Early Detection of Dens Evaginatus Appearing on the 1st and 2nd Premolars and Clinical Management

Abstract

Among the 2,272 patients who visited the Kyushu University Dental Hospital, the incidence of dens evaginatus on the occlusal surfaces of the 1st and 2nd premolars of both upper and lower jaws has been studied with the use of the dental X-ray film and oral examination. The results were as follows.
1. The dens evaginatus of the 171 submerged premolar teeth were able to be detected among 81 patients by X-ray examination and oral examination.
2. The order of the occurrence of dens evaginatus was the lower second premolars >lower first premolars>upper second premolars>upper first premolars. The concordance rate of the occurrence on the left and the right sides was 56.8%(46 cases out of 81 cases).
3. The number of dens evaginatus which the doctor in charge of the patients was able to discover before the eruption, involved 28 teeth (16.4%),75 teeth (43.8%) just after the eruption and before the fracture, and 21 teeth (12.3%)after the fracture. Also the number of dens evaginatus of the patients who stopped visiting our hospital before detection, involves 47 teeth (27.5%).
4. The treatment for dens evaginatus was classified into the following 6 categories, observation (waiting up to the eruption) in 6.4% (11 teeth), grinding treatment 38.6% (66 teeth), endodontic treatment 8.2% (14 teeth), no further treatment 29.2% (50 teeth), root canal filling 1.8% (3 teeth), and the others 15.8% (27 teeth).