Type III B dens invaginatus: diagnostic and clinical considerations using 128-slice computed tomography

Area of Science:

• Dentistry
• Endodontics
• Dental Radiology

Background:

• Thorough understanding of root canal morphology is crucial for successful endodontic therapy.
• Dens invaginatus is a developmental anomaly characterized by tooth invagination before mineralization.
• This condition often presents with early pulpal involvement and periapical lesions.

Observation:

• A 13-year-old female presented with pain and swelling due to an Ellis Type II fracture of the maxillary central incisor.
• Radiographic examination revealed altered morphology, an immature apex, and a periradicular lesion in the adjacent maxillary lateral incisor.
• Conventional radiography has limitations in detailing complex root anatomy.

Findings:

• Computed tomography (CT) is superior to conventional radiography for diagnosing complex root canal anatomy and periradicular lesions.
• A combined endodontic and surgical approach was successfully employed for treatment.
• Post-treatment CT imaging confirmed successful treatment outcomes.

Implications:

• Spiral CT offers enhanced resolution for endodontic diagnosis and treatment planning.
• Advanced imaging modalities like CT are essential for managing complex dental anomalies.
• Accurate diagnosis of dental malformations improves treatment success rates and patient prognosis.