Management of dens evaginatus: evaluation of two prophylactic treatment methods

Dens evaginatus (DE) is an odontogenic anomaly characterized by an enamel covered tubercle, enclosing dentin and pulpal tissue. It most commonly affects premolar teeth of people of mongoloid ethnicity. The prevalence of DE in Singapore is 2.1%. Fracture or attrition of the tubercle may lead to pulpal necrosis. Thus, prophylactic management of DE is preferred. A retrospective cohort study comparing two common prophylactic restorative methods was conducted. This involved 817 children, aged 10 years at the outset, having 1591 DE. The teeth were observed for 2 years. The results showed that significantly less teeth developed pulpal pathology when an enamoplasty-preventive resin restoration method was used (0.52%) as compared to an amalgam cavity restoration (5.37%) and the control (3.65%) [chi 2 = 9.595 (p < 0.01) df = 2]. Knowledge of the various treatment options and prevalence data is important as there is an increasing global migration of people of mongoloid ethnicity.