Radiodiagnostic analysis of dens invaginatus in maxillary lateral incisors: a cone-beam computed tomographic study

This study aims to determine the prevalence of dens invaginatus (DI) in maxillary lateral teeth within a Turkish subpopulation using cone-beam computed tomography (CBCT) and to evaluate the relationship between the invagination and the main root canal.

A total of 953 maxillary lateral teeth from 662 patients were evaluated for the presence of DI. To ascertain the invagination's location in the crown from the axial section, four equidistant areas were delineated, extending from the mesio-palatal to the disto-palatal surface. Measurements included the vertical distance between the top of the palatal pulp horn and the buccal pulp horn (h1), the closest distance between the invagination and the buccal pulp horn (h2), and the dentin thickness from the widest part of the invagination to the tooth's outer walls.

DI was observed in 5% of the patients (33/662). Invaginations in the medial region of the mesiopalatinal surface were statistically significantly more common in males (p=0.049). The distances from the invagination to the buccal and distal walls were also significantly longer in males (p=0.040 and p=0.008, respectively). There was no statistically significant difference in the mean distances h1 and h2 according to sex and age.

Based on CBCT measurements, investigating the presence of DI more mesiopalatinally in males is recommended to prevent excessive tooth structure loss. Additionally, given that DI is significantly closer to the buccal and distal walls in females, a more conservative access cavity approach should be advised to minimize the risk of perforation.