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Fekonja A. Morphological Diversity of Permanent Maxillary Lateral Incisors and Their Impact on Aesthetics and Function in Orthodontically Treated Patients. Diagnostics (Basel) 2022; 12:diagnostics12112759. [PMID: 36428818 PMCID: PMC9689735 DOI: 10.3390/diagnostics12112759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 10/24/2022] [Accepted: 11/01/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to determine the frequency of different crown shapes and associated dental anomalies of the permanent maxillary lateral incisor (PMLI) and their impact on aesthetics and occlusion (function) in orthodontically treated patients. Materials and Methods: The records of 372 subjects, which consisting of study casts, panoramic radiographs and anamnestic data, were investigated for crown shape and associated dental anomalies of PMLI and potential dental treatment to achieve satisfactory aesthetics and function. Descriptive statistics, including means, standard deviations and percentages for the observed variables, were calculated. Data were analyzed using the chi-square test. p-Values < 0.05 were considered as statistically significant. Results: The results showed that the most common crown shapes of PMLI were trapezoidal-shaped (59.8%), followed by central incisor-shaped (26.7%), canine-shaped (11.2%) and peg-shaped (2.3%), without statistically significant difference between genders. Developmental anomalies were found in 86 (11.6%) PMLI. All subjects with developmental anomalies were included in orthodontic treatment, and 91.2% of them need interdisciplinary treatment to achieve satisfactory aesthetics and function. Conclusions: The morphological diversity and developmental anomalies of the PMLI may affect aesthetics and function and should be considered in treatment planning.
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Affiliation(s)
- Anita Fekonja
- Department of Orthodontics, Healthcare Centre Maribor, Ulica Talcev 9, 2000 Maribor, Slovenia;
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
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Norouzi N, Kazem M, Gohari A. Nonsurgical Management of an Immature Maxillary Central Incisor with Type III Dens Invaginatus Using MTA Plug: A Case Report. IRANIAN ENDODONTIC JOURNAL 2017; 12:521-526. [PMID: 29225653 PMCID: PMC5722112 DOI: 10.22037/iej.v12i4.17769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Dens invaginatus is a developmental anomaly, caused by deepening of the enamel organ into the dental papilla before calcification of the dental tissues. Teeth with dens invagination are susceptible to early caries and pulp necrosis within a few years of eruption or even before root end closure. This article reports two immature maxillary central incisors with type I and III dens invaginatus which had necrotic pulp and a large periradicular lesion, that were treated successfully by nonsurgical root canal treatment. After apical plug placement, the remaining space was backfilled using warm vertical gutta-percha technique and the crowns were restored by composite restoration. At 6 months of follow up the patient was asymptomatic and probing depths were less than 3 mm. In addition, the reduction in the size of apical radiolucencies was observed by radiographic examinations. This case report revealed that even type III des invaginatus with an open apex and large periapical lesion, can be treated non-surgically using MTA as an apical plug. Although this case report presents a favorable result, further studies with long term follow-up periods are encouraged to support the use of nonsurgical endodontic treatment for type III dens invaginatus.
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Affiliation(s)
- Negar Norouzi
- Department of Endodontics, Dental School, Mazandaran University of Medical Sciences, Mazandaran, Iran
| | - Majid Kazem
- Department of Endodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atefeh Gohari
- Department of Endodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Zhang P, Wei X. Combined Therapy for a Rare Case of Type III Dens Invaginatus in a Mandibular Central Incisor with a Periapical Lesion: A Case Report. J Endod 2017; 43:1378-1382. [DOI: 10.1016/j.joen.2017.03.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 02/28/2017] [Accepted: 03/01/2017] [Indexed: 02/07/2023]
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Zhu J, Wang X, Fang Y, Von den Hoff JW, Meng L. An update on the diagnosis and treatment of dens invaginatus. Aust Dent J 2017; 62:261-275. [PMID: 28306163 DOI: 10.1111/adj.12513] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2017] [Indexed: 12/15/2022]
Affiliation(s)
- J Zhu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education; School and Hospital of Stomatology; Wuhan University; Wuhan China
- Affiliated Zhongshan Hospital; Sun Yat-sen University; Zhongshan China
| | - X Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education; School and Hospital of Stomatology; Wuhan University; Wuhan China
| | - Y Fang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education; School and Hospital of Stomatology; Wuhan University; Wuhan China
| | - JW Von den Hoff
- Department of Orthodontics and Craniofacial Biology; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - L Meng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education; School and Hospital of Stomatology; Wuhan University; Wuhan China
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Çalışkan MK, Asgary S, Tekin U, Güneri P. Amputation of an Extra-root with an Endodontic Lesion in an Invaginated Vital Maxillary Lateral Incisor: A Rare Case with Seven-year Follow-up. IRANIAN ENDODONTIC JOURNAL 2016; 11:138-41. [PMID: 27141224 PMCID: PMC4841351 DOI: 10.7508/iej.2016.02.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 02/03/2016] [Accepted: 02/20/2016] [Indexed: 11/30/2022]
Abstract
The developmental abnormality of tooth resulting from the infolding of enamel/dentin into the root is called dens invaginatus. Management of such cases is usually challenging due to the morphological complexity of root canal system. This report presents a rare treatment protocol of a clinical case of Oehler’s type III dens invaginatus combined with an endodontic lesion in a vital maxillary lateral incisor. Access to the endodontic lesion located between the central and lateral incisors was achieved by reflection of a full mucoperiosteal flap. Granulomatous tissue as well as aberrant root was removed and the surface of the root and adjacent coronal region were reshaped. Three years later, the patient was orthodontically treated. Seven years after completion of surgical/orthodontic management, the tooth remained asymptomatic and functional with normal periodontium/vital pulp. Radiographically, the healing of the lesion was observed. Actually, vitality of the invaginated tooth and communication between the invagination and the root canal were the most important factors in determining such minimally invasive treatment protocol. Depending on the anatomy of the root canal system, surgical amputation of an invaginated root can be performed to achieve a successful outcome in Oehler’s type III dens invaginatus cases, even though it is associated with apical periodontitis.
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Affiliation(s)
| | - Saeed Asgary
- Iranian Center for Endodontic Research (ICER), Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Uğur Tekin
- Department of Oral and Maxillofacial Surgery, Dental School, Ege University, Izmir, Turkey
| | - Pelin Güneri
- Department of Oral and Maxillofacial Radiology, Dental School, Ege University, Izmir, Turkey
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Pallivathukal RG, Misra A, Nagraj SK, Donald PM. Dens invaginatus in a geminated maxillary lateral incisor. BMJ Case Rep 2015; 2015:bcr-2015-209672. [PMID: 26002668 DOI: 10.1136/bcr-2015-209672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Dens invaginatus (DI) and gemination are two developmental abnormalities that are well reported in the dental literature, but their coexistence in a single tooth is rare. Such situations worsen the risk factors associated with these anomalies, and the treatment plan should be customised as they possess altered morphology and anatomy. A 19-year-old girl came for evaluation of a cracked tooth in the front region of the upper jaw. The tooth showed clinical features of gemination and radiographic features of DI, and was diagnosed as DI in geminated maxillary lateral incisor. The differential diagnoses based on clinical appearance without radiographic investigation may warrant the treatment approach if these two abnormalities coexist in a single tooth. The report also highlights the importance of three-dimensional imaging in diagnosis and treatment planning of teeth with altered pulp canal anatomy. There are few reported cases in the literature detailing the treatment options for these two anomalies occurring in the same tooth.
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Affiliation(s)
| | - Alok Misra
- Faculty of Dentistry, Department of Conservative and Endodontics, Melaka-Manipal Medical College, Melaka, Malaysia
| | - Sumanth Kumbargere Nagraj
- Faculty of Dentistry, Department of Oral Medicine, Oral Diagnosis and Oral Radiology, Melaka-Manipal Medical College, Melaka, Malaysia
| | - Preethy Mary Donald
- Faculty of Dentistry, Department of Oral Medicine, Oral Diagnosis and Oral Radiology, Melaka-Manipal Medical College, Melaka, Malaysia
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Marwah N, Goenka P, Nigam AG, Gs P. Combined surgical and nonsurgical endodontic therapy in the treatment of dens invaginatus type 3: a case report. Int J Clin Pediatr Dent 2009; 2:43-7. [PMID: 25206122 PMCID: PMC4086579 DOI: 10.5005/jp-journals-10005-1018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2009] [Accepted: 11/05/2009] [Indexed: 11/23/2022] Open
Abstract
An accurate understanding of the morphology of the root canal system is a prerequisite for successful root canal treatment. Invaginated
teeth have a complex root canal configuration that cannot be instrumented effectively. Correct diagnosis and treatment planning are
fundamental to treatment of dens invaginatus. Periapical surgery is indicated in cases where a nonsurgical approach fails. A case of
dens invaginatus type 3 in a maxillary lateral incisor with a periapical lesion and its successful treatment by these combined methods is
reported.
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Affiliation(s)
- Nikhil Marwah
- Reader, Department of Pedodontics and Preventive Dentistry, Mahatma Gandhi Dental College, Jaipur, Rajasthan, India
| | - Puneet Goenka
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry, Mahatma Gandhi Dental College, Jaipur, Rajasthan India
| | - Anant Gopal Nigam
- Reader, Department of Pedodontics and Preventive Dentistry, Mahatma Gandhi Dental College, Jaipur, Rajasthan, India
| | - Prathima Gs
- Professor and Head, Department of Pedodontics and Preventive Dentistry, Mahatma Gandhi Dental College, Jaipur, Rajasthan India
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Management of dens invaginatus diagnosed by spiral computed tomography: a case report. J Endod 2009; 34:1138-42. [PMID: 18718382 DOI: 10.1016/j.joen.2008.06.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2008] [Revised: 05/30/2008] [Accepted: 06/17/2008] [Indexed: 01/12/2023]
Abstract
A thorough knowledge of the normal anatomy of the root canal system as well as the possible aberrancies is imperative for success of endodontic therapy. The challenge lies in diagnosing these conditions properly, complete debridement of the root canal system, and 3-dimensional sealing of the same. Conventional diagnostic aids like radiographs play an important role in assessment of complex root canal morphologies. These modalities, however, do not provide detailed information of the complexity as a result of their inherent limitations. This calls for use of more advanced imaging modalities such as spiral computed tomography, which can help the clinician in making a more accurate diagnosis. This report discusses the usefulness of spiral computed tomography in accurate diagnosis of a case of dens invaginatus and its successful management.
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Steffen H, Splieth C. Conventional Treatment of Dens Invaginatus in Maxillary Lateral Incisor with Sinus Tract: One Year Follow-Up. J Endod 2005; 31:130-3. [PMID: 15671826 DOI: 10.1097/01.don.0000137637.94281.82] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Endodontic treatment of a maxillary lateral incisor with dens invaginatus in association with sinus tract and lateroradicular lesion is reported. Invaginated teeth present technical difficulties with respect to their management because of complicated canal morphology. This case was treated by conventional root canal treatment. At follow up examination after one year the tooth was asymptomatic and radiographically showed repair of the lesion.
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Affiliation(s)
- Heike Steffen
- Department of Operative Dentistry, Periodontology and Pediatric Dentistry, Ernst-Moritz-Arndt-University: School of Dentistry, Greifswald, Germany.
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Abstract
AIM To describe the conservative endodontic treatment and the 1-year follow-up of a permanent maxillary lateral incisor with dens invaginatus. SUMMARY Frequently, the root canal treatment of invaginated teeth is challenging because of problems associated with gaining access to the root canals and with variations of canal morphology associated with this type of malformation. The present case describes the complex root canal treatment of dens invaginatus in a maxillary lateral incisor with three root canals (Oehler type III), incomplete apex formation, necrotic pulp and abscess formation. After gaining access to two root canals and the invagination with the help of a dental operating-microscope, the canals and the invagination were instrumented and calcium hydroxide dressing was applied for 6 months. Apexification and osseous bone repair were achieved, and the canals were filled with gutta-percha. A follow-up after 1 year showed that the tooth was free of any clinical symptoms and the periapical condition was normal. KEY LEARNING POINTS The present case demonstrated that conservative root canal treatment can be performed successfully even in sever cases of dens invaginatus. The use of a dental operating microscope can help in the management of complicated cases of invaginated teeth through conventional root canal treatment.
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Affiliation(s)
- M Jung
- Policlinic for Operative and Preventive Dentistry, Justus-Liebig-University, Giessen, Germany.
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