Endodontic treatment of dens invaginatus with periapical lesion

Abstract

Dens invaginatus or dens in dente represent anomaly of the developing tooth due to invagination of the enamel organinto the dental papilla. Dens invaginatus is usually diagnosed by standard radiological methods (RVG, OPG, and 3DCBCT).Clinical examination may reveal a mottled, dilated or conical shape of the crown. Endodontic treatment of dens invaginatuscan be difficult and complex due to the deviated anatomy. This report describes the successful endodontic treatmentof a maxillary lateral incisor that had dens invaginatus and a large periapical lesion. Clinical examination in a 30-year-oldpatient revealed an acute periapical abscess, and a dens invaginatus type II was diagnosed after radiography. Due to theexisting anatomy, endodontic treatment of the main canal was performed through two access cavities, which enabledchemo-mechanical treatment and access to all parts of the root canal. The canal of the invaginated tooth was treatedthrough the third access cavity.