Endodontic management of a rare case of Type III Dens invaginatus in a maxillary canine combined with a previous occurrence of dental trauma

TL;DR

This paper describes a rare case of a maxillary canine with a dental anomaly and trauma, successfully treated with endodontic procedures.

Contribution

The paper presents a rare clinical case of Type III Dens invaginatus in a maxillary canine combined with dental trauma and its successful endodontic management.

Findings

A 14-year-old patient with a maxillary canine affected by Dens invaginatus and dental trauma was successfully treated.

Use of CBCT and apical plug technique with MTA led to complete healing of periapical tissues after two years.

Thorough dental history and radiographic evaluation are crucial for managing complex dental anomalies.

Abstract

Dens Invaginatus (DI) is a developmental anomaly which eventually leads to pulp necrosis and has several clinical implications in sufficient instrumentation and obturation of the root canal system. The present clinical report presents a rare case of a maxillary canine affected with DI leading to pulp necrosis combined with a previous dental trauma, which also led to irreversible pulp damage of the adjacent lateral incisor. A 14-year-old male patient with a history of dental trauma at the right maxillary region, one year earlier, was referred with pain and swelling at the apical area of the right maxillary canine. After CBCT evaluation, complete removal of the invagination was decided. All the procedures were performed under operating microscope and canal obturation was done with apical plug technique using MTA. Two-year follow-up radiographic assessment confirmed complete healing of the periapical tissues for both teeth. The present case describes a rare case of dens invaginatus in a maxillary canine pointing out the importance of obtaining a thorough dental history upon diagnosis, performing also a careful clinical and radiographic evaluation and subsequent treatment planning, especially when addressing complex pathologies and unusual dental malformations. In such cases with high degree of complexity, preoperative CBCT examination is required for decision making and subsequent appropriate management.

Key words:Dens Invaginatus, maxillary canine, endodontic treatment.

Figures