ABSTRACT
Dens invaginatus is a rare developmental anomaly of the teeth that is caused by the infolding of enamel organs or the penetration of their proliferations into dental papillae before calcification has occurred. The presence of double dens invaginatus is extremely rare. This paper describes the use of cone beam computed tomography in the evaluation of a maxillary lateral incisor with double dens invaginatus and periapical periodontitis. The tooth was treated through microscopic root canal therapy. The tooth was free of clinical symptoms, and the periradicular lesion narrowed during the follow-up period of 1 year.
Subject(s)
Humans , Dental Pulp Cavity/abnormalities , Dens in Dente/pathology , Incisor/pathology , Root Canal Therapy , Periapical Periodontitis/pathologyABSTRACT
El diente evaginado (DE) es una anomalía del desa-rrollo que se define como un tubérculo o protube-rancia que se extiende desde la superficie oclusal del diente afectado. La fractura o desgaste de esta pro-longación, internamente compuesta por tejido pul-par, puede causar diversas enfermedades pulpares, como pulpitis, necrosis pulpar e incluso dar lugar a una periodontitis apical. En el presente caso clíni-co se muestra el tratamiento de DE en un segundo premolar superior izquierdo que presentaba como diagnóstico necrosis pulpar y absceso alveolar cró-nico. El tratamiento consistió en realizar la terapia endodóntica con técnica de apexificación empleando BiodentineTM (AU)
Dens evaginatus (DE) is a dental developmental defect defined as a tubercle or protuberance that extends from the occlusal surface of the affected tooth. Fracture or wear of this extension, internally composed of pulp tissue, can cause diverse pulp diseases, such as pulpitis, pulpal necrosis and it can even induce apical periodontitis.The following clinical case shows the treatment of DE in a maxillary left second premolar diagnosed with pulp necrosis and chronic alveolar abscess. The treatment of choice was endodontic therapy using BiodentineTM (AU)
Subject(s)
Humans , Male , Adult , Root Canal Filling Materials , Root Canal Therapy/methods , Dental Pulp Necrosis/therapy , Dens in Dente/pathology , Argentina , Schools, DentalABSTRACT
Permanent mandibular central incisor is rarely affected by tooth shape anomalies of crown and root. Co-occurrence of multiple anomalies in a permanent mandibular central incisor is extremely rare. This paper reports an unusual concurrent combination of multiple dental anomalies affecting both the crown and root of a permanent mandibular left central incisor - talon cusp, dens invaginatus, short root anomaly and macrodontia -, which has not previously been reported together. Case management is described and implications are discussed. The dentist should be aware of these rare entities in order to provide an accurate diagnosis and management for which detailed examination of the tooth both clinically and radiographically is very important.
O incisivo central inferior permanente raramente é afetado por anomalias de forma envolvendo a coroa e a raiz. A co-ocorrência de múltiplas anomalias em um incisivo central inferior permanente é extremamente rara. Este artigo relata uma combinação concomitante incomum de múltiplas anomalias dentais afetando tanto a coroa quanto a raiz de um incisivo central inferior permanente - cúspide em garra (talon cusp), dens invaginatus, anomalia de raiz curta e macrodontia - que ainda não havia sido descrita na literatura. A condução do caso é descrita e suas implicações são discutidas. É importante que o dentista esteja familiarizado com essas entidades raras a fim de proporcionar diagnóstico e tratamento precisos, para os quais exames clínicos e radiográficos detalhados são extremamente importantes.
Subject(s)
Child , Humans , Male , Incisor/abnormalities , Tooth Crown/abnormalities , Tooth Root/abnormalities , Dens in Dente/pathology , Dental Enamel/abnormalities , MandibleABSTRACT
El presente trabajo relata un episodio en el incisivo lateral superior izquierdo, de dens invaginatus (diente invaginado), con aspecto coronario conoideo, asociado a necrosis pulpar y rarefacción ósea periapical. Paciente de sexo femenino, de 13 años, mostraba, al examen clínico, alteración cromática de corona clínica, sin antecedentes de trauma; ausencia de síntoma doloroso espontáneo, si bien provocado por percusión vertical. En ocasión de una planificación ortodóntica se evidenció en examen radiográfico de diagnóstico, rarefacción ósea periapical circunscripta, con imagen sugestiva de dens invaginatus de tipo II a lo largo de la corona y la porción cervical radicular. El tratamiento endodóntico indicado se inicia con la cavidad de acceso y transposición del dens invaginatus, que obstruía la luz del canal. Después del tratamiento endodóntico, en un período de observación de 3 meses, se detecta disminución de la rarefacción ósea periapical.
Subject(s)
Humans , Female , Adolescent , Dens in Dente/pathology , Dens in Dente/therapy , Periapical Diseases/pathology , Root Canal Therapy/methods , Dens in Dente/classification , Incisor/abnormalities , Orthodontics, Corrective/methods , Dental Restoration, Temporary/methodsABSTRACT
Dens invaginatus is a deep surface invagination of the crown or root that is lined by enamel. It is one of the developmental anomalies affecting the teeth. It commonly affects maxillary lateral incisor, followed by central incisor, premolar, canine and molar tooth. Maxillary teeth are more commonly involved than mandibular teeth. It usually occurs unilaterally although 43% occur bilaterally. The invagination within the tooth can be single, double and even triple has been reported. The affected tooth usually is thick, barrel shaped with a small round palatal opening to the invagination. It usually traps plaque, food debris and is prone for dental caries, which may lead to pulpal and periapical pathology. So if detected early the dens invaginatus should be prophylatically restored. Two unilateral and one bilateral case of dens invaginatus are reported here.