Cases reported "Dens in Dente"

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1/51. Surgical treatment of a periradicular lesion on an invaginated maxillary lateral incisor (dens in dente).

    The complex anatomy of invaginated teeth make their root canal treatment difficult. Moreover, this treatment may compromise the future of the tooth if it is destined to support a post-retained coronal restoration. This case reports the successful surgical root canal treatment of an invaginated tooth using a retrograde filling with gutta-percha. After surgical exposure of the root-end and cleaning of the root canal, the gutta-percha was compacted in the root canal which had been coated previously with a zinc oxide-eugenol cement. The gutta-percha was then cold-burnished. Periapical radiographic examination after 1, 2, 3, 6 and 12 months showed periapical healing with osseous formation. This procedure, resulting in minimal loss of hard tissues, permitted subsequent restoration of the tooth.
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2/51. Endodontic treatment of immature tooth with dens invaginatus: a case report.

    The endodontic treatment of a dens invaginatus in an immature permanent upper lateral incisor of a 9-year-old boy is presented. Root canal treatment was performed using calcium hydroxide paste as a temporary root canal filling in order to achieve apexification. This was replaced after closure of the apex with a final root canal filling using gutta-percha and AH 26 as the sealer. The follow-up radiographic control demonstrated the effectiveness of nonsurgical treatment in a case of incomplete root formation in a tooth with dens invaginatus.
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3/51. Complex treatment of dens invaginatus type III in maxillary lateral incisor.

    The complex anatomy and diagnosis of dens invaginatus make endodontic treatment of such teeth difficult. This case describes combined nonsurgical and surgical treatment of a maxillary lateral incisor with a normally shaped canal and a dens invaginatus type III with a lateroradicular lesion. The root canal was treated conventionally with gutta-percha and a zinc oxide-eugenol sealer. The root was surgically exposed and the canal of the dens invaginatus was cleaned, instrumented and obturated with gutta-percha and a zinc oxide-eugenol sealer. At follow-up 3 years 6 months later, the tooth was asymptomatic and radiographically showed repair of the lesion in the region of the dens invaginatus.
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4/51. Unusual case of bilateral talon cusp associated with dens invaginatus.

    CASE REPORT: This paper presents a rare case of bilateral talon cusp in permanent maxillary central incisors, one on the labial and another on the lingual surface of each tooth. The condition was associated with dens invaginatus in a maxillary permanent lateral incisor, but no developmental syndrome was identified. The left central incisor required no treatment because the aesthetic appearance was satisfactory and neither occlusal interferences nor caries were present. After careful investigation of the right lateral incisor, a sealant was applied. Root canal treatment was indicated for the right central incisor that had a wide open apex with thin, weak, divergent walls, and an apical radiolucency.
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5/51. Root canal treatment of an invaginated maxillary lateral incisor with a C-shaped canal.

    The endodontic treatment of an atypical maxillary lateral incisor that contained a C-shaped root canal is described. The unusual anatomic configuration of this particular tooth and the advantage of using image magnification to facilitate endodontic treatment are discussed.
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6/51. Exarticulation and reimplantation utilizing guided tissue regeneration: a case report.

    The extraction and reimplantation of teeth is a technique that has been practiced for many years, resulting in successful retention of teeth for up to 30 years. Although evidence confirming the advantages of this technique is limited, clinical observations and histologic examinations have revealed some important factors that are prerequisites for success: limitation of the time the tooth is exposed to the extraoral environment and preservation of vital periodontal tissue attachments on root surfaces. The latter goal can be achieved by gentle, atraumatic removal of the tooth from its socket, and hence the term exarticulation and reimplantation is more representative of the technique. In the present case report, a maxillary lateral incisor with a developmental defect was treated by exarticulation and reimplantation and application of calcium sulfate. Exarticulation and reimplantation seems to be a useful clinical procedure, but controlled studies are required to confirm its efficacy.
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7/51. Microscopic removal of dens invaginatus.

    Endodontic treatment for teeth that exhibit the dental anomaly, dens invaginatus, can be difficult due to the bizarre anatomy and relative inaccessibility of the diseased pulp tissue. Surgical intervention or extraction are common approaches to dealing with this condition. This article reports the treatment of an extreme form of dens invaginatus, employing the dental-operating microscope and the ultrasonic instrument. Removal of the entire anomalous structure and pulp tissue was possible, and conventional orthograde obturation was accomplished. Two and 4-yr follow-up radiographs show that healing has occurred. The article demonstrates that the anomalous structure of dens invaginatus is a separate entity from the rest of the tooth. This implies that in many instances it may be entirely removed to facilitate conventional endodontic therapy.
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8/51. Dens invaginatus in a primary molar: report of case.

    A case of dens invaginatus in a mandibular second primary molar of an eleven-year-old boy is presented. The tooth was extracted and examined by scanning electron microscopy. SEM findings demonstrated the presence of defective enamel and cementum in the pulp chamber. Dentinal tissues were also irregular and had fewer and thinner tubules. This case of dens invaginatus in primary molar is an unusual case of the malformation being the only one in the literature.
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9/51. Dens invaginatus type III: report of a case and 10-year radiographic follow-up.

    AIM: The purpose of this article is to report the 10-year follow-up of a right mandibular central incisor with 'dens invaginatus' that was root filled. SUMMARY: 'Dens invaginatus' is a rare malformation of teeth, probably resulting from an infolding of the dental papilla during tooth development. It has alternatively been called 'dens in dente' and 'dilated composite odontome'. Radiographic examination may clearly demonstrate this feature, although no signs may be recognized clinically. If no entrance to the invagination can be detected and there are no signs of pulp pathosis, then no treatment is required other than fissure sealing of the invagination. In deep invaginations, it is likely that root-canal treatment may be required. Occasionally, when the tooth has an immature root, apexification is necessary. Root-canal treatment of a right mandibular central incisor with 'dens invaginatus' is described along with 10-year follow-up. KEY learning POINTS: Both clinical and radiographic examinations are necessary to determine morphological features of teeth before root-canal treatment. Sensibility testing to determine the pulp condition is critical prior to treatment.
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10/51. Double dens invaginatus of molarized maxillary central incisors, premolarization of maxillary lateral incisors, multituberculism of the mandibular incisors, canines and first premolar, and sensorineural hearing loss.

    Molarization and premolarization of anterior teeth have never been reported before. Double dens invaginatus is an extremely rare condition. We describe an affected female who had developmental delay and congenital progressive sensorineural hearing loss. Double dens invaginatus of molarized maxillary central incisors and premolarized maxillary lateral incisors were present. In addition, multituberculated mandibular incisors, canines, and first premolar were observed. Histologically, tooth structure was unremarkable. family history of dental abnormalities and hearing loss was denied. Clinical and radiographic examinations were those performed when the patient was 7 and 13 years old. The basic defect is postulated to be of mesenchymal origin.
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