Dens invaginatus – therapeutic possibilities

Abstract:

Dens invaginatus is a rare malformation of teeth. It is defined as a defect in tooth development characterized by invagination of the enamel organ before the calcification phase. The malformation shows a broad spectrum of anatomical and morphological variations. The aetiology of dens invaginatus is still controversial and remains unclear. Numerous classifications of dens invaginatus are mostly based on the stage of the invagination and communication with the periodontal and periapical tissue. The incidence of dens invaginatus is reported to range between 0.04% and 10%, with the upper lateral incisors being most commonly involved. Diagnosis of the invaginated tooth is based on the radiological finding and clinical features. Clinically, an unusual crown morphology or a deep foramen coecum is usually found. Most cases of asymptomatic dens invaginatus are detected on routine radiographic examination with a panoramic x-ray or periapical film. The most frequent symptoms include acute pain and consequences of odontogenic inflammation. Early diagnosis of the complications of the invaginated tooth is mandatory, as well as urgent endodontic or surgical treatment to prevent potential severe complications and to begin opportune planning for the implantoprosthetic rehabilitation. 

Key words:
dens in dente; dental implants; diagnosis; oral surgery; taurodontism, microdontia, and dens invaginatus; therapy