Cone beam computed tomography in the diagnosis of dens invaginatus: case report / Tomografía computarizada de haz cónico en el diagnóstico de diente invaginado: presentación de un caso

The aim of this report is to present a case of dens invaginatus asymptomatic discovered after exam cone beam computed tomography. A 20-year-old patient attended the clinic Radiology to perform tomography to fracture research at the root of the tooth 15. However, the examination was observed the presence of a conoid supernumerary tooth between the tooth located roots 11 and 12, which had a hyperdense line to the apex of the root, representing the invagination of the enamel, dens invaginatus feature. It was also observed extensive hypodense image in the periapical region, with areas of external resorption both in supernumerary tooth as we ll as the roots of teeth 11 and 12. The treatment consisted of surgery for dens invaginatus extraction. The dentists should be aware of the imaginological characteristics of the anomalies that can affect the teeth/jaws, which can be discovered in tests for routine imaging and proper conduct for the treatment of patients.

El objetivo de este trabajo fue presentar un caso dedens invaginatusasintomático descubierto en una tomografía computarizada de haz cónico. Un paciente de 20 años de edad acudió a la clínica radiológica para realizarse una tomografía producto una fractura radicular del diente 15. Sin embargo, en el exámen se observó la presencia de un diente supernumerario cónico localizado entre las raíces de los dientes 11 y 12, observando además una línea hiperdensa hacia el ápice de la raíz, que representa la invaginación del esmalte, característica propia de undens invaginatus.También se observó un área hipodensa en la región periapical, con áreas de reabsorción externa tanto en el diente supernumerario como en las raíces de los dientes 11 y 12. El tratamiento consistió en cirugía de extracción deldens invaginatus. Los dentistas deben conocer las características imagenológicas de las anomalías que pueden afectar a los dientes, las cuales pueden ser descubiertas en exámenes de rutina y también el protocolo adecuado de tratamiento de éstas.

Bilateral dens invaginatus in the mandibular premolar region.

Dens invaginatus (dens in dente, DI) is a rare developmental anomaly resulting from invagination of a portion of the crown rare. It is an important dental anomaly due to the possible pulpal involvement. DI can be detected clinically in a tooth presenting unusual crown morphology or having deep foramen coaceum. Also, clinically, non-suspected affected teeth are commonly diagnosed as an incidental radiographic finding. Presence of DI in the mandibular premolar teeth is unusual. Aims is to introduce a case of bilateral occurrence of DI in mandibular first premolar teeth. A 33- year-old man was referred to our clinic with a chief complaint of severe pain in his lower third molar tooth. Radiographic examination revealed bilateral DI (single at the left, double at the right) in mandibular first premolar teeth. The teeth were restored with fissure sealant. Although bilateral appearance of DI is a frequent situation, mandibular occurrence is very rare. Our review of the literature reveals just nine cases of DI, and only one of them is in a premolar tooth.