Conservative Management of Type III Dens in Dente Using Cone Beam Computed Tomography

Dens in dente, also known as dens invaginatus, dilated composite odontoma, or deep foramen caecum, is a developmental malformation that usually affects maxillary incisor teeth, particularly lateral incisors. It may occur in teeth anywhere within the jaws, other locations are comparatively rare. It can occur within both the crown and the root, although crown invaginations are more common. The use of cone beam computed tomography (CBCT) is very helpful in endodontic diagnosis of complex anatomic variations. In this case we demonstrate the use of CBCT in the evaluation and endodontic management of a Type III dens in dente (Oehler's Type III).

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Use of cone beam computed tomography in the diagnosis, planning and follow up of a type III dens invaginatus case

International Endodontic Journal ◽

10.1111/j.1365-2591.2011.01956.x ◽

2011 ◽

Vol 45 (2) ◽

pp. 198-208 ◽

Cited By ~ 23

Author(s):

F. V. Vier-Pelisser ◽

A. Pelisser ◽

L. C. Recuero ◽

M. V. R. Só ◽

M. G. Borba ◽

...

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Cone Beam ◽

Type Iii ◽

Dens Invaginatus

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A Rare Case of Type III Dens Invaginatus in a Mandibular Second Premolar and Its Nonsurgical Endodontic Management by Using Cone-beam Computed Tomography: A Case Report

Journal of Endodontics ◽

10.1016/j.joen.2016.01.001 ◽

2016 ◽

Vol 42 (4) ◽

pp. 669-672 ◽

Cited By ~ 15

Author(s):

Pritesh Kisanlal Agrawal ◽

Jyoti Wankhade ◽

Manjusha Warhadpande

Keyword(s):

Computed Tomography ◽

Case Report ◽

Cone Beam Computed Tomography ◽

Rare Case ◽

Cone Beam ◽

Type Iii ◽

Dens Invaginatus

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Management of Oehler’s Type III Dens Invaginatus Using Cone Beam Computed Tomography

Case Reports in Dentistry ◽

10.1155/2016/3573612 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6

Author(s):

Jaya Ranganathan ◽

Mohan Kumar Rangarajan Sundaresan ◽

Srinivasan Ramasamy

Keyword(s):

Computed Tomography ◽

Treatment Planning ◽

Cone Beam Computed Tomography ◽

Three Dimensional ◽

Root Apex ◽

Cone Beam ◽

Type Iii ◽

Appropriate Treatment ◽

Diagnostic Difficulties ◽

Dens Invaginatus

Dens Invaginatus is a dental malformation that poses diagnostic difficulties in the clinical context. This anomaly may increase the risk of pulp disease and can potentially complicate endodontic procedure due to the aberrant root canal anatomy. Compared to conventional radiographs, three-dimensional images obtained with Cone Beam Computed Tomography (CBCT) are invaluable in the diagnosis of the extent of this anomaly and in the appropriate treatment planning. Oehler’s classification (1957) for Dens Invaginatus (DI) into three types depending on the depth of the invagination has been used for treatment planning. Of the three types Type III DI is characterized by infolding of the enamel into the tooth up to the root apex and is considered as the most severe variant of DI and hence the most challenging to treat endodontically, due to the morphological complexities. This report describes a case of Oehler’s Type III DI in a necrotic permanent maxillary lateral incisor in which CBCT images played a key role in diagnosis and treatment planning. The case was managed successfully by a combination of nonsurgical and surgical endodontic therapy with orthograde and retrograde thermoplastic gutta percha obturation.

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Regenerative Endodontic Treatment of an Infected Immature Dens Invaginatus with the Aid of Cone-Beam Computed Tomography

Case Reports in Dentistry ◽

10.1155/2014/403045 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Işıl Kaya-Büyükbayram ◽

Şerife Özalp ◽

Emre Aytugar ◽

Seda Aydemir

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Endodontic Treatment ◽

Cone Beam ◽

Radiographic Examination ◽

Periapical Lesion ◽

Type Iii ◽

Regenerative Endodontic Treatment ◽

Dens Invaginatus

Dens invaginatus is a developmental anomaly that results in an enamel-lined cavity intruding into the crown or root before the mineralization phase. This report presents regenerative endodontic treatment of a necrotic immature tooth with Oehler’s type III dens invaginatus of a nine-year-old female patient. A diagnosis of dens invaginatus (Oehler’s type III) and a large periapical lesion was established with the aid of cone-beam computed tomography (CBCT). In the presented case contrary to the classic revascularization protocol, mechanical instrumentation was performed which apparently did not interfere with the regeneration process. After mechanical instrumentation of the invaginated canal by manual K-files, the invaginated canal space was disinfected by triple antibiotic paste followed by blood clot induction from the periapical tissues and the placement of mineral trioxide aggregate. At one-year follow-up, the tooth remained clinically asymptomatic. Radiographic examination revealed complete healing of the periapical lesion. At the 20-month follow-up, the radiographic examination also showed that the open apex was closed and the walls of the root canal were thickened.

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