Non-Surgical Treatment of Bilateral Dens Invaginatus in Maxillary Lateral Incisors: A Case Report

Dens invaginatus (DI) is a dental developmental malformation, with 43% of the reported cases involving bilateral occurrence. Based on its manifestations, DI is classified into different types. Due to the complex anatomy, teeth with DI are more susceptible to caries and pulpitis and are commonly associated with incomplete root formation. The correct diagnosis in these cases requires a combination of clinical examinations, pulp sensitivity tests, and radiographic examinations. The treatment plan may vary from a simple conservative sealing of the invagination to extraction of the involved tooth, depending on the extent of the tooth involvement and severity of the condition. This article reports a case of type II bilateral invagination of two maxillary lateral incisors, the maxillary left lateral incisor with necrotic pulp associated with a large periapical lesion and the maxillary right lateral incisor with reversible pulpitis. Each tooth was successfully treated with different non-surgical methods based on the extent of its involvement. At the follow-ups, the patient was asymptomatic with no signs or symptoms of inflammation, and the two-year follow-up showed significant healing of both teeth, validating the success of the treatment. The results of this case emphasize the effectiveness of non-surgical treatment methods when applied appropriately, as well as the importance of early detection in the successful management of teeth with DI.