Prevalence of dens invaginatus in young Israeli population and its association with clinical morphological features of maxillary incisors

Abstract

Dens invaginatus is an anomaly mostly observed in maxillary incisors. This study aimed to assess the prevalence of dens invaginatus in maxillary incisors in young Israeli population and to study its potential association with clinical coronal morphological features. Data was collected from periapical radiographs and clinical photographs of patients from Orthodontics Department between 2006 and 2018. Radiographic characteristics were evaluated and compared to clinical coronal morphological features. Statistical analysis was performed using the Pearson chi-square test with statistical significance set at p < 0.05. The sample included 1621 maxillary incisors from 547 patients. Dens invaginatus was observed in 422 (26%) of these teeth. Maxillary lateral incisors were more affected than central incisors. In 103 patients dens invaginatus was unilateral, while in all other cases it was bilateral. Unique clinical morphological characteristics were observed in 88% of the teeth that exhibited radiographic evidence of dens invaginatus. Dens invaginatus Type I was most frequently observed, accounting for 90% of the teeth. A significant association between clinical coronal morphological features and dens invaginatus was detected. Dens invaginatus is common in maxillary incisors of the study population. Several clinical morphological features may predict the presence of dens invaginatus.

Assessment of dens invaginatus and its characteristics in maxillary anterior teeth using cone-beam computed tomography

“…In the present study, DI affected both sexes equally, which is consistent with the findings of previous studies 3 , 5 , 6 , 11 , 13 , 15 . However, other studies have found males to be more affected 4 , 14 .…”

“…In a sample of Saudi patients, DI was detected in 10% of the patients 17 . A higher value (37%) was recently reported in an Israeli population 13 . These variations may be related to different ethnic groups, methods of assessment, and/or diagnostic criteria.…”

“…Some studies reported higher percentages of bilateral DI 6 , 12 , 14 , 15 , 26 , while others found unilateral DI to be more frequent 3 – 5 , 11 , 25 . Yet, a recent study reported equal occurrence of the two patterns 13 . It has been suggested that bilateral DI can be associated with other dental anomalies, including gemination, microdontia, taurodontism and dentinogenesis imperfecta 6 .…”

“…It has been suggested that bilateral DI can be associated with other dental anomalies, including gemination, microdontia, taurodontism and dentinogenesis imperfecta 6 . In contrast, the implication of local factors was proposed for the unilateral DI occurrence 13 . Since bilateral DI is not an unusual finding, it is recommended to examine the contralateral tooth in cases where DI is detected in a certain tooth.…”

“…Unlike conventional two-dimensional (2D) intraoral radiographs, CBCT allows visualization of the 3D morphology of DI, and thus provides more details about this anomaly, including its exact site of emergence and extension, course of penetration into the tooth, and whether it is associated with apical pathosis 5 , 10 . Previous studies have mainly assessed DI using 2D periapical and/or panoramic radiographs 1 – 4 , 6 , 11 – 13 . To date, limited studies have utilized CBCT to investigate the prevalence and characteristics of DI 5 , 14 , 15 .…”