Dens invaginatus with an open apex: a case report

Area of Science:

• Dentistry
• Endodontics
• Dental Anomalies

Background:

• Dens invaginatus, a developmental anomaly, can lead to complex endodontic challenges.
• Severe presentations often require specialized management to preserve tooth structure and function.
• This anomaly involves an invagination of the enamel and dentin into the pulp chamber.

Observation:

• A severe case of dens invaginatus was observed in an upper central incisor.
• The tooth presented with a discharging sinus tract, indicating infection.
• Histological examination revealed vital pulp in the outer chamber and necrotic material in the inner chamber.

Findings:

• Root canal treatment was performed, utilizing long-term calcium hydroxide dressings.
• The primary goal of calcium hydroxide was to induce apical closure.
• Successful canal filling and a four-year follow-up confirmed treatment efficacy.

Implications:

• This case highlights the successful management of severe dens invaginatus with endodontic therapy.
• Long-term calcium hydroxide application can be effective in promoting apical closure in complex cases.
• The findings contribute to understanding treatment strategies for dental anomalies impacting pulp vitality.