Root Canal Treatment of Oehlers Type III Dens Invaginatus in Maxillary Lateral Incisor and Remote Sinus Tract Using Dental Surgical Microscope and Cone-Beam Computed Tomography

Bull Tokyo Dent Coll. 2023 Jun 10;64(2):67-74. doi: 10.2209/tdcpublication.2022-0032. Epub 2023 May 15.

Abstract

Dens invaginatus is a morphological abnormality of the tooth that results from a developmental anomaly during tooth formation, in which part of the enamel and dentin of the crown invaginates into the pulp cavity. This report describes a case of a maxillary lateral incisor with apical periodontitis apparently caused by Oehlers Type III dens invaginatus. The patient was a 69-year-old man who visited our clinic complaining of discomfort in the maxillary right lateral incisor. Cone-beam computed tomography (CBCT) revealed dens invaginatus of the maxillary lateral incisor and a sinus tract in the maxillary central incisor region, which was derived from apical periodontitis of the maxillary lateral incisor. The dens invaginatus was accompanied by a complex root canal morphology. Treatment, which was performed using a dental surgical microscope, had a favorable outcome. The patient remains in good condition at 1 year postoperatively.

Keywords: Cone-beam computed tomography; Dens invaginatus; Dental surgical microscope; Maxillary lateral incisor; Non-surgical treatment.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Cone-Beam Computed Tomography / methods
  • Dens in Dente* / complications
  • Dens in Dente* / diagnostic imaging
  • Dens in Dente* / therapy
  • Dental Pulp Cavity / abnormalities
  • Humans
  • Incisor / abnormalities
  • Incisor / diagnostic imaging
  • Incisor / surgery
  • Inflammation
  • Male
  • Periapical Periodontitis* / diagnostic imaging
  • Periapical Periodontitis* / surgery
  • Root Canal Therapy / methods