Edition V06N01 | Year 2016 | Editorial Case Report | Pages 43 to 48
Introduction: Dens invaginatus is an anomaly occurring during morpho-differentiation of the tooth in which there is an alteration caused by invagination of the inner epithelium of the enamel organ before its mineralization. In this context, endodontic therapy can face a great challenge in terms of endodontic access, chemical-mechanical preparation and root canal filling. Objective: To report a clinical case of endodontic intervention of tooth #22 presenting internal anatomical variation called dens invaginatus. Methods: Caucasian female patient was referred to endodontic evaluation. The main complaint reported by the patient was mild sensibility to palpation and crown darkening. Clinical examination showed alteration in the shape of the dental crown and presence of orthodontic appliance in both arches. Radiographic examination revealed image compatible to dens invaginatus and extensive periapical rarefying osteitis between teeth #21 and #22. Diagnosis of pulp necrosis and periapical diagnosis suggestive of periradicular granuloma of tooth #22 were established after performing pulp sensibility tests, and endodontic therapy was instituted. In the first visit, endodontic access was performed before manual instrumentation and application of intracanal medication with PA calcium hydroxide and propylene glycol. Subsequently, the root canal was sealed with Coltosol for 30 days. In the second visit, the patient was asymptomatic and the root canal system was filled by means of the thermoplasticized technique prior to definitive restorative treatment. Conclusion: The proposed treatment achieved the objective. Clinical and radiographic follow-up after three years showed periapical repair and re-establishment of masticatory and esthetic functions by means of restorative procedure.
Santos BS, Silva RV, Pereira RP, Nunes E. Endodontic intervention for type II dens invaginatus: a case report. Dental Press Endod. 2016 Jan-Apr;6(1):43-8. DOI: http://dx.doi.org/10.14436/2358-2545.6.1.043-048.cre