Management of Dens Invaginatus Type III with Large Periradicular Lesion
Luciana de Souza Falcão, Priscila Sousa de Freitas, Raquel de Oliveira Marreiro, Ângela Delfina Bittencourt Garrido
Citation Information :
de Souza Falcão L, de Freitas PS, de Oliveira Marreiro R, Garrido ÂD. Management of Dens Invaginatus Type III with Large Periradicular Lesion. J Contemp Dent Pract 2012; 13 (1):119-124.
This study describes a clinical case of type III dens invaginatus with an extensive periradicular lesion treated successfully.
Background
Dens invaginatus is a maldevelopment of the dental germ which occurs as a result of the invagination of the enamel organ. These cases may present difficulties with respect to its diagnosis and treatment because of canal morphology. The success of endodontic therapy requires a knowledge of dental anatomy and its anomalies.
Case report
A 17-year-old female patient is reported presenting right maxillary lateral incisor (tooth no. 7) classified as type III dens invaginatus with necrotic pulp and presence of an extensive radiolucid lesion. Endodontic treatment was recommended for tooth. However, intracanal exudate was present, suggesting a resistant infection. Enucleation of the lesion was performed as a complementary approach. The root canal obturation was carried out by the gutta-percha thermoplastification technique with root canal sealer, followed by restoration of the tooth. Healing of the lesion with hard tissue formation was confirmed at follow-up.
Conclusion
A combination of endodontic and surgical treatments were fundamental to the maintenance of the tooth. The treatment was considered successful.
Clinical significance
Root canal therapy of dens invaginatus should be based on a thorough clinical and radiographic evaluation. The knowledge of classification and anatomical variations of teeth with dens invaginatus are of great importance for correct treatment.
How to cite this article
de Souza Falcão L, de Freitas PS, de Oliveira Marreiro R, Garrido ÂDB. Management of Dens Invaginatus Type III with Large Periradicular Lesion. J Contemp Dent Pract 2012;13(1):119-124.
Nonsurgical endodontic treatment of dens invaginatus in a mandibular premolar with large periradicular lesion: A case report. J Endod 2007;33(3):322-24.
Endodontic treatment of a maxillary canine with type 3 dens invaginatus and large periradicular lesion: A case report. J Endod 2008;34(6):756-58.
Management of dens invaginatus diagnosed by spiral computed tomography: A case report. J Endod 2008;34(9):1138-42.
Endodontic treatment of dens invaginatus: A 5-year follow-up. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101(1):e15-21.
Rare associations of dens invaginatus and mesiodens. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;104(2):e41-44.
Dens invaginatus: A retrospective study of prophylactic invagination treatment. Int J of Paed Dent 2001;11(2):92-97.
Prevalence of dens invaginatus in Jordanian adults. Int Endod J 2004;37(5):307-10.
Combined endodontic and surgical management of a mandibular lateral incisor with a rare type of dens invaginatus. J Endod 2008;34(10):1255-60.
A rare presentation of dens invaginatus in a mandibular lateral incisor occurring concurrently with bilateral maxillary dens invaginatus: Case report and review of literature. Aust Dent J 2004;49(2):90-93.
Root abnormalities, talon cusps, dens invaginati with reduced alveolar bone levels: Case report. Int J of Paed Dent 1998;8(1):41-45.
Dens invaginatus in a primary canine: A case report. Int J of Paed Dent 1998;8(1):61-64.
Dens invaginatus (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.
Dens invaginatus and treatment options based on a classification system: Report of a type II invagination. Int Endod J 2008;41(8):702-09.
Bilateral dens invaginatus in the mandibular premolar region. Ind J Dent Res 2009;20(2):238-40.
Dens in dente associated with infective endocarditis. Oral Surg Oral Med Oral Pathol 1994;78(1):47-50.
Anatomical redesign for the treatment of dens invaginatus type III with open apexes: A literature review and case presentation. J Am Dent Assoc 2006;137(2):180-85.
Dens invaginatus in an immature maxillary lateral incisor: A case report of complex endodontic treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;102(2):e37-41.
Endodontic treatment of a maxillary lateral incisor with vital pulp, periradicular lesion and type III dens invaginatus: A case report. Int Endod J 2010;43(7):608-14.
Dens invaginatus. Part 2: Clinical, radiographic features and management options. Int Endod J 2008;41(12):1137-54.
Clinical management of dens invaginatus in a maxillary lateral incisor with the aid of cone-beam computed tomography: A case report. Dent Traumatol 2011, [Epub ahead of print].
Comparison of the in vivo antimicrobial effectiveness of sodium hypochlorite and chlorhexidine used as root canal irrigants: A molecular microbiology study. J Endod 2011;37(2):143-50.
In vitro effects of endodontic irrigants on endotoxins in root canals. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;104(1):135-42.
Quantification of endotoxins and cultivable bacteria in root canal infection before and after chemomechanical preparation with 2.5% sodium hypochlorite. J Endod 2008;34(3):268-72.
Endodontic treatment of a periradicular lesion on an invaginated type III mandibular lateral incisor. Ind J Dent Res 2009;20(2):243-45.
Management of dens invaginatus type I and open apex: Report of three cases. J Endod 2010;36(6):1079-85.
Properties and applications of calcium hydroxide in endodontics and dental traumatology. Int Endod J 2011;44(8):697-730.
New perspectives on radicular cysts: Do they heal? Inter Endod J 1998;31(3):155-60.
Incidence of periapical cysts in relation to root canal. J Endod 1980;6(11):845-48.
Types and incidence of human periapical lesions obtained with extracted teeth. Oral Surg Oral Med Oral Pathol 1996;81(1):93-102.
Conventional endodontic therapy of upper central incisor combined with cyst decompression: A case report. J Endod 2007;33(6):753-57.
Nonsurgical endodontic treatment of dens invaginatus with large periradicular lesion: A case report. J Endod 2004;30(8):597-600.
Use of cone beam computed tomography in the diagnosis, planning and follow up of a type III dens invaginatus case. Int Endod J 2011, [Epub ahead of print].
