Dens invaginatus--a pathway to pulpal pathology: a literature review

Dens invaginatus is the most common dental anomaly in a group of dental anomalies, related by their embryologic development and by the fact that their defects provide a potential pathway for bacteria to cause pulpal pathology. It occurs when the inner enamel epithelium invaginates into the dental papilla prior to calcification. It exists in erupted teeth as an enamel-lined tract, which either ends in a blind sac inside the crown or root or exits into the periodontal ligament. The lining may be incomplete in areas and may not protect the pulp. Methods of providing preventive treatment for teeth with dens invaginatus are described. When pulpal pathosis occurs, the dens may displace the pulp and complicate access cavity preparation and subsequent endodontic treatment, adversely affecting the prognosis. The learning objective of this article is to present treatment planning considerations and suggestions.