Restor Dent Endod.  2012 Mar;37(1):50-53. 10.5395/rde.2012.37.1.50.

Endodontic management of a maxillary lateral incisor with dens invaginatus and external root irregularity using cone-beam computed tomography

• Lim YJ
• Nam SH
• Jung SH
• Shin DR
• Shin SJ
• Min KS

• KMID: 1995684
• DOI: http://doi.org/10.5395/rde.2012.37.1.50

Abstract

Cone-beam computed tomography (CBCT) is a useful diagnostic tool for identification of both internal and external root configurations. This case report describes the endodontic management of a lateral incisor with both dens invaginatus and external root irregularity by using CBCT. Nonsurgical endodontic retreatment was performed on the lateral incisor with dens invaginatus. A perforation through the dens invaginatus and external concavity was repaired using mineral trioxide aggregate. After 18 mon of follow-up, there were no clinical symptoms. Recall radiographs appeared normal and showed healing of the periapical pathosis. The understanding of both internal root canal configuration and external root irregularity using CBCT can ensure predictable and successful results.

Keyword

Cone-beam computed tomography; Dens invaginatus; External root irregularity; Perforation

MeSH Terms

Aluminum Compounds
Calcium Compounds
Cone-Beam Computed Tomography
Dental Pulp Cavity
Dietary Sucrose
Drug Combinations
Follow-Up Studies
Incisor
Oxides
Retreatment
Silicates
Aluminum Compounds
Calcium Compounds
Dietary Sucrose
Drug Combinations
Oxides
Silicates

Figure

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  Figure 1 (a) Clinical view of maxillary lateral incisor showing cervical non-carious defect; (b) Radiographic view of dens invaginatus. Periapical radiolucency can be seen; (c) Sagittal CBCT section of the tooth. White arrow indicates the perforation site.

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  Figure 2 A set of transverse CBCT scan showing external concavity of the maxillary left lateral incisor. Note perforation communicates with periodontium through this concavity (white arrow). CBCT, cone-beam computed tomography.

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  Figure 3 (a) Radiographic view showing root fillings. White arrow indicates the MTA to repair perforation; (b) Radiographic view after 18 months showing apical healing. MTA, mineral trioxide aggregate.

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