Abstract : Dens invaginatus is a malformation of teeth, caused by an invagination of the enamel organ into dental papilla. It used to be called dens in dente ; however, the anatomy is different from general root canal systems. The prevalence of dens invaginatus varies depending on the experimental design. Miyoshi et al. demonstrated that 38.5% of upper lateral incisors showed invagination by visual examination ; however, dens invaginatus was seen in only 5.1% on dental X-ray radiographs. Thus, X-ray observation is necessary to obtain a precise diagnosis.
A patient was referred to the Department of Oral Surgery, Nihon University Dental Hospital for extraction of an impacted upper left canine. Preoperative cone beam computed tomography (CBCT) demonstrated that radiolucency was present from the apex of the upper left lateral incisor to the impacted canine. Therefore, extraction of the impacted canine and apicoectomy of the lateral incisor were planned, and the patient was referred to our department for endodontic treatment of the lateral incisor.
Based on the CBCT image, the lateral incisor was diagnosed as Oehlers type 3 dens invaginatus with a severely curved root canal. Operative microscopes and nickel-titanium rotary files were used for the root canal treatment, and favorable results were obtained.
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