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VOLUME 10 , ISSUE 5 ( September, 2009 ) > List of Articles

RESEARCH ARTICLE

Management of a Type III Dens Invaginatus using a Combination Surgical and Non-surgical Endodontic Therapy: A Case Report

Mithra N. Hegde, Aditya Shetty, Rekha Sagar

Citation Information : Hegde MN, Shetty A, Sagar R. Management of a Type III Dens Invaginatus using a Combination Surgical and Non-surgical Endodontic Therapy: A Case Report. J Contemp Dent Pract 2009; 10 (5):82-87.

DOI: 10.5005/jcdp-10-5-82

License: CC BY-NC 3.0

Published Online: 01-09-2009

Copyright Statement:  Copyright © 2009; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim

The aim of this report is to present a case of Type III dens invaginatus in a maxillary lateral incisor with a periapical lesion and its successful treatment using a combination of surgical and non-surgical therapy.

Background

The morphology of the root canal system is unique for individual teeth. A precise understanding of the morphology is very important for a successful root canal treatment. Dens invaginatus is a rare dental anomaly that can give rise to many complex anatomical forms. The complete removal of the diseased pulp tissue can be a challenge for clinicians due to the complexity of internal canal anatomy and may require either non-surgical endodontic therapy alone or that therapy may have to be combined with surgical endodontics to achieve an adequate sealing of the root canal system.

Case Report

A 22-year-old male presented for evaluation of a recurrent painless sinus tract in the attached gingiva adjacent to the maxillary right lateral incisor. The tooth responded negatively to vitality tests while the right central incisor responded normally. Clinically an anatomical malformation in the crown was detected in the form of an abnormal bulbous contour of the tooth in the palatal region above the cingulum. Radiograph evaluation confirmed the presence of dens invaginatus and a periapical radiolucent lesion. The patient received combined nonsurgical and surgical endodontic therapy to achieve a favorable outcome.

Summary

Complications presented by Type III dens invaginatus and acute periapical abscess necessitated the use of combined non-surgical and surgical endodontic therapy to attain a favorable seal of the root canal. The prognosis at a six-month post-treatment evaluation appeared to be good.

Clinical Significance

Dens invaginatus requires an early diagnosis and treatment. It may result in radicular and periapical pathosis requiring a combined non-surgical and surgical endodontic approach to treatment.

Citation

Hegde MN, Shetty A, Sagar R. Management of a Type III Dens Invaginatus using a Combination Surgical and Non-surgical Endodontic Therapy: A Case Report. J Contemp Dent Pract [Internet]. 2009 Sept; 10(5). Available from: http://www.thejcdp.com/journal/view/ management-of-a-type-iii-dens-invaginatususinga- combination-surgical-and-.


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  1. Dens invaginatus: aetiology, classification, prevalence, diagnosis, and treatment considerations. Int Endod J 1997;30(2):79–90.
  2. Dens invanginatus (dilated composite odontome). I. Variations of the invagination process and associated anterior crown forms. Oral Surg Oral Med Oral Pathol 1957;10(11):1204–18.
  3. Radicular variety of dens invanginatus. Oral Surg Oral Med Oral Pathol 1958;11:1251–60.
  4. Endodontic treatment of dens invaginatus type III with three root canals and open apical foramen. Int Endod J 2004;37(3):205–13.
  5. Clinical considerations in the treatment of dens invaginatus. Endod Dent Traumatol 1987;3(5)249–54.
  6. Anatomical redesign for the treatment of dens invaginatus type III with open apexes. JADA 2006; 137:180-185.
  7. Combined endo therapy and surgery in treatment of dens invaginatus type III –case report. J Can Dent Assoc 2005; 71(11):855-858.
  8. Dens invaginatus: treatment choices. Endod Dent Traumatol 1998;14(4):152–8.
  9. Conventional treatment of dens invaginatus in maxillary lateral incisor with sinus tract –one year follow up. JOE 2005; 31:13-133.
  10. Combined therapy in treatment of dens invaginatus JOE 2004; 30(9):672-674.
  11. Treatment of dens invaginatus by endo therapy, apicocurettage and retro filling JOE 1987; 13(9):469-472.
  12. Traumatic geminaton — triple tooth. Survey of the literature and report of a case. Endod Dent Traumatol 1992;8(3):130–3.
  13. Complex treatment of dens invaginatus type III in a maxillary lateral incisor. Endod Dent Traumatol 1999;15(2):88–90.
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