Dens invaginatus: a review and case series

Dens invaginatus is a dental anomaly resulting in an abnormal tooth morphology, most commonly affecting the permanent dentition. An associated infolding of the outer enamel organ results in structural pocketing and increased susceptibility to dental disease. Clinical sequalae of affected teeth may include dental caries, pulpal pathology, devitalisation, discolouration, localised periodontal pocketing or increased tooth mobility. Early diagnosis is therefore essential in the delivery of effective prevention and informed treatment planning. Clinicians should be aware of the diverse clinical and radiographic presentations of dens invaginatus. Treatment principles may range from conservative approaches to multidisciplinary input within tertiary care services for anatomically challenging presentations. We present six clinical cases referred to the paediatric dentistry department at Guy's and St Thomas' NHS Foundation Trust, demonstrating a range of management approaches.