18-Year Follow-up of Dens Invaginatus: Retrograde Endodontic Treatment

Abstract

Introduction: Dens invaginatus is a rare developmental anomaly that occurs during odontogenesis, with a higher prevalence in the Caucasian race and no significant sex predilection; it can be bilateral. This anomaly occurs in approximately 1.26% of the teeth, and the maxillary lateral incisor is most often affected. Methods: This case report describes a female patient with dens invaginatus in the maxillary right conoid lateral incisor. The patient presented to Aracatuba School of Dentistry, Universidade Estadual Paulista, Sao Paulo, Brazil, in 1995 with an acute periapical abscess in the palatal region of the tooth in question. After access preparation, the pulp in the main root canal was found to be vital and not associated with the abscess; therefore, surgical drainage of the abscess and root canal treatment of the main canal were performed. Surgical complementation was also performed to eliminate the infectious focus, which involved retrograde endodontic treatment of the dens invaginatus being obturated with Sealapex (Sybron Dental Specialties, Glendora, CA) and Ultrafil (Coltene/Whaledent AG, Altstatten, Switzerland). Radiographic assessments were completed periodically to verify healing. After 18 years, the patient returned to Aracatuba School of Dentistry, presenting crown fracture of the tooth in question. Results: Radiographic examination showed repair and favorable conditions for tooth maintenance, so a post and porcelain core were made. Conclusions: The treatment was successful, achieving adequate repair with 18 years of follow-up.