RESUMEN
Dens invaginatus is a rare developmental anomaly of the teeth that is caused by the infolding of enamel organs or the penetration of their proliferations into dental papillae before calcification has occurred. The presence of double dens invaginatus is extremely rare. This paper describes the use of cone beam computed tomography in the evaluation of a maxillary lateral incisor with double dens invaginatus and periapical periodontitis. The tooth was treated through microscopic root canal therapy. The tooth was free of clinical symptoms, and the periradicular lesion narrowed during the follow-up period of 1 year.
Asunto(s)
Dens in Dente , Periodontitis Periapical , Humanos , Cavidad Pulpar/diagnóstico por imagen , Cavidad Pulpar/anomalías , Dens in Dente/diagnóstico por imagen , Dens in Dente/terapia , Dens in Dente/patología , Incisivo/diagnóstico por imagen , Incisivo/anomalías , Incisivo/patología , Tratamiento del Conducto Radicular , Periodontitis Periapical/terapia , Periodontitis Periapical/patologíaRESUMEN
Dens invaginatus is a rare developmental anomaly of the teeth that is caused by the infolding of enamel organs or the penetration of their proliferations into dental papillae before calcification has occurred. The presence of double dens invaginatus is extremely rare. This paper describes the use of cone beam computed tomography in the evaluation of a maxillary lateral incisor with double dens invaginatus and periapical periodontitis. The tooth was treated through microscopic root canal therapy. The tooth was free of clinical symptoms, and the periradicular lesion narrowed during the follow-up period of 1 year.
Asunto(s)
Humanos , Cavidad Pulpar/anomalías , Dens in Dente/patología , Incisivo/patología , Tratamiento del Conducto Radicular , Periodontitis Periapical/patologíaRESUMEN
El diente evaginado (DE) es una anomalía del desa-rrollo que se define como un tubérculo o protube-rancia que se extiende desde la superficie oclusal del diente afectado. La fractura o desgaste de esta pro-longación, internamente compuesta por tejido pul-par, puede causar diversas enfermedades pulpares, como pulpitis, necrosis pulpar e incluso dar lugar a una periodontitis apical. En el presente caso clíni-co se muestra el tratamiento de DE en un segundo premolar superior izquierdo que presentaba como diagnóstico necrosis pulpar y absceso alveolar cró-nico. El tratamiento consistió en realizar la terapia endodóntica con técnica de apexificación empleando BiodentineTM (AU)
Dens evaginatus (DE) is a dental developmental defect defined as a tubercle or protuberance that extends from the occlusal surface of the affected tooth. Fracture or wear of this extension, internally composed of pulp tissue, can cause diverse pulp diseases, such as pulpitis, pulpal necrosis and it can even induce apical periodontitis.The following clinical case shows the treatment of DE in a maxillary left second premolar diagnosed with pulp necrosis and chronic alveolar abscess. The treatment of choice was endodontic therapy using BiodentineTM (AU)
Asunto(s)
Humanos , Masculino , Adulto , Materiales de Obturación del Conducto Radicular , Tratamiento del Conducto Radicular/métodos , Necrosis de la Pulpa Dental/terapia , Dens in Dente/patología , Argentina , Facultades de OdontologíaRESUMEN
Dens invaginatus is a progressive abnormality resulting from invagination of the crown or root before calcification. This case report presents nonsurgical endodontic treatment and nine-year follow-up results of a right maxillary canine tooth with type II dens invaginatus. A 40-year-old female patient was referred to the clinic for treatment of her maxillary right canine tooth. The invagination was managed on a two-visit appointment. On the first visit, the invagination area, which was disconnected, was completely removed from the root canal. The invagination area was instrumented, and the root canal was dressed with calcium hydroxide. At the second appointment, apexification was done using mineral trioxide aggregate compacted to the apical 3mm. Finally, the invaginated area and the root canal were obturated with a warm vertical compaction technique. At a nine-year follow-up, the invaginated tooth was asymptomatic, and the periradicular lesion showed satisfactory healing radiographically.
Asunto(s)
Dens in Dente , Femenino , Humanos , Dens in Dente/diagnóstico por imagen , Dens in Dente/terapia , Dens in Dente/patología , Incisivo/diagnóstico por imagen , Tratamiento del Conducto Radicular/métodos , Apexificación/métodos , Tomografía Computarizada de Haz Cónico/métodosRESUMEN
A rare case of radicular dens invaginatus (dens in dente) was found during dental cleaning of a 5-year-old male Rottweiler dog. Radiographic examination revealed intense radiopacity, which extended from the crown to the apical root region of the affected tooth. Macroscopically, the crown of the left maxillary first molar tooth (209) had irregular and deformed buccal and lingual surfaces. Microscopic examination revealed dentine invagination in the pulp cavity in of the crown and root and pulp necrosis. Based on the gross, radiographic and histological findings, a diagnosis of radicular dens invaginatus was made.
Asunto(s)
Dens in Dente/veterinaria , Enfermedades de los Perros , Animales , Dens in Dente/diagnóstico por imagen , Dens in Dente/patología , Perros , Masculino , Corona del Diente/patologíaRESUMEN
This is a case report on the management of a vital lateral incisor with a radiolucent cervical area associated with the presence of necrotic pulp due to a dens invaginatus (DI) type III. A nine-year-old boy presented to a university pediatric dental clinic with dental trauma. The examination showed poor oral hygiene, an uncomplicated fracture in the permanent maxillary left central incisor, and a fistula near the permanent maxillary right lateral incisor. A radiograph showed that the right lateral incisor had incomplete root development and a type III DI. Although sensitive to thermal pulp testing, tracing of the fistula indicated that the radiolucent area was associated with the DI, extending laterally to the periodontal ligament. Endodontic treatment was performed only in the invagination, keeping the root canal of the lateral incisor vital. After two years of follow-up, complete root formation and injury repair associated with invagination were observed.
Asunto(s)
Dens in Dente/patología , Dens in Dente/terapia , Necrosis de la Pulpa Dental/terapia , Incisivo/lesiones , Periodontitis Periapical/patología , Periodontitis Periapical/terapia , Niño , Dens in Dente/complicaciones , Necrosis de la Pulpa Dental/complicaciones , Humanos , Masculino , Obturación del Conducto RadicularAsunto(s)
Dens in Dente/diagnóstico , Dens in Dente/cirugía , Adulto , Dens in Dente/patología , Diagnóstico Diferencial , Femenino , Humanos , MaxilarRESUMEN
Dens invaginatus is a developmental anomaly that often presents a perplexing challenge to the endodontist. It involves the maxillary central incisor less commonly than the maxillary lateral incisor. Double dens invaginatus is even rarer. Herein a unique case of dens invaginatus in a maxillary central incisor is presented. The tooth had an inadequate previous root canal treatment. On retreatment, multiple canals and double dens invaginatus were found. The invaginations were Oehlers type 3b and type 2. The complex morphology was diagnosed and confirmed with cone-beam computed tomography imaging and managed with a combined surgical and orthograde approach. Four canals and a blind sac along with an open apex were found. There were many intercommunications between the canals. During the treatment, a complication of a separated instrument occurred, which was managed successfully. The 1-year follow-up shows successful outcome of the treatment. Dens invaginatus may be more complicated than it seems. It needs meticulous treatment by a specialist. Failure or a delay in referring the case to a specialty setting may further increase the complications. With the advancements in equipment and materials, it is possible to save even severe cases of dens invaginatus.
Asunto(s)
Dens in Dente/diagnóstico , Dens in Dente/patología , Incisivo/patología , Adolescente , Tomografía Computarizada de Haz Cónico , Dens in Dente/diagnóstico por imagen , Dens in Dente/cirugía , Femenino , Humanos , Incisivo/diagnóstico por imagen , Incisivo/cirugía , Retratamiento , Resultado del TratamientoRESUMEN
AIM: Dens Invaginatus (DI) is a rare malformation of the teeth, showing a broad spectrum of morphologic variations. The aim of this study was to perform in vitro radiographic analyses of three extracted dens invaginatus (DI) teeth with complex root anatomy using plain radiographs, CBCT, MRI and micro CT techniques. MATERIALS AND METHODS: Study design: Three maxillary lateral incisors (A, B and C) from two patients were extracted due to poor prognosis and were radiographically analysed. Initially, conventional two dimensional digital radiographs were taken. Subsequently CBCT, micro CT and MRI analyses were performed. RESULTS: According to the Schulze and Brand system of classification, teeth A, B and C were classified as A2, B3 and B2 respectively. To detect the relationship between the invagination to the oral cavity and pulp chamber, conventional two dimensional radiographs were of no help. CBCT and MRI images were found to be complementary to each other but provided lesser structural detail than micro CT images. CONCLUSION: Reporting on these three DI teeth, normal conventional radiographs did not provide detailed structural information about the malformation due to geometric distortion and lack of information. Even though Oehlers classification system is the most widely used, classification by Schulze and Brand is more applicable in rare and deviant teeth.
Asunto(s)
Dens in Dente/diagnóstico por imagen , Incisivo/anomalías , Niño , Tomografía Computarizada de Haz Cónico/métodos , Dens in Dente/patología , Esmalte Dental/anomalías , Esmalte Dental/diagnóstico por imagen , Pulpa Dental/anomalías , Pulpa Dental/diagnóstico por imagen , Cavidad Pulpar/anomalías , Cavidad Pulpar/diagnóstico por imagen , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Incisivo/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Radiografía Dental Digital/métodos , Ápice del Diente/anomalías , Ápice del Diente/diagnóstico por imagen , Corona del Diente/anomalías , Corona del Diente/diagnóstico por imagen , Raíz del Diente/anomalías , Raíz del Diente/diagnóstico por imagen , Microtomografía por Rayos X/métodosRESUMEN
A talon cusp is a prominent accessory horn-like structure that projects from the cingulum or cementoenamel junction of the maxillary or mandibular teeth. It can occur in primary and permanent dentition and can lead to occlusal interference, irritation of the tongue, pulpal necrosis, caries, and periodontal problems. Talon cusp has been reported to affect both sexes, and may be unilateral or bilateral. Talon cusps occur most often on the palatal surface of permanent maxillary incisors. A comprehensive literature review revealed only 6 reported cases of facial talon cusps. A talon cusp occurring simultaneously with dens invaginatus in a tooth is extremely rare; to date, only 9 case reports have been published. This article presents a unique case of concurrent dens invaginatus and palatal and facial talon cusps in the right maxillary central incisor of a 12-year-old girl.
Asunto(s)
Dens in Dente/complicaciones , Incisivo/anomalías , Anomalías Dentarias/diagnóstico , Niño , Dens in Dente/diagnóstico , Dens in Dente/patología , Femenino , Humanos , Incisivo/patología , Anomalías Dentarias/patologíaRESUMEN
The aim of this paper is to describe a unique and unusual case of concomitant appearance of morphological dental anomalies in the maxillary anterior region, along with its management in a patient with no systemic abnormality. This case report describes the clinical and radiographic features of talon cusp, dens invaginatus, shovel-shaped incisors and a supernumerary tooth occurring in a single patient, which is a rare presentation. All 4 permanent maxillary incisors had dens invaginatus, the permanent maxillary canines showed the presence of talon cusps, the permanent maxillary central incisors were shovel-shaped and an erupted mesiodens was also observed. Treatment included restorative, surgical and orthodontic approaches.
Asunto(s)
Dens in Dente/patología , Incisivo/anomalías , Corona del Diente/anomalías , Diente Supernumerario/patología , Adulto , Humanos , MasculinoRESUMEN
Dens invaginatus (DI) is a dental anomaly originated from invagination of the enamel organ into the dental papilla, during odontogenesis. DI may be associated with other abnormalities such as dysmorphic mesiodens, and this unusual condition may be detected by chance on the conventional radiography. However, the three-dimensional nature and the exact morphological patterns of DI are impossible to appreciate from this method. We present a morphological study of impacted mesiodens in a 9-year-old girl, which the three coronal invaginations were detected only by Cone-Beam Computed Tomography (CBCT) in the pre-surgical examination. CBCT, radiographic and microscopic reproductions allow transfer of images to facilitate cooperation of working groups, examination as well as for teaching purposes.
Asunto(s)
Dens in Dente/patología , Diente Impactado/patología , Niño , Dens in Dente/diagnóstico por imagen , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Radiografía Panorámica , Diente Impactado/diagnóstico por imagenRESUMEN
Dens invaginatus, also known as dens in dente, is a rare anomaly affecting human dentition. The condition results in invagination of an amelodental structure within the pulp. This case report discusses the current management protocol of dens invaginatus as demonstrated in an adolescent female and describes treatment options. As with most conditions, early diagnosis and preventive measures help minimize complications in dens invaginatus cases.
Asunto(s)
Dens in Dente/patología , Incisivo/anomalías , Tratamiento del Conducto Radicular , Adolescente , Dens in Dente/complicaciones , Dens in Dente/terapia , Femenino , Humanos , Masculino , Maxilar , Absceso Periapical/complicacionesRESUMEN
INTRODUCTION: Dens invaginatus is a developmental anomaly that poses treatment challenges when nonsurgical root canal therapy is deemed necessary. Teeth with complex root canal morphology often require a comprehensive treatment approach to effectively clean, shape, and disinfect the pulp canal space before obturation. Endodontic clinical management of a tooth with dens invaginatus might include using cone-beam computed tomography (CBCT) to aid in the diagnosis and treatment-planning phase and use of the surgical operating microscope in performing the clinical phase of treatment. A novel approach could include using the revascularization technique as the final treatment step in the management of a dens invaginatus case in which the root apex has not completed formation. METHODS: This case report will provide both an overview of the feasibility of using CBCT scans in diagnosis and treatment planning and a step-by-step clinical technique, by using surgical operating microscope and the revascularization technique, in the successful endodontic management of a complex dens invaginatus case. CONCLUSIONS: Five-month and 12-month follow-up clinical and radiographic findings will provide a candid view of inherent advantages and challenges of this technique.
Asunto(s)
Dens in Dente/terapia , Tratamiento del Conducto Radicular/métodos , Compuestos de Aluminio/uso terapéutico , Antibacterianos/uso terapéutico , Compuestos de Calcio/uso terapéutico , Niño , Tomografía Computarizada de Haz Cónico/métodos , Dens in Dente/patología , Cavidad Pulpar/anomalías , Sensibilidad de la Dentina/terapia , Dentina Secundaria/diagnóstico por imagen , Combinación de Medicamentos , Estudios de Factibilidad , Estudios de Seguimiento , Cementos de Ionómero Vítreo/química , Humanos , Óxido de Magnesio/química , Masculino , Microscopía/instrumentación , Óxidos/uso terapéutico , Planificación de Atención al Paciente , Cemento de Policarboxilato/química , Materiales de Obturación del Conducto Radicular/uso terapéutico , Irrigantes del Conducto Radicular/uso terapéutico , Preparación del Conducto Radicular/instrumentación , Silicatos/uso terapéutico , Hipoclorito de Sodio/uso terapéutico , Raíz del Diente/anomalías , Óxido de Zinc/químicaRESUMEN
This article presents the case of a Japanese woman who had Ekman-Westborg-Julin trait. She had general macrodontia with multituberculism, evagination of the premolar, single conical roots, shovel-shaped incisors, enamel hypoplasia, impacted tooth, dental crowding, and an open bite. The oral and general characteristics of this patient are described and include the histological and radiographic findings of the mandibular third molars. We suggest that the distinctive oral features with macrodontia of the permanent teeth, multituberculism, evagination, single conical roots, and impaction of the tooth could be defined as the Ekman-Westborg-Julin trait.
Asunto(s)
Anomalías Dentarias/patología , Adolescente , Diente Premolar/anomalías , Diente Canino/anomalías , Dens in Dente/patología , Hipoplasia del Esmalte Dental/patología , Femenino , Estudios de Seguimiento , Humanos , Incisivo/anomalías , Maloclusión/patología , Diente Molar/anomalías , Mordida Abierta/patología , Síndrome , Corona del Diente/anomalías , Raíz del Diente/anomalías , Diente Impactado/patologíaRESUMEN
BACKGROUND: The authors' objective in this case report is to demonstrate an effective nonsurgical endodontic treatment in open-apex teeth affected by dens invaginatus (DI) by using a collagen membrane as an apical barrier and using a mineral trioxide aggregate (MTA) apical plug. CASE DESCRIPTION: . The authors present two cases of DI with open apexes in maxillary lateral incisors. In the first case, an adolescent had bilateral Oehlers type II DI and extensive periradicular radiolucency, internal root resorption and a vestibular fistula in the left maxillary lateral incisor. In the second case, an adult had Oehlers type II DI and an incomplete apex in the left maxillary lateral incisor. For both patients, the clinician placed a collagen membrane through the apexes of the left maxillary incisors to provide a resorbable extraradicular barrier against which MTA cement could be packed. The clinician obturated the adolescent's right lateral incisor. RESULTS: In the adolescent, the vestibular sinus tract was closed after one week. At subsequent follow-up examinations, the periradicular regions were completely healed, and postoperative radiographs revealed good bone healing in the lateral incisors. The teeth were asymptomatic and healing was achieved without any need for further endodontic surgical intervention. In the adult patient, the tooth was symptom free after one week, and radiography performed six months after the procedure showed complete healing. CONCLUSIONS: and CLINICAL IMPLICATIONS: Despite complex anatomy and diagnoses of DI and open apexes, both patients successfully underwent nonsurgical endodontic treatment involving the use of a collagen membrane and an MTA apical plug. Using an extraradicular barrier clinically can help improve the adaptation of MTA in the apexes of open-apex teeth to achieve a complete seal.
Asunto(s)
Colágeno , Dens in Dente/terapia , Incisivo/anomalías , Membranas Artificiales , Tratamiento del Conducto Radicular/métodos , Ápice del Diente/patología , Implantes Absorbibles , Adolescente , Compuestos de Aluminio/uso terapéutico , Apexificación/métodos , Compuestos de Calcio/uso terapéutico , Dens in Dente/patología , Fístula Dental/terapia , Necrosis de la Pulpa Dental/terapia , Combinación de Medicamentos , Femenino , Estudios de Seguimiento , Humanos , Incisivo/patología , Óxidos/uso terapéutico , Periodontitis Periapical/terapia , Técnica de Perno Muñón , Materiales de Obturación del Conducto Radicular/uso terapéutico , Preparación del Conducto Radicular/métodos , Silicatos/uso terapéutico , Adulto JovenRESUMEN
Ekman-Westborg and Julin is a trait that shows multiple macrodontia and multituberculism affecting only the teeth with no other anomalies (E-WJ). The aim of this report is to present a case which appears to manifest all the clinical signs of the E-WJ trait including odontoma formation. A 18-year-old girl with gingival inflammation particularly in the maxillary insicor area was referred to the authors' department. Panoramic, periapical and cephalometric radiographs were examined and complex odontoma associated with unerupted maxillary permanent lateral incisors was revealed. Intraoral examination revealed anterior crossbite, Angle Class III type malocclusion with mandibulary prominence and macrodontia of teeth 37, 12, 11 and 21. The patient was accepted as a new sporadic case of E-WJ. More case reports are needed to elucidate the causes and pathogenesis of this condition.
Asunto(s)
Incisivo/anomalías , Neoplasias Maxilares/patología , Odontoma/patología , Corona del Diente/anomalías , Adolescente , Cefalometría/métodos , Diente Canino/anomalías , Dens in Dente/patología , Femenino , Humanos , Diente Molar/anomalías , Radiografía de Mordida Lateral , Radiografía Panorámica , Síndrome , Diente no Erupcionado/patologíaRESUMEN
Multiple macrodontia is a rare finding and is defined as a condition in which a tooth is significantly larger than normal. Macrodontia may occur as an isolated finding, part of a group of dental anomalies, or as a component of a syndrome with multiple oral and systemic manifestations. The purpose of this paper was to report a case of macrodontia affecting all permanent teeth and exhibiting shovel-shaped maxillary and mandibular incisors and multituberculate molars and premolars. Some or all of this patient's characteristics have been reported in both males and females, with a ratio of 5:2. No inheritance pattern has been established, as these traits have generally occurred spontaneously. As more individuals are identified and as molecular techniques continue to advance, it is probable that a gene or genes responsible for macrodontia and the associated traits will be identified.
Asunto(s)
Anomalías Dentarias/patología , Diente Premolar/anomalías , Niño , Diente Canino/anomalías , Dens in Dente/patología , Estudios de Seguimiento , Humanos , Incisivo/anomalías , Masculino , Maloclusión/patología , Diente Molar/anomalías , Odontometría , Síndrome , Corona del Diente/anomalías , Diente Impactado/patología , Diente Supernumerario/patologíaRESUMEN
Permanent mandibular central incisor is rarely affected by tooth shape anomalies of crown and root. Co-occurrence of multiple anomalies in a permanent mandibular central incisor is extremely rare. This paper reports an unusual concurrent combination of multiple dental anomalies affecting both the crown and root of a permanent mandibular left central incisor - talon cusp, dens invaginatus, short root anomaly and macrodontia -, which has not previously been reported together. Case management is described and implications are discussed. The dentist should be aware of these rare entities in order to provide an accurate diagnosis and management for which detailed examination of the tooth both clinically and radiographically is very important.