Root canal treatment of type Ⅱ and ⅢA double dens invaginatus in maxillary lateral incisor: a case report / 华西口腔医学杂志

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.

Tratamiento de diente evaginado mediante técnica de apexificación: reporte de caso / Treatment of dens evaginatus by apexification technique: a case report

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)

Dilated odontoma in the mandibular third molar region: a case report / Odontoma dilatado na região de terceiro molar mandibular: um relato de caso

ABSTRACT Dilated odontoma is a rare dental developmental anomaly that belongs to a class od dens in dente, being rarely described in the posterior region of the mandible. To be describe a dilated odontoma in the lower third molar region. this study had a qualitative, transversal, descriptive and documentar approach, of the case report type. Developed in the Integrated Health Clinics of a University in the Extreme South of Santa Catarina, in the Dentistry Service. This article presets a case of dilated odontoma in a 32-year-old male patient. The patient had pain and swelling in the left posterior region of the mandible. The Crown of this element was clinically within the normal range, however the radiographic examination showed barrel-shaped root alteration in element 38 and expansion of the buccal and lingual cortical bone. An incisional biopsy of the anomaly whas performed and sent to anatomopathological examination. According to the clinical, radiographic and anatomopathological characteristics, the diagnosis of dilated odontoma was reached. Due to the aberrant root anatomy, complete removal was chosen. The diagnosis of this abnormality depeds on the clinical, radiographic and anatomoathological characteristics and its therapy varies according to the invagination. In cases of deep invagination, extraction is indicated.

RESUMO O Odontoma Dilatado é uma rara anomalia de desenvolvimento dentário que pertence a uma classe de dens in dente, sendo raramente descrito na região posterior da mandíbula. O objetivo desse artigo foi descrever um Odontoma Dilatado na região de terceiro molar inferior. Materiais e métodos: este estudo teve abordagem qualitativa, transversal, descritiva e documental, do tipo relato de caso. Desenvolvido na Universidade do Extremo Sul Catarinense, no Serviço de Odontologia. Este artigo apresenta um caso de Odontoma Dilatado em um paciente do sexo masculino de 32 anos. O paciente apresentou dor e inchaço na região posterior esquerda da mandíbula. A coroa deste elemento encontrava-se, clinicamente, dentro dos padrões de normalidade, entretanto no exame radiográfico foi demonstrada a alteração radicular em forma de barril no elemento 38 e expansão de cortical óssea vestibular e lingual. Foi realizada a biópsia incisional da anomalia e enviado ao anatomopatológico. De acordo com as características clínicas, radiográficas e anatomopatológicas, chegou-se no diagnóstico de Odontoma Dilatado. Devido a anatomia aberrante optou-se pela remoção completa. O diagnóstico desta anormalidade é dependente das características clínicas, radiográficas e anatomopatológicas e sua terapêutica varia de acordo com a invaginação. Em casos de invaginação profunda a exodontia está indicada.

Talon's cusp in a primary maxillary central incisor A report of a rare odontogenic anomaly

Talon's cusp, a type of dens evaginatus (DE) in a primary tooth, is a rare odontogenic anomaly which is reported sparingly in the literature. We report this case describing the presence of a talon's cusp on the right primary maxillary central incisor in a 2-year-old boy precipitating discomfort, owing to occlusal interference. The treatment plan involved pulpectomy and reduction of the lingula DE extension under general anesthesia.

Dens invaginatus u odontoma dilatado, controversia de una definición / Dens invaginatus or dilated odontoma, a definition controversy

El diente invaginado (DI) es una alteración en el desarrollo del órgano dentario, el cual se produce a consecuencia de una invaginación del epitelio interno del órgano del esmalte, también conocido con otros nombres, entre ellos dens in dent. Tiene una serie de características clínicas, histológicas e imagenológicas debidamente descritas a través de la literatura. Su variante más extrema presenta una configuración muy compleja y, debido a la magnitud de la invaginación que presenta, se le denomina también odontoma dilatado, término que para algunos profesionales genera confusión.Este término ha sido mencionado como sinónimo tanto de DI como, en algún momento, de una nueva variante de odontomas, si bien existe una diferencia entre ambos tipos: uno es una anomalía del desarrollo y el otro, un crecimiento de aspecto hamartomatoso. Sin embargo, la literatura sigue utilizando ambos términos para definir al DI, por lo que es importante conocer el origen y tener claro que la controversia está basada en referencias históricas y de costumbre. (AU)

The invaginate tooth (IT) is an alteration in the development of the dental organ, which occurs as a consequence of invagination of the internal epithelium of the enamel organ. IT is also known as "dens in dente", among other denominations, and presents a series of clinical, histological and imaging characteristics. The most extreme variant of IT has a very complex configuration, and the magnitude of the intussusception has led to it also being called dilated odontoma, being a term that generates confusion in some professionals.While the term odontoma has been reported as a synonym for both IT as well as a new variant of odontomas, there is a difference betweene the two types: one is a developmental anomaly and the other is a growth with a hamartomatous appearance. However, the literature continues to use both terms to define IT, and thus, it is important to know the origin and be aware that the controversy is based on historical and customary references. (AU)

A Case of Crowned Dens Syndrome Successfully Treated with Daiobotampito and Shimotsuto / 日本東洋医学雑誌

Crowned dens syndrome (CDS) is a pseudogout of the cervical vertebra, which shows calcification around the dens of the axis. We report a case of CDS that was successfully treated with daiobotampito and shimotsuto. An 83-year-old woman visited our clinic because of neck pain. She was diagnosed with CDS and was initially administered daiobotampito and eppikajutsuto. Her neck pain improved slightly, but recurred. She was then administered daiobotampito and shimotsuto, after which her neck pain disappeared. We considered that daiobotampito and shimotsuto were effective for this prolonged illness based on persistent stasis and blood deficiency according to her treatment course and laboratory findings.

Síndrome de la apófisis odontoides coronada, una manifestación inusual de dolor cervical. Presentación de un caso / Crowned Dens Syndrome, an Unusual Manifestation of Cervical Pain. A Case Report

Resumen Las enfermedades por depósito de cristales de pirofostato dehidratado de calcio o hidroxiapatita se pueden manifestar en cualquier articulación, y cuando se acumulan en la columna cervical pueden ser causa de dolor. El síndrome de la apófisis odontoides coronada es una rara condición clínica que se presenta por calcificación, en forma de corona, de los ligamentos que rodean a la apófisis odontoides. Se presenta el caso de un hombre de 70 años, con una semana de cervicalgia, cefalea y fiebre, que ingresó por sospecha de patología neurológica. Se realizó tomografía computarizada (TC) de cráneo que documentó calificaciones lentiformes del ligamento transverso del atlas. Se instauró manejo con corticoides y antiinflamatorios no esteroideos con mejoría. Una adecuada anamnesis junto con estudio por imagen evita procedimientos innecesarios y permite incluir esta entidad en el diagnóstico diferencial del dolor cervical agudo.

Abstract The calcium pyrophosphate dehydrate (CPPD) or hydroxyapatite (HA) crystal deposition disease can appear in any joint and the accumulation fo crystals in the cervical spine may be painful. Crowned dens syndrome is a rare clinical condition that involves crown-like calcification of the ligaments around the odontoid process. A 70-year-old man presented cervical pain, fever and a headache for over a week, therefore, a neurological condition was suspected. A CT scan revealed lentiform calcifications of the transverse ligament of the atlas. Steroid treatment and a non-steroidal anti-inflammatory diminished the symptoms. A proper clinical history and imaging studies avoid unnecessary procedures and makes it possible to include this entity as a differential diagnosis in acute cervical pain.

Avaliação radiográfica de densin dente em indivíduos com fissura labiopalatina / Radiographic evaluation of dens in dente in individuals with cleft lip and palate

A fissura labiopalatina é uma malformação craniofacial que, como o próprio nome induz, envolve lábio, rebordo alveolar e palato. Pode ser acompanhada por algumas anomalias dentárias como o dens in dente, que necessita de avaliação radiográfica para auxílio em seu diagnóstico. Objetivo: Identificar nas radiografias periapicais o dens in dente em indivíduos com fissura labiopalatina, especificamente na região próxima à fissura. Metodologia: Foram avaliados 10 exames de radiografias periapicais de indivíduos com fissura labiopalatina, do arquivo de imagens digitais da Seção de Diagnóstico Bucal do Hospital de Reabilitação de Anomalias Craniofaciais (HRAC-USP, Bauru-SP, Brasil). Em uma primeira etapa, foram identificados os dens in dentes de cada indivíduo e posteriormente classificados de acordo com Oehlers (1957). Após essas etapas, todos os prontuários dos indivíduos foram avaliados quanto ao histórico de tratamento desses dentes. Conclusão: Na amostra radiográfica de indivíduos com fissura labiopalatina, encontrou-se a maior frequência do dens in dente no dente 12. De acordo com a classificação de Oehlers, 70% dos casos foram grau II, 30% grau I e o grau III não foi encontrado. Entre os lados das fissuras avaliadas com a presença de dens in den-te, 40 % estavam do lado direito, 40% bilateralmente e 20% do lado esquerdo. A radiografia periapical é fundamental para complementar o diagnóstico clínico. O tratamento pode variar de acordo com os níveis de comprometimento dessa anomalia dentária e depende da correta avaliação por parte do dentista.

The cleft lip and palate is a craniofacial malformation that, as its name induces, involves the lip, alveolar ridge, and palate. It may be accompanied by some dental anomalies such as dens in dente, which needs radiographic evaluation to aid in its diagnosis. Objective: To identify in periapical radiographs the dens in dente in individuals with cleft lip and palate, specifically in the region close to the cleft. Methods: Ten periapical radiographs of individuals with cleft lip and palate from the digital image file of the Oral Diagnosis Section at Hospital for Rehabilitation of Craniofacial Anomalies - University of São Paulo (Bauru, São Paulo, Brazil) were evaluated. In a first step, the dens in dente of individuals were identified. In a second step, they were classified according to the Oehlers (1957). After these phases, all the records of the individuals were evaluated regarding the treatment history of these teeth. Conclusion: In the radiographic sample of individuals with cleft lip and palate, the highest frequency of dens in dente was found in tooth 12. According to the Oehlers classification, 70% of the cases were type 2, 30% type 1, and type 3 was not found. Between the sides of the cleft evaluated for the presence of dens in dente, 40% were on the right side, 40% bilaterally, and 20% on the left side. Periapical radiography is essential to complement the clinical diagnosis. Treatment can vary according to the levels of impairment of this dental anomaly and depends on the correct evaluation by the dentist.

Dens in dente Tipo III A: relato de caso / Dens invaginatus type III A: case report

Introdução: dens in dente é uma anomalia rara de desenvolvimento, caracterizada pela invaginação dos tecidos dentários, podendo variar de um ligeiro aumento da fosseta do cíngulo a um profundo sulco, que pode se estender até o ápice dentário. Objetivo: o objetivo do presente artigo foi relatar um caso clínico e descrever as peculiaridades dos achados clínicos e radiográficos de um dens in dente Tipo III A, com ênfase na descrição de sua morfologia completamente atípica, além das dificuldades que foram encontradas no diagnóstico e durante o tratamento endodôntico. Caso clínico: o paciente compareceu ao ambulatório de uma clínica de Endodontia com queixa de dor e leve edema. Ao exame clínico e radiográfico, observou-se imagem sugestiva de dens in dente no elemento #22, sendo, então, proposto tratamento endodôntico convencional, com estudo tomográfico. Resultados: após 1 ano e 6 meses de acompanhamento, o paciente encontrava-se assintomático. Notou-se reparo satisfatório, com formação óssea, apesar da sobre-extensão do cone. Conclusão: foi possível perceber a importância da tomografia computadorizada de feixe cônico como auxiliar no diagnóstico e planejamento da conduta frente a casos de dens in dente, principalmente por aumentar as chances de sucesso, evitando a perda precoce de elementos dentários (AU).

Introduction: Dens invaginatus is a rare dental anomalycharacterized by invagination of dental tissues, which maybe from a slight increase in the pit of the cingulum to a deep groove that may extend to the tooth apex. This report describes clinical and radiographic findings and the morphology of a completely atypical and unique anomaly, and discusses the difficulties in the diagnosis and endodontic treatment of the root canal of teeth with this complex anatomy. Clinical case: Patient seen in the outpatient clinic of the Endodontic Service with a complaint of pain and mild edema. Clinical and radiographic examinations were suggestive of invagination itooth #22, and conservative endodontic treatment and CT scans were indicated. Results: Patient was asymptomatic and had no functional disorders at 18 months of follow-up. Repair and new bone formation were satisfactory, despite cone overextension. Conclusion: Cone-beam CT seems to be an important method of diagnosis and treatment planning in cases of dens invaginatus, especially because it increases the chances of treatment success and prevents the early loss of teeth (AU).

Dens invaginatus of right maxillary second molar: A case report and literature review / 吉林大学学报(医学版)

Objective: To explore the process of diagnosis and treatment of the patients with dens invaginatus of right maxillary second molar, to analyze the clinical features, the radiographic features and the pathological features of the dens invaginatus, and to make a reasonable treatment plan. Methods: The clinical data, imaging findings and pathological data of a patient with dens invagination were collected. The clinical diagnostic criteria and treatment methods of these cases were summarized with relevant literature review. Results: The patient, female, 28 years old, was diagnosed with a hole in the upper right posterior teeth for 6 months. The special examination results showed that the 17-toothed face was flat, the crown was huge, and the occlusal surface was seen in the sag and sputum; the medullary cavity was not reached. The radiograghic examination results showed that the enamel density image of the 17-toothed surface was sunken to the root, with a depth of about 7. 7 mm, diagnosed as dens invaginatus. At the time of initial treatment, the humus was removed and the sag received sedative treatment. The spontaneous pain still existed during the follow-up examination, and the problem of food embolism was not solved. Considering the poor recovery after treatment, the patient agreed to remove the tooth. The isolated tooth was observed by pathological grinding, and the enamel and dentin structures of the invaginatus were abnormal observed under microscope. Conclusion: The patients with dens invagination occurs in the molar area are rare; the type of disease and treatment plan should be determined by imaging examination during the process of diagnosis and treatment; it suggests that the patients with poor recovery after treatment should remove the teeth.

One stage temporary atlantoaxial segmental fixation and reduction for Grauer type IIB dens fractures in teenagers / 中国骨伤

OBJECTIVE@#To assess the clinical results of one stage temporary atlantoaxial segmental fixation and reduction for Grauer type IIB dens fractures in teenagers.@*METHODS@#From February 2009 to April 2015, 19 teenagers with Grauer type IIB dens fractures not amenable to anteiror screw fixation were enrolled and treated using one stage temporary atlantoaxial segmental fixation and reduction without fusion. There were 14 males and 5 females, aged from 14 to 32 years with an average of (24.6±5.0 ) years. The internal fixation was removed after bone healing confirmed by CT scan. At the last follow-up (at least 1 year after internal fixation removal), dynamic CT was used to assess the atlantoaxial rotation activity. Visual analogue scale (VAS) was recorded before the first operation, before the second operation (removal of internal fixation) and at the last follow-up. Neck Disability Index(NDI) was used to evaluate the efficacy before the second operation (removal of internal fixation) and the last follow-up.@*RESULTS@#After operation, 2 patients developed the symptoms of occipital nerve stimulation such as numbness and pain in the occipitocervical region, and were treated with drugs such as dehydration and neurotrophic drugs, and the symptoms were relieved after 1 to 2 months. All the internal fixations were removed and all the patients were followed up more than 1 year, with time ranging from 18 to 25 months and an average of (21.47±2.41) months. The time of bone fusion after operation was 6 to 10 months with the mean of(8.21±1.27) months. Secondary surgical removal of internal fixation were performed immediately after fracture healing without internal fixation failure. The symptoms of neck pain improved significantly after operation, VAS score decreased from 6.74±0.65 before operation to 0.42±0.51 at the last follow-up after the second operation (removal of internal fixation), with statistically significant differences(<0.01). The NDI value decreased from (10.58±2.04)% before the second operation (removal of internal fixation) to (3.79±2.23)% at the last follow-up after the second operation (removal of internal fixation), with statistically significant difference(<0.01). At the last follow-up after the second operation (removal of internal fixation), dynamic CT showed that the unilateral rotation of the atlantoaxial spine reached (15.73±5.57)° to the left, (15.55±5.78)° to the right, and the overall rotation of the atlantoaxial spine was (31.28±10.71)°.@*CONCLUSIONS@#One stage temporary atlantoaxial segmental fixation and reduction for the treatment of Grauer type IIB dens fractures not amenable to anteiror screw fixation in teenagers can avoid the loss of atlantoaxial rotation function caused by atlantoaxial fusion, and to some extent retain the rotation activity of atlanto-axial joint.

Endodontic-periodontal combined therapy for type Ⅲ dens invaginatus in maxillary lateral incisor: a case report / 华西口腔医学杂志

We report a clinical case of type Ⅲ dens invaginatus with endodontic-periodontal lesion in a maxillary lateral incisor. The palatal radicular anomaly predisposed the tooth to periodontal lesions. The caries along the palatal groove caused tooth pulp necrosis and periapical lesions. By means of microscopic root canal therapy, apical surgery, and guided periodontal tissue regeneration, the apical and periodontal infection were controlled, and the affected tooth was retained.

Apical barrier technology to treat chronic apical periodontitis caused by type Ⅱ dens invaginatus: a case report / 华西口腔医学杂志

Dens invaginatusis a rare malformation of the teeth, resulting in frequent pulp necrosis and chronic apical periodontitis. In this paper, the apical barrier technology was used to treat a case of chronic apical periodontitis caused by type Ⅱ dens invaginatus.

Guided endodontics: a case report of maxillary lateral incisors with multiple dens invaginatus

Navigation of the main root canal and dealing with a dens invaginatus (DI) is a challenging task in clinical practice. Recently, the guided endodontics technique has become an alternative method for accessing root canals, surgical cavities, and calcified root canals without causing iatrogenic damage to tissue. In this case report, the use of the guided endodontics technique for two maxillary lateral incisors with multiple DIs is described. A 16-year-old female patient was referred with the chief complaint of pain and discoloured upper front teeth. Based on clinical and radiographic findings, a diagnosis of pulp necrosis and chronic periapical abscess associated with double DI (Oehler's type II) was established for the upper left lateral maxillary incisor (tooth #22). Root canal treatment and the sealing of double DI with mineral trioxide aggregate was planned for tooth #22. For tooth #12 (Oehler's type II), preventive sealing of the DI was planned. Minimally invasive access to the double DI and the main root canal of tooth #22, and to the DI of tooth #12, was achieved using the guided endodontics technique. This technique can be a valuable tool because it reduces chair-time and, more importantly, the risk of iatrogenic damage to the tooth structure.

A case report of multiple bilateral dens invaginatus in maxillary anteriors

The present report presents a case of dens invaginatus (DI) in a patient with 4 maxillary incisors. A 24-year-old female complained of swelling of the maxillary left anterior region and discoloration of the maxillary left anterior tooth. The maxillary left lateral incisor (tooth #22) showed pulp necrosis and a chronic apical abscess, and a periapical X-ray demonstrated DI on bilateral maxillary central and lateral incisors. All teeth responded to a vitality test, except tooth #22. The anatomic form of tooth #22 was similar to that of tooth #12, and both teeth had lingual pits. In addition, panoramic and periapical X-rays demonstrated root canal calcification, such as pulp stones, in the maxillary canines, first and second premolars, and the mandibular incisors, canines, and first premolars bilaterally. The patient underwent root canal treatment of tooth #22 and non-vital tooth bleaching. After a temporary filling material was removed, the invaginated mass was removed using ultrasonic tips under an operating microscope. The working length was established, and the root canal was enlarged up to #50 apical size and obturated with gutta-percha and AH 26 sealer using the continuous wave of condensation technique. Finally, non-vital bleaching was performed, and the access cavity was filled with composite resin.

Dens invaginatus: reporte de un caso clínico / Dens invaginatus: case report

RESUMEN Introducción: De las malformaciones dentales una de las más frecuentes es el dens in vaginatus o dens in dente, esta alteración anatómica representa un reto para el clínico, debido a su anatomía compleja; sin embargo, gracias a los auxiliares de diagnóstico como la tomografía cone-beam, podremos planear el tratamiento para ofrecer el mejor pronóstico. El presente artículo relata un caso clínico de dens in dente presente en diente veintiuno, con necrosis pulpar y periodontitis apical asintomática. Se solicitó TAC cone-beam, se diagnosticó como tipo II según Oehlers; es instrumentado, irrigado con ultrasonido y obturado con técnica «onda continua de calor¼, con un éxito radiográfi co a seis meses de evolución. Actualmente, gracias a los métodos de diagnóstico y auxiliares de tratamiento tales como el ultrasonido, los sistemas de inyección de gutapercha, se pueden ofrecer tratamientos más efi cientes en la terapéutica endodóncica.

ABSTRACT Introduction: The Dens Invaginatus or Dens in dent it is the most common dental abnormal structure, this anatomic variation means a true clinic challenge because of its complex anatomy, however , thanks to the auxiliary tools for diagnosis just like Cone Beam Computerized Tomography, we can plan a good treatment to offer the best diagnosis. This article describes a clinic case about Dens in Dent in twenty one tooth with pulp necrosis and asymptomatic apical periodontitis. Cone Beam Computerized Tomography was requested, the image helped to classify the kind of Dens in Dent which is type II according to Oehlers´s classifi cation. It is instrumented, irrigated with ultrasound and sealed with "continuous wave of heat "technique. This technique ensures a radiographic success with six months of evolution. Currently, thanks to diagnostic methods and treatment aids such as ultrasound, gutta-percha injection system more effi cient treatments can be offered in endodontic therapeutics.

Dens in dente y talón cuspídeo en un incisivo permanente: reporte de un caso y tratamiento preventivo / Dens in dente and cusp talon in a permanent incisor: report of a case and preventive treatment

Los dientes pueden presentar trastornos originados por factores externos o hereditarios que afectan su forma. Dens in dente es una anomalía durante el desarrollo que resulta en la invaginación del esmalte y dentina, en la cara lingual o vestibular, que puede extenderse profundamente dentro de la raíz. El talón cuspídeo es caracterizado por la proyección de una cúspide accesoria en el cíngulo de los órganos dentarios anteriores y la superficie oclusal de los posteriores. Se presenta el caso de una niña de 7 años de edad, con dens in dente y talón cuspídeo en el incisivo central superior derecho que provoca interferencia oclusal prematura, sin sintomatología. Se realizó desgaste gradual del talón cuspídeo, con aplicación de fluoruro de sodio. El diagnóstico temprano de anomalías dentales en pacientes pediátricos es la clave para un tratamiento conservador y preventivo para el adecuado funcionamiento masticatorio y estético del paciente (AU)

Teeth may have disorders caused by external or hereditary factors that affect their shape. Dens invaginatus is an anomaly during development that results in invagination of the enamel and dentin, lingual or vestibular surface, which can extend deeply into the root. Talon cusp is characterized by the projection of an accessory cusp in the cingulate area in anterior and occlusal aspects of the posterior teeth. We present a case of a 7 year old girl with dens invaginatus and talon cusp on the maxillary central incisor that causes premature occlusal interference, without symptomatology. The treatment employed were gradual wear of cuspal talon with several applications of sodium fluoride. Early diagnosis in pediatric patients is the key to a conservative and preventive treatment for a proper masticatory and aesthetic functioning of the patient (AU)

Morphometric Study of Axis Vertebra in Subjects of Indian Origin

Background: The axis vertebra, exhibits complex and extensive variability in the morphology and there are vital neurovascular structures in its proximity. Knowledge of this variability is important for neurosurgeons, orthopaedicians, otorhynologists and other physicians who in everyday practice are in contact with disorders of the spine and their consequences. Objective: The aim was to evaluate various morphometric dimensions of axis vertebrae and to compare with the available data. Material and Methods: 50 dried human axis vertebrae of Indian origin, available in the Department of Anatomy, Dayanand Medical College and Hospital, Ludhiana were studied. Various dimensions were taken with vernier calipers, metric scale and graph paper. The dimensions were measured in millimetres and statistically analysed with paired t-test. Results: The mean of maximum anteroposterior diameter (max.APD) and maximum transverse diameter (max.TD) of Superior Articular Facet (SAF) was measured as 17.42mm±1.73 and 15.31mm±1.44 on the right side, 17.64mm±1.51 and 15.17mm±1.48 on left side. The mean Distance from Lateral most edge of SAF to Midline was measured as 22.56mm ± 2.37 and 22.40mm ± 2.16 on the right and left sides, respectively. The mean Distance from Tip of Transverse Process to Midline was 26.45mm ± 2.85 on the right and 26.03mm ± 2.64 on the left side. The mean Height of Dens was measured as 13.83mm ± 1.52, mean Width of Dens as 9.57mm ± 0.85. Width of Pedicle was measured as 10.52mm ± 1.99 and 10.61mm ± 1.67on right and left sides, respectively. Conclusion: The knowledge of these dimensions can provide useful information for safe planning of osseous fixation.

Multiple Dens Evaginatus- A Rare Case Report With A Review Of Literature

Densevaginatus (DE) is a developmental disturbance affecting the shape of the teeth which is characterized by the presence of accessory enamel projections along with dentin and pulpal core on the occlusal or lingual surface of the teeth. It affects both the primary and permanent dentition. The clinical intendment is focused on early pulpal exposure due to occlusal trauma, fracture or attrition leading to infection. Treatment may be conservative or interventional. The occurrence of DE either isolated or conjoined with other dental anomalies has been reported. This article presents with a case report of conjoined occurrence of multiple DE (Schulge type 5) along with partial anodontia of maxillary premolars and left molars and also reviews the etiology, classification, diagnosis and management strategies of the teeth with DE.

Hallazgos imagenológicos de dens in dente tipo II con formato de odontoma dilatado en un mesiodiente / Imaging findings of a dilated odontoma shaped type II dens in dente in a mesiodens

Introduction: there are three types of dens in dente: Type I, minimal invagination confined to the crown of the tooth which does not extend beyond the amelocemental junction; Type II, invagination extends to the pulp chamber, but remains within the root canal with no communication with the periodontal ligament; and Type III, invagination extends to the root of the affected tooth, beyond the cementoenamel junction. The term dilated odontoma is used to describe the most severe variant of invagination (Type III), which is characterized by crown and/or root dilation of the affected tooth. Objective: describe a rare case of a dilated odontoma shaped dens in dente in a mesiodens and its imaging findings, diagnosed by cone beam computed tomography. Case presentation: a 14-year-old male patient was referred for radiographic examination of the mandible and maxilla to determine the cause of abnormal tooth eruption chronology. Two mesiodens were found on the maxilla. Due to the peculiar morphology of the mesiodens on the right side, cone beam computed tomography was performed. Multiplanar reconstructions revealed an oval structure on the eruption path of the upper right central incisor, in contact with its palatal surface. Coronal and sagittal reconstructions showed that invagination extended beyond the cementoenamel junction, without any additional apical/lateral formation. Conclusions: the final diagnosis was dilated odontoma shaped type II dens invaginatus in a mesiodens(AU)

Introducción: existen tres categorías de dens in dente: Tipo I, invaginación mínima confinada a la corona del diente y que no se extiende más allá de la unión amelo-cementaria; Tipo II, la invaginación se extiende a la cámara de la pulpa, pero permanece dentro del canal de la raíz, sin comunicación con el ligamento periodontal; y Tipo III, la invaginación se extiende a la raíz del diente afectado, más allá de la unión cemento-esmalte. El término odontoma dilatado se utiliza para describir la variante más grave de la invaginación (tipo III), que se caracteriza por la dilatación de la corona y/o laraíz del diente afectado. Objetivo: describir un caso raro de un dens in dente con formato de odontoma dilatado en un mesiodiente y sus hallazgos imagenológicos, diagnosticados mediante tomografía computarizada de haz cónico. Presentación del caso: paciente varón, 14 años de edad, fue enviado a un servicio de Radiología Odontológica con el fin de determinar la causa de anómala cronología de la erupción dental en maxilar superior y mandíbula. Dos mesiodientes fueron identificados en el maxilar superior. El mesiodiente del lado derecho llamó la atención debido a su peculiar morfología, por lo que se realizó la tomografía computarizada de haz cónico. Las reconstrucciones multiplanares revelaron una estructura ovalada ubicada en el trayecto de erupción del incisivo central superior derecho, en contacto con su superficie palatina. Reconstrucciones coronales y sagitales demostraron que era posible identificar la extensión de la invaginación más allá de la unión cemento-esmalte, sin constitución de forma apical/lateral accesoria. Conclusiones: el diagnóstico final fue dens invaginatus tipo II en forma de odontoma dilatado en un mesiodiente(AU)