesion.

Introduction: Developmental disturbances of teeth at the stage of morpho-differentiation have been related to abnormalities associated with changes in the tooth shape and size. Dens evaginatus and dens invaginatus are the developmental variations of the human dentition. Dens evaginatus, a rare anomaly characterized by the presence of a tubercle on the occlusal surface of teeth is seen to occur due to abnormal proliferation and folding of the inner enamel epithelium and part of the dental papilla into the stellate reticulum of the enamel organ; whereas, dens invaginatus is seen to occur due to infolding of the enamel and dentine into the pulp cavity and sometimes extending to the root apex. Case report: We report cases with bilateral dens evaginatus in mandibular second premolars and dens invaginatus in maxillary lateral incisor. Conclusion: Such developmental anomalies of teeth deserve clinical importance, as high chances of early pulpal pathosis.

Dens invaginatus may be associated with peri-invagination lesions and vital pulp concurrently. This case report examines the successful preservation of vital pulp and minimally invasive treatment of invagination for Oehlers type IIIA dens invaginatus with an extensive peri-invagination lesion. A healthy 19-year-old man presented with occasional swelling of the left maxillary anterior region. Pulp vitality tests revealed vital and healthy tooth pulp. CBCT indicated Oehlers type IIIA dens invaginatus with an invagination parallel to the pulp cavity. The diagnosis was type IIIA dens invaginatus with a peri-invagination lesion. The treatment plans involved preservation of the vital pulp and minimally invasive treatment of the invagination. A 5-year follow-up revealed that both healing of the peri-invagination lesion and preservation of the vital pulp had been successful. Pulp vitality can be preserved in type IIIA dens invaginatus associated with a peri-invagination lesion through minimally invasive treatment of the invagination.

Objective: This study assesses the prevalence and characteristics of dens invaginatus (DI) in a sample of Chinese population by using cone‐beam computed tomography (CBCT) images. Methodology: A retrospective study was conducted by using the CBCT images of 1,004 patients. The whole dentition was evaluated for the presence and characteristics of DI. Periapical pathosis status and bilateral feature of affected teeth were also examined. Results: Dens invaginatus was observed in 85 of 1,004 subjects, with a prevalence of 8.47% and a tooth prevalence of 0.494%. Males presented a higher prevalence of DI than females (p =.011). Type I DI was the most commonly observed type of dens invaginatus, followed by type II and type III. The structure form of different types of DI was various. Overall 2.48% of the patients with type I DI, 5.88% of the patients with type II DI, 100% of the patients with type III DI had apical pathosis. Bilateral DI was found in 63.53% of the affected patients. Conclusions: This study indicates that DI was not rare, and clinicians should be aware of its existence. CBCT examination can provide an accurate representation of dental anatomy and should be incorporated into early diagnosis and treatment planning for teeth with DI. [ABSTRACT FROM AUTHOR]

Shovel-shaped incisors (SSIs) are teeth with thick marginal ridges adjacent a deep lingual fossa. Dens invaginatus (DI) is a malformation of teeth most likely causing from an infolding of the dental papilla during development of tooth. Protostylid is used for any additional cusps on the buccal surface of maxillary and mandibular premolars and molars. Morphological dental anomalies of the permanent teeth are seen to occur frequently; however, multiple anomalies in a single patient are relatively uncommon. A 19-year-old non-syndromic healthy Malay teenage girl who came for correction of misaligned teeth presented with an amalgamation of dental anomalies consists of SSIs and DI of the upper right lateral incisor, protostylid on bilateral upper maxillary molars, unilateral protostylid of right mandibular premolar, and Class III incisor relationship. The intraoral radiograph of tooth 12 revealed radiopaque invaginations from the palatal pits confined to the crowns of the teeth and there was no pulpal extension into the accessory cusp of both maxillary permanent second molars. The definitive treatment included sealing and build up the incisor DI tooth with composite, fissure sealant of deep fissure protostylid on bilateral maxillary second molars, close monitoring of the prostostylid on lower right premolar and fixed orthodontics appliance for the management of Class III incisor relationship. Early diagnosis, comprehensive treatment and regular follow-up are crucial to prevent any future consequences that may be associated with these dental anomalies. [ABSTRACT FROM AUTHOR]

This report demonstrates that root canal treatment of dens invaginatus in a maxillary lateral incisor with a sinus tract and large periradicular lesion can be successfully managed over a long period of time. The aim of this article is to show that contemporary technology, including a dental microscope and modern materials like mineral trioxide aggregate, are essential to secure a high survival of teeth, which have a difficult anatomy. The complex morphology of the root canal system and the invagination requires accurate intracoronal inspection, in order to find all delicate parts that need to be instrumented, disinfected and obturated. An 11-year-old girl with a type III dens invaginatus was referred to the Department of Operative Dentistry. A multiple-visit endodontic procedure was necessary to find, instrument and seal both the root canal and the invagination successfully. The presented case was treated by means of conventional non-surgical root canal treatment and apical placement of ProRoot MTA (Dentsply DeTrey, Konstanz, Germany). At 10-year follow-up the tooth was asymptomatic (no response to percussion or palpation) and complete periapical bone healing was observed radiographically. In the meantime the tooth was restored with a ceramic crown. [ABSTRACT FROM AUTHOR]

In vital pulp therapy, pulp testing aids in the differential diagnosis and influences the treatment plan. Different from previous doppler flowmetry studies that only recorded waves and data, we report the first time, the use of a laser doppler blood flow monitor and imager with a colored image to present pulp vitality information in the dental field. We report here a case of Oehlers type IIIa dens invaginatus of the right upper lateral incisor in a 31-year-old girl, with the opening of the invagination near CDJ and a peri-invagination lesion sized 8 × 9 mm2. Cone beam computed tomography was used to verify specific spatial and stereoscopic data. After removing the source of infection, mineral trioxide aggregate was selected to fill the invagination. Laser doppler was scheduled for further assessment. After three years of regular follow-up, the patient's clinical condition improved, the peri-invagination lesion healed, and the laser doppler and electric pulp test both showed a positive reaction. Laser doppler has successfully improved the diagnostic accuracy Thus, unnecessary interventions can be avoided while reducing the treatment time by preserving the vitality. However, further work is needed to resolve the limitations of laser doppler. [ABSTRACT FROM AUTHOR]

Dens invaginatus (DI) is a rare congenital dental malformation characterized by enamel or cementum folded into dentine. Such teeth are susceptible to caries, pulp infection or necrosis and periradicular lesion. The complex anatomy of this disease results in difficult treatment and a high rate of therapeutic failure. Therapeutic options, such as debriding and filling invagination, root canal treatment (RCT) and intentional replantation, vary according to the morphology and infection of the involved tooth. The present study reports five cases of DI with chronic apical periodontitis. The treatment strategies and procedures, including RCT, removing the invagination, intentional replantation and surgical treatment, are discussed according to the classification and the condition of pulp and periapical tissue. The study also reports the prognosis: All patients were followed up for ≥12 months and all teeth demonstrated periapical healing and clinical asymptomatic. In summary, appropriate treatment is based on accurate analysis of the anatomical variation in different types of DI and intentional replantation is a reliable and viable treatment to preserve the tooth. [ABSTRACT FROM AUTHOR]

Dens invaginatus, also known as dens in dente, is a rare anomaly affecting human dentition. The condition results in the invagination of an amelodental structure within the pulp. This case report discusses the current management protocol of dens invaginatus as demonstrated in an adolescent female and describes treatment options. As with most conditions, early diagnosis and preventive measures help minimize complications in dens invaginatus cases. Dens invaginatus, also known as dens in dente, is an anomaly of the tooth formation of embryologic origin. The condition results in invagination of an amelodental structure within the pulp. On radiographic evaluation, the deformation scan sometimes looks like a tooth within a tooth, which explains the nomenclature dens in dente. The radiographic examination will show an infolding of enamel and dentin that may extend deep into the pulp cavity, root, and even the root apex. Other names are invaginated odontome, dilated gestant odontome, dilated composite odontome, tooth inclusion, and dentoid in dente. Hovland and Block estimated the incidence as 0.04%-10%, affecting either deciduous or permanent dentition and commonly involving the upper lateral incisors. The bilateral occurrence has been reported in some patients. It occurs in maxillary lateral incisors in 43% of all cases. The cause for dens invaginatus is unclear; however, some evidence suggests a hereditary component. This case report describes the management of a case of unilateral dens invaginatus associated with the maxillary lateral incisor. [ABSTRACT FROM AUTHOR]

A 14-year female presented with an atypical looking tooth #7 with a sinus tract on tooth #8. A gutta-percha point inserted into the sinus tract confirmed the affected tooth #7. A radiographic examination of tooth showed a lateral radiolucency with respect to tooth #7. Cone-beam computed tomographic imaging was done for the three-dimensional reconstruction analysis. Dens invaginatus (Oehler’s type III) with pulp necrosis and chronic apical periodontitis was the definitive diagnosis. Use of the dental operating microscope and ultrasonics helped in the removal of the invaginated structure. At the two year follow-up, no clinical and radiographic evidence of infection was observed.

Dens in dente is known as a growth disorder caused by inversion of the coronary tissue into the pulp chamber prior to mineralization; it can be constrained to the crown or extent the root and influence the periapical area. The condition seen in radiographic image like a tooth within a tooth. Although it happens rarely, it is the most frequent malformation detected in human dentition. It can be specially observed in maxillary lateral and then central incisors. Because of the complexity as well as strange anatomy, the tooth has the potential to show pulp necrosis and open apex, which may bring about some challenges to manage it. An early detection of the malformation is critical for better handling and makes treatment plan more conservative like restorative procedures. We describe the management of an uncommon case of type III dens in dente diagnosed using cone-beam CT scan in a maxillary lateral incisor, having a chronic periapical lesion, buccal sinus tract as well as palatal expansion healed successfully after treating with non-surgical root canal procedure.

Dens in dente é uma anormalidade descrita como o dobramento do órgão do esmalte na papila dentária durante o estágio de formação. Acomete principalmente os incisivos laterais superiores, sendo sua frequência de ocorrência de 0,04% a 10%. O objetivo deste trabalho é apresentar as diferentes intervenções clínicas descritas na literatura com foco na necessidade de tratamento endodôntico em casos de dens in dente. Foi realizada uma busca nas bases de dados PubMed, Biblioteca Virtual da Saúde (BVS) e Google Acadêmico utilizando as palavras-chave: “dens in dente”, “dens invaginatus”, “dental malformation”, “endodontic treatment”, “root canal treatment”, “endodontic therapy”, “endodontics” combinadas com os operadores booleanos “AND” e “OR”. O tratamento do dens in dente inclui o selamento de esmalte, tratamento endodôntico, tratamento cirúrgico combinado, reimplante intencional e extração. A escolha do tratamento depende de sua classificação, que pode ser dividido em tipo I, II ou III. O uso da tomografia tem sido indicado para diagnóstico e planejamento. A limpeza e a modelagem nesses casos se mostram de difícil complexidade. O uso de insertos ultrassônicos podem ser utilizados para potencializar os efeitos da substância química auxiliar na limpeza do canal. A técnica de obturação termoplastificada se mostra satisfatória por proporcionar um melhor preenchimento na obturação do canal radicular. Conclui-se que para a abordagem dos casos de Dens in dente, o profissional necessita ter conhecimento sobre diagnóstico, anatomia interna, interpretação radiográfica e tomográfica, e conhecer as possibilidades de intervenção clínica de acordo com a sua classificação.

Introduction: Dilated odontoma is the most severe form of a dens invaginatus, which is a rare dental malformation resulting from an invagination of the enamel organ into the dental papilla before calcification occurs. Observation: A healthy 7-years-old girl was referred to the oral surgery department to remove an impacted odontoma causing a delayed dental eruption of the right mandibular lateral incisor (tooth 42). The patient was painless and a lingual osseous swelling was observed. A computed tomography and a 3D segmentation revealed a shell-shaped mass in the position of the right mandibular lateral incisor, showing a complex anatomy. Surgical excision was carried out under general anesthesia. Histological analysis confirmed the diagnosis of DO. Discussion and conclusion: We performed a literature review investigating 16 cases of severe forms of dens invaginatus which required extraction. It highlighted the atypical aspect of our case and the importance of 3D imaging and segmentation in contributing to the accurate diagnosis and treatment of this dental malformation. [ABSTRACT FROM AUTHOR]

From a technical point of view, root canal treatment of invaginated teeth is not an easy task due to the complexity of their canal morphology. In this article, three cases are reported, for which two different treatment approaches were applied. One case was treated following the conventional approach, whereas the other two were treated applying the conventional approach together with endodontic surgery. Follow-up examinations showed successful clinical and radiographic results in the three cases mentioned in this article. [ABSTRACT FROM AUTHOR]

Introduction: Dens invaginatus is a malformation of the tooth during embryonic development that presents in several morphological types. This article reports a case of a type II dens invaginatus with an extensive periradicular lesion that was treated successfully. Methods: Three-dimensional imaging, cone beam computed tomography (CBCT) was used to identify the morphology of dens invaginatus and to help devise a treatment plan. Nonsurgical and surgical endodontic treatments were performed to achieve a favourable outcome. Conclusions: Understanding both the configuration of the internal root canal and irregularities of the external root using CBCT can ensure predictable and successful results, as in this case. The 2-year follow-up showed complete healing of the periapical pathosis. [ABSTRACT FROM AUTHOR]

This report describes the management of an uncommon case of dens invaginatus of a microdontic upper lateral incisor, with an extended apical lesion. Dens invaginatus is a developmental abnormality of a tooth where enamel and dentin fold into the pulpal space. This abnormal anatomy, and the separation of two distinct root canal spaces, complicates conventional treatment, making the apical portion inaccessible to instrumentation and impeding disinfection of the canal space. The coexistence of dens invaginatus affecting a microdontic tooth is a rare anomaly found in the literature. This case report describes a young female patient with dens invaginatus affecting a microdontic maxillary lateral incisor, combined with necrotic pulp and apical periodontitis. The conventional treatment was completed first to disinfect the coronal portion of the accessible pulpal space. At a subsequent appointment, it was completed by a surgical approach to cleanse and seal the apical part of the root canal space. The tooth was then restored, and the orthodontic treatment was initiated. One-year follow-up demonstrated a complete healing of the apical lesion.

Dens invaginatus (DI) is a dental anomaly associated with complex internal anatomy. Our article discusses an unusual maxillary lateral incisor with two DI. The treatment was planned and performed using cone-beam computed tomographic (CBCT) imaging. During clinical and radiographic evaluations, tooth #7 was diagnosed with DI and pulp necrosis with asymptomatic apical abscess. Periapical radiographs of the tooth showed 2 roots and complex internal anatomy. CBCT evaluation revealed tooth #7 had 2 separate cul-de-sacs (that separate the main canal into four portions). Root canal treatment was completed in 2 visits. The tooth was obturated with EndoSeal MTA. At the 6-month re-evaluation, the patient remained asymptomatic and his tooth had remained functional. Clinical and radiographic examination showed tooth #7 had no sensitivity to percussion or palpation, probe depths within normal limits (#3 mm), no mobility and continued improvement of periapical lesion, despite the commencement of orthodontic Rx 3months previous. Radiographic assessment at the one-year follow up showed significant osseous [ABSTRACT FROM AUTHOR]

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.

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This is a case of swelling originating from dens invaginatus associated with lateral incisor, misdiagnosed as a globulomaxillary cyst. The initial diagnosis of globulomaxillary cyst was made solely from radiographs by observing a reverse pear-shaped radiolucency between the lateral incisor and cuspid. The results following pulp testing and Cone Beam Computed Tomography (CBCT) evaluation revealed the endodontic origin of the lesion, which entailed the treatment carried out by surgical enucleation and apicoectomy. This also details the clinical and diagnostic dilemma as well as conflicts associated with the diagnosis and management of the cystic lesion. [ABSTRACT FROM AUTHOR]

Dens invaginatus is an uncommon malformation of teeth due to infolding of the dental papilla during tooth development. Most often it is detected by chance on a radiograph. A deep foramen caecum is the first indication of this condition. Due to the tortuous lingual anatomy, it is possible for caries to develop without any clinically detectable lesion. As the enamel lining is thin and close to the pulp chamber, caries can cause pulp involvement rapidly. Maxillary lateral incisors are most commonly affected, followed by maxillary central incisors, premolars, canines and molars. This case report discusses the diagnosis and management of a case of Oehlers Type II dens invaginatus in a maxillary lateral incisor. The technique of proper cleaning and obturation of such complex canal systems, namely irrigation followed by ultrasonic agitation and use of sectional obturation together with thermoplasticised backfilling, is also discussed. [ABSTRACT FROM AUTHOR]

Objective: To document the clinical, radiographic, and histological characteristics of mandibular first molar teeth with developmental abnormalities previously attributed to dens invaginatus and enamel pearls in dogs.Materials and Methods: Affected mandibular first molar teeth from dogs were evaluated grossly and via intraoral radiography. Endodontically and/or periodontally compromised teeth were extracted and subjected to some combination of micro-computed tomography, histopathology, and immunohistochemistry with anti-amelogenin antibody.Results: Six dogs with developmental abnormalities of mandibular first molar teeth were identified, representing 11 affected teeth. The condition was bilateral in 5 dogs, while in 1 dog, only one mandibular first molar tooth was present. Patient weight ranged from 1.7 to 6 kg (median = 4.09 kg). On intraoral radiographs, root convergence or parallelism was noted in 6 of 11 teeth, and root dilaceration was noted in 3 of 11 teeth. Eight teeth required extraction due to periapical lucencies or periodontitis. On micro-CT, the abnormal teeth were characterized by the presence of abnormal, heterogenous hard tissue with beam attenuation characteristics midway between that of enamel and dentin. Enamel fissures were identified in 4 of 8 teeth, while ectopic radicular enamel was identified in 2 of 8 teeth. The abnormal tissue was traversed by channels measuring 20–40 μm in diameter. Channels communicated with the enamel fissures in 2/8 teeth, the furcation in 2/8 teeth and the pulp in 4/8 teeth. The abnormal tissue was frequently surrounded by disorganized dentin. Histologic features of enamel and dentin were absent from the abnormal tissue and immunohistochemistry to detect amelogenin in the abnormal tissue was negative in all samples.Conclusion: The dental abnormalities described here correspond to a previously unrecognized developmental abnormality involving the mandibular first molar teeth in dogs. The developmental origin of the abnormal tissue could not be ascertained, and further investigations are required to determine the mode of formation, origin of the abnormal tissue, and factors associated with development. These developmental abnormalities more closely resemble molar-incisor malformation, rather than dens invaginatus or enamel pearls as described in humans. The authors propose that affected mandibular first molar teeth simply be referred to as having carnassial tooth malformations.

Background/Aim: Dens invaginatus is a developmental anomaly of teeth. The endodontic treatment of these teeth may be difficult because of adversity in accessing the root canals and also complicated variations of internal structure. In this case, the report is presented the nonsurgical management and follow-up of a tooth with class II dens invaginatus with an open apex and sinus tract.

Dens invaginatus is a developmental anomaly resulting from an invagination in the surface of a tooth crown before its calcification. It involves more commonly maxillary anterior teeth. Dens invaginatus with supernumerary teeth and double dens invagintus were also reported. The management of dens invaginatus includes simple prophylactic restoration to conventional endodontic treatment or extraction, depending on the type of invagination, function, esthetics, and morphology of the root canal. Extraction is indicated as a last choice of treatment in cases of failure of root canal treatment and in supernumerary teeth associated with dens invaginatus. In this paper, we have reported a series of cases of dens invagintus.

Dens invaginatus (DI or dens in dente) and Talons cusp or dens evaginatus are relatively rare developmental anomalies which affect the shape of teeth. DI is a deep surface invagination of the crown or root which is commonly detected on routine radiographic examination. Talon cusp is an additional cusp that projects predominately from the lingual surface of anterior teeth. These anomalies most commonly may be observed in the maxillary lateral tooth. Concurrently, the coexistence of these two anomalies in a single tooth is considered extremely rare. However, still in literature, there are a few reports cases available. This article is a case report of Talons cusp with DI involving maxillary lateral incisors in a 16-year-old patient.

Dens invaginatus (DI) is an unusual anomaly of teeth, presumably resulting from an infolding of the dental papilla during tooth development. The root canal treatment of such teeth is arduous because of problems associated with gaining access to the root canals and with variations of canal morphology associated with this type of malformation. The present case describes the effective endodontic treatment of an Oehlers Type IIIB DI in a mandibular right central incisor associated with periapical lesion. It likewise demonstrates that spiral computed tomography scan is a significant auxiliary aid to avoid errors in diagnosis and treatment of the dental anomaly.

Dens invaginatus (DI) (dens in dente) is a developmental anomaly resulting from an invagination in part of variable depth of the enamel organ into the dental papilla in the surface of the crown before calcification of the dental tissues. This anomaly usually involves the upper lateral incisors. These teeth are frequently expressed by an unusual form of crown and accentuation in the cingulum or a cusp. They are a target for caries leading to pulp necrosis and apical pathosis, so the diagnosis and early prevention measures are important. When treatment is necessary, conservative, endodontic, and periodontal possibilities are very effective. Surgical interventions are only rarely indicated. The present paper deals with the treatment of series cases with DI.

Dens invaginatus (DI) as a dental anomaly suggests a broad spectrum of morphologic variations and predisposes the tooth to decay and in intense invaginations to pulpitis and apical periodontitis. The involved tooth requires endodontic or combined endodontic-surgical treatment which often is complicated because of the abnormal morphology. As intraoral periapical radiographs provide insufficient information because of its two-dimensional nature, a cone-beam computed tomographic scan is recommended in complex cases with aberrant root canal anatomy that allows visualization of pathology in three dimensions. This article reports a case in which multiple teeth were involved with DI associated with open apex and periapical pathology which was successfully treated with endodontic and combined endodontic-surgical approach. The success of the present case suggest MTA as a preferable material to aid regeneration of the apical tissue in nonvital teeth with open apex and thus can be used in cases of DI.

Dilated odontoma is the most severe variant of dens invaginatus. It is extremely uncommon in the posterior mandible. It is thought to originate during the morpho-differentiation stage of dental development. However, its etiology and pathogenesis remain obscure. We report here the clinical and pathologic findings of an incidentally discovered dilated odontoma arising in the left third mandibular molar germ of an 11-year-old male and a review of the pertinent literature. As dilated odontoma is not established as an independent entity in the current WHO classification of odontogenic tumors and is the result of a well-established developmental anomaly of the tooth (that is, the invagination of the enamel organ into the dental papilla), it should be better identified as dilated dens invaginatus.

This article reports on an unusual case of dens invaginatus in a maxillary third molar that was causing severe symptoms of irreversible pulpitis. This malformation was not clinically or radiographically identified, and the occurrence of referred pain made the early identification of the responsible tooth difficult. Determination of the tooth that was the source of symptoms was only possible after an observation period and fast aggravation of the pathologic process to cause pulp necrosis and extreme tenderness to percussion. The diagnosis of dens invaginatus was made only after extraction and sectioning. Histopathologic and histobacteriologic features of this case are illustrated. [ABSTRACT FROM AUTHOR]

Background: Cleidocranial dysplasia (CCD) is an autosomal dominant malformation syndrome affecting bones and teeth. It has been demonstrated that mutation of the RUNX2 gene which controls osteoblastic differentiation, appropriate osteogenesis and odontogenesis via participation in odontoblast differentiation, enamel organ formation and dental lamina proliferation is responsible for CCD. The dental abnormalities associated with CCD are often the reason for diagnosis in mildly affected individuals. Here we present two cases of cleidocranial dysplasia with radiographic analysis, both presenting with a rare dental anomaly; dens invaginatus. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Dental Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of LKS is the property of Czech Dental Chamber and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: To report a case of type III dens invaginatus associated with peri-invagination periodontitis in an immature permanent mandibular central incisor with open apex, in which only the invagination area was treated and vitality was preserved. Case presentation: A 9-year-old boy was referred complaining of pain in the mandibular left central incisor. After radiographic examination, an invagination into the pulp chamber of the tooth associated with periapical radiolucency was detected. Endodontic access was performed and the orifice was identified under a dental operating microscope. The invagination area was chemo-mechanically cleaned. After 1 week, the invagination was obturated with mineral trioxide aggregate. During the 2-year follow up period, the tooth was asymptomatic. Radiographic examination revealed significant progression of periapical healing and root development in the main root canal of the tooth. Conclusion: Non-surgical root canal treatment of the invagination may preserve pulp vitality, and continuous root development of the tooth. [ABSTRACT FROM AUTHOR]

A case of dens invaginatus in a maxillary lateral incisor with a periapical lesion (that was discovered by chance after a panoramic radiographic examination despite the abnormal anatomy) responded successfully to non-surgical treatment involving chemomechanical root canal preparation associated with longterm treatment with calcium hydroxide. [ABSTRACT FROM AUTHOR]

Dens invaginatus in molar teeth is extremely rare. This report presents a case in a right mandibular second molar. The pulp was necrotic and there was a buccal sinus tract associated with the tooth. The dens invaginatus was revealed following a periapical radiograph that also showed a periradicular lesion. Conventional root canal treatment was carried out; a calcium hydroxide paste was used as an intracanal dressing. The root canal space was filled with gutta-percha and sealer using a thermomechanical compaction technique. At follow-up, after 1 year, the tooth was symptom-free and there was radiographic evidence of healing. As a result, endodontic surgery was not required. [ABSTRACT FROM AUTHOR]

Dens invaginatus is a malformation that can arise in any tooth, but cases in molars are rare. A young adult patient in good dental health presented with an extensive infection of his right maxilla, and a diagnosis of acute periodontal abscess was made. Further investigation revealed acute periapical periodontitis arising from a necrotic third molar pulp. With the tooth extracted, a rare and seldomly reported case of a maxillary third molar dens invaginatus was revealed. Micro CT is useful for studying this type of malformation. [ABSTRACT FROM AUTHOR]

Dens invaginatus is a dental malformation that may give rise to several complications. Caries of the invagination can severely weaken the whole tooth, making it susceptible to fracture. Subgingival fractures are major complications threatening tooth survival and usually require periodontal/orthodontic/prosthetic treatment if long-term viability is to be ensured. This article describes a case of single-session restoration of a fractured invaginated tooth by means of endodontic treatment followed by fragment reattachment. [ABSTRACT FROM AUTHOR]

The etiology of dental anomalies is multifactorial; and genetic and environmental factors that affect the dental lamina have been implicated. We investigated two families of European ancestry in which males were affected by taurodontism, microdontia and dens invaginatus. In both families, males were related to each other via unaffected females. A linkage analysis was conducted in a New Zealand family, followed by exome sequencing and focused analysis of the X-chromosome. In a US family, exome sequencing of the X-chromosome was followed by Sanger sequencing to conduct segregation analyses. We identified two independent missense variants in KIF4A that segregate in affected males and female carriers. The variant in a New Zealand family (p.Asp371His) predicts the substitution of a residue in the motor domain of the protein while the one in a US family (p.Arg771Lys) predicts the substitution of a residue in the domain that interacts with Protein Regulator of Cytokinesis 1 (PRC1). We demonstrated that the gene is expressed in the developing tooth bud during development, and that the p.Arg771Lys variant influences cell migration in an in vitro assay. These data implicate missense variations in KIF4A in a pathogenic mechanism that causes taurodontism, microdontia and dens invaginatus phenotypes.

In vital pulp therapy, pulp testing aids in the differential diagnosis and influences the treatment plan. Different from previous doppler flowmetry studies that only recorded waves and data, we report the first time, the use of a laser doppler blood flow monitor and imager with a colored image to present pulp vitality information in the dental field. We report here a case of Oehlers type IIIa dens invaginatus of the right upper lateral incisor in a 31-year-old girl, with the opening of the invagination near CDJ and a peri-invagination lesion sized 8 × 9 mm2. Cone beam computed tomography was used to verify specific spatial and stereoscopic data. After removing the source of infection, mineral trioxide aggregate was selected to fill the invagination. Laser doppler was scheduled for further assessment. After three years of regular follow-up, the patient’s clinical condition improved, the peri-invagination lesion healed, and the laser doppler and electric pulp test both showed a positive reaction. Laser doppler has successfully improved the diagnostic accuracy Thus, unnecessary interventions can be avoided while reducing the treatment time by preserving the vitality. However, further work is needed to resolve the limitations of laser doppler.

The endodontic treatment of an atypical maxillary lateral incisor that contained a C-shaped root canal is described. The unusual anatomic configuration of this particular tooth and the advantage of using image magnification to facilitate endodontic treatment are discussed. {Quintessence Int 1999:30:707-711) [ABSTRACT FROM AUTHOR]