Abstract
Two cases of fracture of dens evaginatus in children are described.
The first case; a 15-year-old girl was referred to the Division of Dentistry, Chiba Children's Hospital, because of swelling in the right mandibular region. A radiolucent region at the apex of the lower right second premolar was confirmed by radiographic examination, and fracture of dens evaginatus of the premolar was found. Root canal treatment of the tooth was begun, and the root canal was filled with calcium hydroxide two weeks later. The radiolucent area of the root apex gradually expanded in spite of the root canal treatment. So, extraction of the apical lesion, apicoectomy and filling of the root canal with gutta-percha points were performed under general anesthesia 10 months after the initial treatment. A radicular cyst was diagnosed through histopathological examination. One-year postoperative radiographs revealed a complete repair at the periapex of the tooth.
The second case; an 11-year-old girl was referred to the Division of Dentistry, Chiba Children's Hospital, because of swelling in the right buccal region and fever. She was diagnosed with periosteitis due to fracture of dens evaginatus of the right lower first premolar. The inflammatory reaction quickly disappeared with the administration of antibiotics and anodyne.
The radicular pulp was expected to be viable, so the tooth was kept under medical observation without endodontic treatment for several months. The root of the tooth continued developing for four months after the onset, but a fistula adjacent to the tooth occurred. Following completion of endodontic treatment of the tooth, the fistula disappeared.
