Diagnosis of maxillary lateral incisor dens invaginatus and therapeutic approach

Abstract

Dens invaginatus (DI) is a developmental malformation caused by infolding of enamel and dentin toward the pulp cavity. A deep foramen cecum or unusual crown morphology is often seen in the area of affected teeth, which re most frequently in maxillary lateral incisors. DI is often associated with occurrence of internal caries without the clear symptoms and occasionally causes the pulp death, thus early diagnosis and treatment are important, as well as schedule follow-up examinations. Report here is a child aged 9 years 5 months with DI in the maxillary left lateral incisor. Based on cone beam computed tomography (CBCT) findings, the case was diagnosed as pulp necrosis and acute periapical abscess related to Oehlers type I DI. Endodontic treatment in consideration of the affected immature tooth and canal filling with calcium hydroxide paste were performed. Post-procedure CBCT imaging showed deposition of a calcified mass in the canal and reduced apical radiolucency, suggesting a favorable treatment outcome. Careful clinical and radiographic examinations should be conducted to identify DI and manage affected patients.