Conservative Endodontic Management of Type II Dens Invaginatus With Talon Cusp in a Maxillary Central Incisor: A...

Dens invaginatus (DI) is a developmental dental anomaly that complicates diagnosis and treatment due to its varied morphology and potential pulpal and periapical involvement. This case report presents the successful endodontic management of a Type II DI in a 14-year-old female patient, affecting the maxillary left central incisor, which also exhibited a talon cusp. The patient was asymptomatic, and the lesion was discovered during orthodontic evaluation. Cone-beam computed tomography (CBCT) revealed an enamel-lined invagination extending into the root canal system without communication with the periodontal ligament, confirming a Type II DI. Clinical tests indicated pulp necrosis. A conservative treatment plan was adopted, targeting only the main canal and leaving the invaginated portion untreated. Modern diagnostic tools, including CBCT imaging and a dental operating microscope, facilitated accurate diagnosis and precise execution of the treatment. Follow-up at 3 months and two years showed complete healing of the periapical lesion, and the patient remained asymptomatic. This case highlights the efficacy of a minimally invasive, selective treatment strategy supported by advanced imaging and magnification in managing DI.