Type III Dens Invaginatus with an Associated Cyst: A Case Report and Literature Review

Abstract

Dens invaginatus (dens in dente) is a rare malformation with a widely varied morphology. An unusual presentation of a type III dens invaginatus affecting a conical shaped permanent lateral incisor in an 8-year-old female patient is reported. The presence of a pulp stone and a periapical radiolucency further added onto the complexity of the case. The etiology, pathophysiology, association with other dental anomalies as well as the challenges in management of this anomaly are discussed. An extensive literature review is also presented.

Dilated odontoma: an unusual case report and literature review

“…The female to male ratio is 3:1 [3]. In our review, almost 60% of the cases involved women [1,5,7,[10][11][12][13][14][15]. Eleven cases were related to maxillary teeth [3,4,6,8,9,[11][12][13][14][15][16].…”

“…Among them, eight were categorized as DO [1,[4][5][6][7][8][9]. Pain or swelling related to a local periapical infection are the main causes of DO discovery, as illustrated in 12 out of the 16 cases [3,4,[6][7][8][9][10][11][12][13][14]. Indeed, one of the most significant clinical concern of DI is the risk of developing pulpal necrosis.…”

“…Invagination can communicate with the oral cavity, and the enamel is generally thin, of poor quality or even missing, allowing microorganisms to colonize the pulp. Some canals can also extend directly from the invagination to the pulpal tissue, leading to pulpal or periapical pathologies even in the absence of caries [11]. The maxillary teeth are more commonly affected than mandibular teeth.…”

“…In our review, almost 60% of the cases involved women [1,5,7,[10][11][12][13][14][15]. Eleven cases were related to maxillary teeth [3,4,6,8,9,[11][12][13][14][15][16]. Among them, nine were located in the anterior maxillary region [3,4,8,9,[11][12][13]15,16].…”

Nonsurgical endodontic management of dens invaginatus with open apex: A case report

“…In this case, nonsurgical root canal treatment of dens invaginatus, which was characterized by the presence of an open apex, loss of vitality with the presence of periapical cyst formation, was performed and was successful. Meghana and Thejokrishna[ 14 ] suggested that the nonsurgical root canal treatment should be attempted first irrespective of the size of lesion, and surgical intervention must be the second option and is only indicated when non-surgical root canal treatment has failed or the anatomic variations of the canals do not allow access for the biomechanical preparation of the canals. Periapical surgery is indicated in cases of unsuccessful apexification in immature teeth with dens invaginatus and nonvital pulp.…”