Morphologic findings in dens evaginatus

Endodontic treatment of bilateral dens evaginatus premolars with large periapical lesions

Dens evaginatus is a developmental anomaly characterized by the presence of an accessory cusp composed of enamel and dentine, usually containing pulp tissue. This condition is clinically important because of fracture or wear of the tubercle, which can frequently lead to the major complication of pulp necrosis and periapical infection. Treatment varies according to pulp condition, tubercle integrity, and stage of root development. Here we report a case of bilateral dens evaginatus with large periapical lesions. Non-surgical root canal treatment using calcium hydroxide medication was performed for both mandibular second premolars. At the 3-year postoperative recall examination, the teeth were asymptomatic and radiographically showed healing of the periapical lesions.

The Ekman-Westborg and Julin trait: report of a case

Macrodontia associated with multituberculism, central cusps, and pulpal invaginations is reported in a 7-year-old Hungarian girl. Over 5 years' follow-up the problems of the diagnosis, the similarity with and relationship to the Ekman-Westborg and Julin trait, and the difficulties of the treatment are discussed.

Dens evaginatus from an orthodontic perspective: report of several clinical cases and review of the literature

The anomaly of dens evaginatus manifests itself as an innocuous-looking tubercle of enamel on the occlusal surface of a premolar tooth. Problems can arise when the tubercle is either worn, ground, or fractured off, resulting in pulpal exposure and possible loss of vitality of the tooth. Orthodontists should be particularly aware of this dental anomaly, which occurs in at least 2% of the Asian and Native Indian population. Premolar extraction cases should be planned to include extraction of the anomalous premolars instead of the normal ones. In addition, the orthodontist should be wary of occlusal changes during treatment or occlusal equilibration that might jeopardize the vitality of teeth with dens evaginatus. Pulp-capping or partial pulpotomy has been postulated as the most reliable form of treatment to prevent loss of vitality of the affected teeth and to allow continued root maturation where necessary.

Management of dens evaginatus: evaluation of two prophylactic treatment methods

Dens evaginatus (DE) is an odontogenic anomaly characterized by an enamel covered tubercle, enclosing dentin and pulpal tissue. It most commonly affects premolar teeth of people of mongoloid ethnicity. The prevalence of DE in Singapore is 2.1%. Fracture or attrition of the tubercle may lead to pulpal necrosis. Thus, prophylactic management of DE is preferred. A retrospective cohort study comparing two common prophylactic restorative methods was conducted. This involved 817 children, aged 10 years at the outset, having 1591 DE. The teeth were observed for 2 years. The results showed that significantly less teeth developed pulpal pathology when an enamoplasty-preventive resin restoration method was used (0.52%) as compared to an amalgam cavity restoration (5.37%) and the control (3.65%) [chi 2 = 9.595 (p < 0.01) df = 2]. Knowledge of the various treatment options and prevalence data is important as there is an increasing global migration of people of mongoloid ethnicity.

Dens evaginatus of anterior teeth. Literature review and radiographic survey of 15,000 teeth

Case reports published between 1970 and 1995 that describe the characteristics of dens evaginatus of anterior teeth were reviewed. In addition, a radiographic survey of 15,000 anterior teeth was conducted to determine the occurrence of this developmental malformation. In this survey, dens evaginatus was found in about 1% of the anterior dentition and was more frequent in the maxilla, particularly in the lateral incisor. This anomaly was less frequent in the mandible.