Double Dens Invaginatus with Multiple Canals in a Maxillary Central Incisor: Retreatment and Managing Complications

Zoya, Asma; Ali, Shamshad; Alam, Sharique; Tewari, Rajendra Kumar; Mishra, Surendra Kumar; Kumar, Ashok; Andrabi, Syed Mukhtar-Un-Nisar

doi:10.1016/j.joen.2015.08.017

Cited by 25 publications

(21 citation statements)

References 43 publications

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“…Clinical management of teeth with infected type 3 invagination and PIP is a real challenge for clinicians. Based on the complex dental anatomy, different treatment models may be suggested, including nonsurgical endodontic treatment of the infected invagination, treatment of entire root canal system, combined endodontic and surgical treatment, or regenerative endodontic procedures . In our case, no previously suggested treatment methods fitted the situation.…”

Section: Discussionmentioning

confidence: 92%

Successful treatment of dens invaginatus type 3 with infected invagination, vital pulp, and cystic lession: A case report

Dembinskaite

Veberiene

Mačhiulskienė

2018

Clinical Case Reports

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Section: Discussionmentioning

confidence: 92%

Successful treatment of dens invaginatus type 3 with infected invagination, vital pulp, and cystic lession: A case report

Dembinskaite

Veberiene

Mačhiulskienė

2018

Clinical Case Reports

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“…[ 8 ] For instance, type 1, saclike invagination was limited to the coronal part, and not extended beyond the cementoenamel junction (CEJ); type 2, invagination was advance beyond the CEJ but not joined the periodontal ligament; type 3a, invagination reached through the root surface and was linked together with periodontal ligament laterally; type 3b, invagination was arrived to the root and communicated with the periodontal ligament at the apical foramen. [ 9 ] The maxillary central incisor in this case was regarded as Oehlers type 3a. The root is divided into three parts by the longitudinal fissure of the buccal and the lingual sides, which extends from the neck of the tooth to the root furcation, forming three independent roots, and each root has a single root canal.…”

Section: Discussionmentioning

confidence: 99%

“…The root is divided into three parts by the longitudinal fissure of the buccal and the lingual sides, which extends from the neck of the tooth to the root furcation, forming three independent roots, and each root has a single root canal. Although it is extremely rare to find the more than an additional root canal in the maxillary central incisor, [ 9 , 10 ] an astute clinician needs to be conscious of unexpected root canal morphology when performing root canal therapy. It is difficult to be completely cured only with endodontic therapy if root infection extends to the periapical area.…”

Section: Discussionmentioning

confidence: 99%

A maxillary center incisor with three independent roots and three root canals

Wang¹,

Zhang²,

Zhou

2020

Medicine

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Rationale: Three root canals (mesiobuccal, distobuccal and palatal) are rarely found (frequency <1%) in the maxillary central incisor even though root canal morphology in maxillary premolars is highly variable. Therefore, research papers showed that dentists can easily miss the root canals in diagnosis and inflammatory diffusion; which could cause unsuccessful root canal treatment leading to various possible infections and no change in original inflammations. In this report, the diagnose and clinical management of an unusual case of a maxillary center incisor with three independent roots and three root canals is presented, along with a demonstration of using CBCT (Cone Beam Computed Tomography) and collaborate with other departments to successfully accomplish an accurate diagnosis of the morphology and quantity of the root canal system. Patient concerns: The patient was referred to clinic for his repeatedly abscessed in the gums of the left upper central incisor. Diagnoses: Based on clinical and radiographic evidences, the patient was tentatively diagnosed with a chronic periapical periodontitis for #21 tooth. Interventions: The patient was performed with the conventional root canal treatment and then clinical observed. Outcomes: At the second visit after 7 days, the patient was not sensitive to percussion. After operation for 3 months, and found that the sinus opening had not healed. Then, the patient was undergone with the periodontal flap surgery to remove root infection for 2 weeks. Lessons: From this clinical case, the lesson learned is that the previous clinical experiences cannot be used to make judgments or decisions; it requires specific analysis from the information gathered through CBCT(Cone Beam Computed Tomography)and the cooperation between different departments to come up with a responsible decision. In any stomatological hospitals, due to the large number of departments and the strong specialized focuses for each department; it is very important to encourage and support the cooperation between the departments, to limit any judgment bias due to lack of knowledge and maximize each department's strengths.

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“…Conventional location of root canal system of DI results difficult, and has the risk to cause perforations, fractures or weak the tooth. Furthermore, the complex and irregular anatomy of DI make any canal susceptible of being omitted, leading to endodontic treatment failure (19). Therefore, is important to consider an access cavity procedure able to locate all canals without removing excess tooth structure.…”

Section: Introductionmentioning

confidence: 99%

Endodontic re-treatment and restorative treatment of a dens invaginatus type II through new technologies

Zubizarreta-Macho¹,

Ferreiroa²,

Agustín-Panadero³

et al. 2019

J Clin Exp Dent

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Background The complex anatomy of dens invaginatus makes access cavity to root canal system difficult, which has an impact on the prognosis of these teeth. A novel technique, based on new technologies, is proposed to make access cavity conservative and guided with minimal dental structure lost. Material and Methods This case report shows the root canal retreatment and the endodontic surgery of a dens invaginatus type II in a left lateral upper incisor previously treated which was affected by a chronic apical abscess and an apical fracture. A Cone Beam Computed Tomography was performed to better diagnosis the dental anatomy. An intraoral scan was performed to get a digital 3D model. A computer-guided implant planning software was used to plan the access cavity and design the splint guided. Finally, the clinical crown was restored by a resin nanoceramic veneer made by a chairside system made up of an intraoral scanning unit and a grinding unit. Last, the authors carried through the endodontic surgery to extract the apical fractured fragment. Results Follow-up appointments at 6, 12 and 18 months showed a radiographic reduction of the periapical lesion and absence of clinical signs. Conclusions The splint guide allowed a guided and conservative access cavity to root canal system. It facilitates the root canal retreatment and improves the prognosis of the teeth with dental malformations. Key words: CAD-CAM, Cone-Beam Computed Tomography, dens in dente, dens invaginatus, dental pulp cavity, endodontics.

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Double Dens Invaginatus with Multiple Canals in a Maxillary Central Incisor: Retreatment and Managing Complications

Cited by 25 publications

References 43 publications

Successful treatment of dens invaginatus type 3 with infected invagination, vital pulp, and cystic lession: A case report

Successful treatment of dens invaginatus type 3 with infected invagination, vital pulp, and cystic lession: A case report

A maxillary center incisor with three independent roots and three root canals

Endodontic re-treatment and restorative treatment of a dens invaginatus type II through new technologies

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