Abstract
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.
Highlights
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 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
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]
Summary
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]. Muhlreiter (1873), Baume (1874) and Busch (1897) call this malformation dens in dente because of the radiographic appearance of ‘a tooth in a tooth’ [5, 9, 10] This anomaly has been described in the literature under several names including dentoid in dente, invaginated odontome, dilated gestant odontome, dilated composite
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