A complex treatment of dens invaginatus

Dens invaginatus is a developmental malformation of teeth. A case is presented of successful treatment of a peg lateral incisor with a severe dens invaginatus extending to the root apex. Both conventional endodontic therapy and periapical surgery were ineffective in resolving a persistent, long-standing sinus tract. Removal of the tooth in the present case would have created a difficult prosthetic problem. Intentional replantation, with improved access to the apical part of the canal was attempted as a last resort. A 10-month recall radiograph is presented showing successful healing of the periapical lesion. Pre-treatment and post-treatment photographs are presented to show successful esthetic treatment, using bonded composite resin.