Abstract
BackgroundDens invaginatus (DI) is a developmental anomaly, Oehlers Type III DI is the most complex type and early diagnosis and treatment is complicated and challenging. This report presents a rare case of a type IIIb DI associated with a periapical lesion in bilateral immature permanent mandibular central incisors.Case presentationAn eight-year-old boy referred to our clinic manifesting with pain along with swelling in the mandibular incisors for the past one month. Radiographic examination showed periapical radiolucency exhibiting a scantly defined border, as well as an invagination which had a central invaginated canal extending from the pulp chamber throughout the apical foramen in both mandibular central incisors. We performed two different treatment procedures on the basis of the condition of the main pulp of the mandibular central incisors. in which only the invagination root canal was treated in the right mandibular central incisor, while the invagination and main root canals were treated in the left mandibular central incisor. During the 18-month follow-up period, the teeth were clinically asymptomatic. Imaging examinations indicated complete healing of the periapical lesion and revealed that the wall of the root canal was thickened and the open apex was closed.ConclusionFor young permanent teeth with type III Dens invaginatus, it is particularly important to keep pulp vitality, which could maintain root development and allow a good long-term prognosis.
Highlights
Dens invaginatus (DI) is a developmental anomaly, Oehlers Type III DI is the most complex type and early diagnosis and treatment is complicated and challenging
Dens invaginatus is a considerably common condition with an estimated incidence of between 0.3% and 10% in all teeth [3], with maxillary lateral incisors being the most usually affected, and subsequently by the maxillary central incisors, but it is rare in the mandibular incisor [4]
The goal of the therapy could be to keep pulp vitality of the tooth for additional root development, there are extensive management methods for these cases [9]. This case report describes a rare case of type IIIb DI linked to a periapical lesion in bilateral immature permanent mandibular central incisors, in which only the invagination root canal was treated in the right mandibular central incisor, on the contrary the invagination and main root canals were treated in the left mandibular central incisor
Summary
For young permanent teeth with type III Dens invaginatus, it is important to keep pulp vitality, which could maintain root development and allow a good long-term prognosis.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
