Contemporary treatment of class II dens invaginatus

To present the nonsurgical management of a tooth with class II dens invaginatus with an open apex utilizing contemporary techniques.

Root canal treatment of teeth with complex root canal anatomy such as dens invaginatus can be problematic because infected pulpal tissues may remain in inaccessible areas of the canal system. The cleaning and debridement of such root canal systems are therefore challenging and may sometimes be considered impossible. An immature apical root-end development is another challenge in root canal treatment especially in controlling the apical extent of the filling material and achieving an apical seal. When difficulties in cleaning and filling combine, management options may include surgical intervention or extraction. This article reports the nonsurgical endodontic treatment of a case of an open apex and dens invaginatus utilizing the operating microscope, endodontic ultrasonic instruments and mineral trioxide aggregate.

Teeth with class II dens evaginatus and an open apex may be managed successfully with contemporary nonsurgical materials and techniques.