Imaging Sci Dent.  2013 Sep;43(3):209-213. 10.5624/isd.2013.43.3.209.

A rare case of dilated invaginated odontome with talon cusp in a permanent maxillary central incisor diagnosed by cone beam computed tomography

• Jaya R
• Mohan Kumar RS
• Srinivasan R

• KMID: 2167460
• DOI: http://doi.org/10.5624/isd.2013.43.3.209

Abstract

It has been a challenge to establish the accurate diagnosis of developmental tooth anomalies based on periapical radiographs. Recently, three-dimensional imaging by cone beam computed tomography has provided useful information to investigate the complex anatomy of and establish the proper management for tooth anomalies. The most severe variant of dens invaginatus, known as dilated odontome, is a rare occurrence, and the cone beam computed tomographic findings of this anomaly have never been reported for an erupted permanent maxillary central incisor. The occurrence of talon cusp occurring along with dens invaginatus is also unusual. The aim of this report was to show the importance of cone beam computed tomography in contributing to the accurate diagnosis and evaluation of the complex anatomy of this rare anomaly.

Keyword

Dens Invaginatus; Dental Pulp; Endodontics; Maxillary Incisor; Cone-Beam Computed Tomography

MeSH Terms

4-Hydroxycoumarins
Cone-Beam Computed Tomography
Dental Pulp
Endodontics
Imaging, Three-Dimensional
Incisor
Tooth
Tooth Abnormalities
4-Hydroxycoumarins

Figure

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  Fig. 1 A. Labial view clinically. B. Palatal view clinically showing the presence of talon cusp.

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  Fig. 2 A reformatted panoramic CBCT image shows the appearance of an immature root.

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  Fig. 3 A. CBCT three-dimensional frontal view. B. CBCT image shows the ring-like formation of the root.

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  Fig. 4 A. CBCT parasagittal section shows the invagination and dilation in the root portion. B. CBCT axial image at the cervical level. C. CBCT cross section at the midroot level.

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  Fig. 5 A. Proximal view of the extracted tooth. B. The view from the root end of the extracted tooth showing the wide ring-like invagination.

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  Fig. 6 Histological examination of the contents of the inva-gination (H&E stain, 200×).

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