2007 Volume 28 Issue 3 Pages 154-160
Abstract : The risk associated with developmental anomalies of crown is an early pulpal involvement. The purpose of the present study was to examine the effect and prognosis of preventive treatment of developmental anomalies of crown on immature permanent teeth.
The subjects of this study were patients who visited the pediatric dental clinic of the Tokyo Medical and Dental University. The cases included 3 teeth from 3 patients aged 6 to 9 years at their initial visits.
1. In the upper lateral incisor with dens invaginatus detected by X-ray prior to eruption, the surgical exposed pit and invaginated space were thoroughly debrided with endodontic files and filled with calcium hydroxide paste before being obturated with root canal cement and resin composite restoration. These treatments were successful to keep the pulp vital and to promote root development.
2. In the upper first premolar with hypoplasia (Turner’s tooth) which was coated with cement and bonding resin after eruption, the pulp survived soundly and the root formation continued. This was administered with provisional restoration while the patients were children, then a partial crown was made with minimum crown preparation when they had become adults.
3. In the upper first premolar with dens evaginatus, reinforcement with composite resin was performed after eruption. 2 years and 8 months later, total pulpitis was detected in this tooth. The risk associated with dens evaginatus is an early pulpal involvement after eruption.
These findings may explain why earlier screening and intervention can prevent pulpal infection, pulpal inflammation and subsequent necrosis. It is suggested that X-ray examination is desirable prior to eruption of permanent teeth for the detection of developmental anomalies of crown. For normal future occlusion, appropriate provisional restoration and its management are necessary.
