Pre-eruptive diagnosis and management of occlusal dens evaginatus in premolar teeth

Abstract

Dens evaginatus is an uncommon dental aberration that occurs primarily on the occlusal surfaces of premolar teeth. Developmentally, it is similar to a talon cusp, though the latter manifests on the palatal or lingual surfaces of anterior teeth. Its anatomical location is often the central fossa of the associated tooth; it can vary significantly in size and can be present symmetrically in the ipsilateral and contralateral quadrants. Histologically, the enamel protuberance may contain dentinal and pulpal tissue. If early, ideally pre-eruptive diagnosis is not made, there is a significant risk that, on eruption, these protuberances will shear off under occlusal forces, exposing the pulp, and potentially leading to loss of teeth in an otherwise healthy dentition. Therefore, its clinical implications are significant to the general dental practitioner, the paediatric dentist, the orthodontist and the restorative dentist. CPD/Clinical Relevance: This review article aims to summarize the available dental literature and illustrate the appropriate management of a patient with dens evaginatus.