PubMed · 14420759
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L R MANSON-HING. 1960. Multiple dens in dente.. https://doi.org/10.1016/0030-4220(60)90181-x
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Dens invaginatus is a dental malformation that may give rise to several complications. Caries of the invagination can severely weaken the whole tooth, making it susceptible to fracture. Subgingival fractures are major complications threatening tooth survival and usually require periodontal/orthodontic/prosthetic treatment if long-term viability is to be ensured. This article describes a case of single-session restoration of a fractured invaginated tooth by means of endodontic treatment followed by fragment reattachment.
Dens invaginatus is a malformation of teeth probably due to infolding of the dental papilla during tooth development. A wide range of morphologic variations have been described. Both coronal and radicular invaginations have been demonstrated. Typical characteristics associated with the coronal invagination are the complex anatomy and the early pulp necrosis. The etiology, epidemiology, classification and therapeutic considerations are reviewed.
BACKGROUND: Dens Invaginatus (DI), commonly known as dens in dente, is a developmental malformation of tooth that most commonly affects permanent maxillary lateral incisor teeth. Deciduous teeth are infrequently affected. Presence of DI in mandibular permanent teeth is extremely rare. Further, the presence of DI bilaterally in the maxillary lateral incisors of the same patient is even more unusual. METHODS: In this article, an unusual case of DI affecting a mandibular lateral incisor tooth is described. This malformation was uncovered after a full mouth radiographic examination when the patient presented for dental treatment unrelated to this finding. In addition, the various radiographic appearances of DI as they present within the maxillary and mandibular teeth are described. Essential clinical considerations and treatment options are presented. A review of the pertinent literature is undertaken and a table summarizing previous published findings of mandibular DI is presented. RESULTS: A review of the literature indicates that DI in mandibular teeth is extremely rare with only 10 other cases involving 13 teeth reported previously. CONCLUSIONS: Although this is an extremely rare case, DI is an anomaly that should be familiar to all practising dentists due to the clinical implications of potential sequelae of pulpal involvement.