Endodontic treatment of a maxillary lateral incisor with vital pulp, periradicular lesion and type III dens invaginatus: a case report

Keles A, Cakici F. Endodontic treatment of a maxillary lateral incisor with vital pulp, periradicular lesion and type III dens invaginatus: a case report. International Endodontic Journal 43, 608–614, 2010. Abstract Aim To report the healing of a periradicular lesion and maintaining vitality of the pulp following endodontic treatment of the invaginated canal of a dental invagination. Summary Dens invaginatus is a developmental malformation resulting from invagination of the tooth crown or root before calcification has occurred. A case of type III dens invaginatus, an invagination that extends from the crown to the apex, in the maxillary right lateral incisor with a healthy pulp and large peri-invagination periodontitis is reported. Non-surgical root canal treatment of the invagination was performed. There appeared to be no communication between the main root canal and the invaginated canal. The invaginated canal was filled by lateral condensation of gutta-percha and a calcium hydroxide sealer. The final restoration of the tooth was completed using composite, and the tooth was reviewed after 1 and 2 years. Non-surgical root canal treatment of the invagination retained the pulp in a health condition and resulted in resolution of a substantial peri-invagination lesion. Key learning points • Even though there are no symptoms, radiography should be performed in teeth that exhibit anatomical differences from the contralateral tooth. • Even if there is extensive apical pathology in a tooth with type III dens invaginatus, pulp sensibility tests should be performed. • Correct diagnosis and treatment planning are fundamental when treating dens invaginatus.