Endodontic clinical management of a dens invaginatus case by using a unique treatment approach: a case report

J Endod. 2012 Aug;38(8):1145-8. doi: 10.1016/j.joen.2012.04.020. Epub 2012 Jun 7.

Abstract

Introduction: Dens invaginatus is a developmental anomaly that poses treatment challenges when nonsurgical root canal therapy is deemed necessary. Teeth with complex root canal morphology often require a comprehensive treatment approach to effectively clean, shape, and disinfect the pulp canal space before obturation. Endodontic clinical management of a tooth with dens invaginatus might include using cone-beam computed tomography (CBCT) to aid in the diagnosis and treatment-planning phase and use of the surgical operating microscope in performing the clinical phase of treatment. A novel approach could include using the revascularization technique as the final treatment step in the management of a dens invaginatus case in which the root apex has not completed formation.

Methods: This case report will provide both an overview of the feasibility of using CBCT scans in diagnosis and treatment planning and a step-by-step clinical technique, by using surgical operating microscope and the revascularization technique, in the successful endodontic management of a complex dens invaginatus case.

Conclusions: Five-month and 12-month follow-up clinical and radiographic findings will provide a candid view of inherent advantages and challenges of this technique.

Publication types

  • Case Reports

MeSH terms

  • Aluminum Compounds / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Calcium Compounds / therapeutic use
  • Child
  • Cone-Beam Computed Tomography / methods
  • Dens in Dente / pathology
  • Dens in Dente / therapy*
  • Dental Pulp Cavity / abnormalities
  • Dentin Sensitivity / therapy
  • Dentin, Secondary / diagnostic imaging
  • Drug Combinations
  • Feasibility Studies
  • Follow-Up Studies
  • Glass Ionomer Cements / chemistry
  • Humans
  • Magnesium Oxide / chemistry
  • Male
  • Microscopy / instrumentation
  • Oxides / therapeutic use
  • Patient Care Planning
  • Polycarboxylate Cement / chemistry
  • Root Canal Filling Materials / therapeutic use
  • Root Canal Irrigants / therapeutic use
  • Root Canal Preparation / instrumentation
  • Root Canal Therapy / methods*
  • Silicates / therapeutic use
  • Sodium Hypochlorite / therapeutic use
  • Tooth Root / abnormalities
  • Zinc Oxide / chemistry

Substances

  • Aluminum Compounds
  • Anti-Bacterial Agents
  • Calcium Compounds
  • Drug Combinations
  • Glass Ionomer Cements
  • Oxides
  • Polycarboxylate Cement
  • Root Canal Filling Materials
  • Root Canal Irrigants
  • Silicates
  • mineral trioxide aggregate
  • Magnesium Oxide
  • Ketac-cem
  • Sodium Hypochlorite
  • Zinc Oxide