Outcomes and Predisposing Factors of Two Prophylactic Treatments in Dens Evaginatus Premolars: A Retrospective Study

Dens evaginatus (DE) in premolars may contain a pulpal extension inside the occlusal tubercle. DE prophylaxis should be performed to prevent pulpal exposure due to tubercle fracture. The aim of this study was to compare the outcomes of 2 prophylactic treatments, that is, prep and fill (PF) and reinforcement (RF), in DE premolars based on clinical and radiographic data, and to identify the predisposing factors. Furthermore, DE prevalence was reported.

The DE premolar data were collected from dental and radiographic records at the Faculty of Dentistry, Mahidol University, and Bangkok Hospital, Thailand during 2000-2020. Their prevalence and characteristics were determined. Only DE teeth treated with PF or RF prophylaxis were included. Outcomes and possible predisposing factors of the 2 prophylactic groups were evaluated and statistically analyzed.

Initially, 303 DE premolars from 110 patients were identified, with the highest prevalence observed in second mandibular premolars (37.21%). The prevalence of contralateral, same quadrant, and opposite arch DE premolars was 50.91%, 39.09%, and 34.55%, respectively. A total of 216 DE teeth met the criteria with an ∼82% recall rate, with 190 and 26 premolars treated by PF and RF, respectively. With mean recall periods of ∼31 and 23 months, the outcomes in the PF and RF group were 95.79% and 80.77% success, respectively, which were significantly different (P = .01). No significant predisposing factor was found.

Prophylactic treatment in DE premolars with PF provided a significantly higher success rate than those treated with RF.