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An Immature Type II Dens Invaginatus in a Mandibular Lateral Incisor with Talon's Cusp: A Clinical Dilemma to Confront.

Gangwar A, Singal D, Giri KY, Agarwal A, Keerthi SS - Case Rep Dent (2014)

Bottom Line: Dens invaginatus (DI) is a malformation of teeth probably resulting from an infolding of the dental papilla during tooth development.Structural defects do exist in the depth of the invagination pits, and as a consequence, the early development of caries and the subsequent necrosis of the dental pulp, as well as abscess and cyst formation are clinical implications associated with DI.This case report illustrates grinding of the talons cusp followed by nonsurgical endodontic management of dens invaginatus type II with an immature apex and periapical lesions, in which Mineral Trioxide Aggregate (MTA) shows a complete periapical healing with bone formation at the site of the lesions.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric & Preventive Dentistry, Institute of Dental Sciences, Uttar Pradesh Bareilly-243006, India.

ABSTRACT
Dens invaginatus (DI) is a malformation of teeth probably resulting from an infolding of the dental papilla during tooth development. DI is classified as type I, II, and III by Oehlers depending on the severity of malformation. The maxillary lateral incisor is the most commonly affected tooth. Structural defects do exist in the depth of the invagination pits, and as a consequence, the early development of caries and the subsequent necrosis of the dental pulp, as well as abscess and cyst formation are clinical implications associated with DI. Occasionally, we can see more than one developmental anomaly occurring in a single tooth. In such cases it becomes important to identify the anomalies and initiate a proper treatment plan for good prognosis. In this paper, an unusual case of DI which clinically presented as a huge talons cusp affecting a mandibular lateral incisor tooth is described. This case report illustrates grinding of the talons cusp followed by nonsurgical endodontic management of dens invaginatus type II with an immature apex and periapical lesions, in which Mineral Trioxide Aggregate (MTA) shows a complete periapical healing with bone formation at the site of the lesions.

No MeSH data available.


Related in: MedlinePlus

Radiograph showing the whole removal of parts of invagination and rudimentary canal in relation to 32 and metapex dressing in 31.
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fig5: Radiograph showing the whole removal of parts of invagination and rudimentary canal in relation to 32 and metapex dressing in 31.

Mentions: With emergency treatment the abscess was drained through the vestibular sulcus. Antibiotics and analgesics were prescribed. Six days later the patient was recalled again and Talons cusp in relation to 32 was grinded to expose the pulp. A large central canal was found but there was no communication between the mesial and distal rudimentary canals in the DI. This was confirmed by the radiographic dye. Then complete elimination of invagination was done with the aid of a K-Flex #80 file [Figure 5]. In the same appointment, access preparation in 31 was done. Treatment was performed under local anaesthesia under complete rubber dam isolation.


An Immature Type II Dens Invaginatus in a Mandibular Lateral Incisor with Talon's Cusp: A Clinical Dilemma to Confront.

Gangwar A, Singal D, Giri KY, Agarwal A, Keerthi SS - Case Rep Dent (2014)

Radiograph showing the whole removal of parts of invagination and rudimentary canal in relation to 32 and metapex dressing in 31.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3934391&req=5

fig5: Radiograph showing the whole removal of parts of invagination and rudimentary canal in relation to 32 and metapex dressing in 31.
Mentions: With emergency treatment the abscess was drained through the vestibular sulcus. Antibiotics and analgesics were prescribed. Six days later the patient was recalled again and Talons cusp in relation to 32 was grinded to expose the pulp. A large central canal was found but there was no communication between the mesial and distal rudimentary canals in the DI. This was confirmed by the radiographic dye. Then complete elimination of invagination was done with the aid of a K-Flex #80 file [Figure 5]. In the same appointment, access preparation in 31 was done. Treatment was performed under local anaesthesia under complete rubber dam isolation.

Bottom Line: Dens invaginatus (DI) is a malformation of teeth probably resulting from an infolding of the dental papilla during tooth development.Structural defects do exist in the depth of the invagination pits, and as a consequence, the early development of caries and the subsequent necrosis of the dental pulp, as well as abscess and cyst formation are clinical implications associated with DI.This case report illustrates grinding of the talons cusp followed by nonsurgical endodontic management of dens invaginatus type II with an immature apex and periapical lesions, in which Mineral Trioxide Aggregate (MTA) shows a complete periapical healing with bone formation at the site of the lesions.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric & Preventive Dentistry, Institute of Dental Sciences, Uttar Pradesh Bareilly-243006, India.

ABSTRACT
Dens invaginatus (DI) is a malformation of teeth probably resulting from an infolding of the dental papilla during tooth development. DI is classified as type I, II, and III by Oehlers depending on the severity of malformation. The maxillary lateral incisor is the most commonly affected tooth. Structural defects do exist in the depth of the invagination pits, and as a consequence, the early development of caries and the subsequent necrosis of the dental pulp, as well as abscess and cyst formation are clinical implications associated with DI. Occasionally, we can see more than one developmental anomaly occurring in a single tooth. In such cases it becomes important to identify the anomalies and initiate a proper treatment plan for good prognosis. In this paper, an unusual case of DI which clinically presented as a huge talons cusp affecting a mandibular lateral incisor tooth is described. This case report illustrates grinding of the talons cusp followed by nonsurgical endodontic management of dens invaginatus type II with an immature apex and periapical lesions, in which Mineral Trioxide Aggregate (MTA) shows a complete periapical healing with bone formation at the site of the lesions.

No MeSH data available.


Related in: MedlinePlus