Abstract
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.
Highlights
A 14-year female presented with an atypical looking tooth #7 with a sinus tract on tooth #8
Use of the Cone-beam computed tomographic imaging (CBCT) and dental operating microscope (DOM) in clinical endodontic practice has increased the feasibility and knowledge regarding various anatomical complexities. This case presents an overview of the practicability of using CBCT in the diagnosis and treatment planning, along with DOM and ultrasonics in the nonsurgical endodontic management of the Dens invaginatus (DI)
Based on the literature review to date, there are no studies related to the removal of DI in maxillary lateral incisor with mature apex aided with CBCT analysis, DOI and ultrasonics, followed by successful endodontic treatment
Summary
Abstract: A 14-year female presented with an atypical looking tooth #7 with a sinus tract on tooth #8. Use of the dental operating microscope and ultrasonics helped in the removal of the invaginated structure. Use of the CBCT and dental operating microscope (DOM) in clinical endodontic practice has increased the feasibility and knowledge regarding various anatomical complexities. This case presents an overview of the practicability of using CBCT in the diagnosis and treatment planning, along with DOM and ultrasonics in the nonsurgical endodontic management of the DI. The DI was troughed by using ET20 ultrasonic tip (P5, Satelec, France) carefully to separate the invaginated structure from the pulp canal. At the 2-year follow-up, the tooth was asymptomatic, and the periapical radiograph showed complete healing of periapical radiolucency of tooth #7 (Fig.2f). Informed consent has been obtained from the patient and all individuals in this case report
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