Endodontic Management of a Maxillary Lateral Incisor with Dens Invagination and Periapical Lesion: A Case Report and Mini Review of the Literature
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Abstract
Dens invagination (DI) is a dental anomaly that can cause pulpal and periapical pathoses of the affected tooth. We describe the treatment of a healthy 18-year-old female with a chief complaint of recurrent facial swelling pertaining to a peg-shaped maxillary lateral incisor with DI. Examinations showed necrosis of the involved tooth with symptomatic apical periodontitis. Cone-beam computed tomography corresponded to Oehlers type II DI. Orthograde endodontic treatment was performed. To completely debride the canal and resolve the persistent purulent discharge, various methods and medicaments were used in separate sessions including passive ultrasonic activation of 5.25% sodium hypochlorite solution, calcium hydroxide mixed with 2% chlorhexidine, and double antibiotic paste as intracanal medicament. After resolution of the symptoms, the root canal and the invaginated space were filled by a mineral trioxide aggregate plug and backfilled with thermoplasticized gutta-percha. At the one-year follow-up, complete bone healing was noted in the affected periradicular area.
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13. van der Sluis LW, Versluis M, Wu MK, Wesselink PR. Passive ultrasonic irrigation of the root canal: a review of the literature. Int Endod J. 2007;40(6):415-26.
14. Kim J-H, Choi N-K, Kim S-m. A retrospective study of association between peg-shaped maxillary lateral incisors and dental anomalies. J Clin Pediatr Dent. 2017;41(2):150-3.
15. Różyło TK, Różyło-Kalinowska I, Piskórz M. Cone-beam computed tomography for assessment of dens invaginatus in the Polish population. Oral radiol. 2018;34(2):136-42.
16. Sjögren U, Figdor D, Persson S, Sundqvist G. Influence of infection at the time of root filling on the outcome of endodontic treatment of teeth with apical periodontitis. Int Endod J. 1997;30(5):297-306.
17. Silveira AMV, Lopes HP, Siqueira Jr JF,
Macedo SB, Consolaro A. Periradicular repair after two-visit endodontic treatment using two different intracanal medications compared to single-visit endodontic treatment. Braz Dent J. 2007;18(4):299-304.
18. Mohammadi Z, Dummer PMH. Properties
and applications of calcium hydroxide in endodontics and dental traumatology. Int Endod J. 2011;44(8):697-730.
19. Sinha N, Patil S, Dodwad PK, Patil AC, Singh B. Evaluation of antimicrobial efficacy of calcium hydroxide paste, chlorhexidine gel, and a combination of both as intracanal medicament: An in vivo comparative study. J Conserv Dent. 2013;16(1):65.
20. Sabrah AH, Yassen GH, Gregory RL. Effectiveness of antibiotic medicaments against biofilm formation of Enterococcus faecalis and Porphyromonas gingivalis. J Endod. 2013;39(11):1385-9.
21. Hameed MH, Gul M, Ghafoor R, Badar SB. Management of immature necrotic permanent teeth with regenerative endodontic procedures—a review of literature. J Pak Med Assoc [Internet]. 2019;69(10):1.
22. Torabinejad M, Nosrat A, Verma P, Udochukwu O. Regenerative endodontic treatment or mineral trioxide aggregate apical plug in teeth with necrotic pulps and open apices: a systematic review and meta-analysis. J Endod. 2017;43(11):1806-20.
2. Oehlers F. Dens invaginatus (dilated composite odontome): I. Variations of the invagination process and associated anterior crown forms. Oral Surg Oral Med Oral Pathol. 1957;10(11):1204-18.
3. Gul M, Adnan S, Umer F. A Variant of the Current Dens Invaginatus Classification. Front Dent. 2020;17(28).
4. Alani A, Bishop K. Dens invaginatus. Part 1: classification, prevalence and aetiology. Int Endod J. 2008;41(12):1123-36.
5. Thakur S, Thakur NS, Bramta M, Gupta M. Dens invagination: A review of literature and report of two cases. J Nat Sc Biol Med. 2014;5(1):218.
6. Chen L, Li Y, Wang H. Investigation of dens invaginatus in a Chinese subpopulation using Cone‐beam computed tomography. Oral Dis. 2020;27(7):1755-60.
7. Satvati SA, Shooriabi M, Sharifi R, Parirokh M, Sahebnasagh M, Assadian H. Co-existence of two dens invaginations with one dens evagination in a maxillary lateral incisor: A case report. J Dent (Tehran). 2014;11(4):485.
8. Shokri A, Poorolajal J, Khajeh S, Faramarzi F, Kahnamoui HM. Prevalence of dental anomalies among 7-to 35-year-old people in Hamadan, Iran in 2012-2013 as observed using panoramic radiographs. Imaging Sci Dent. 2014;44(1):7-13.
9. Saberi EA, Ebrahimipour S. Evaluation of developmental dental anomalies in digital panoramic radiographs in Southeast Iranian Population. J Int Soc Prev Community Dent. 2016;6(4):291-5.
10. Haghanifar S, Moudi E, Abesi F, Kheirkhah F, Arbabzadegan N, Bijani A. Radiographic Evaluation of Dental Anomaly Prevalence in a Selected Iranian Population. J Dent (Shiraz). 2019;20(2):90-4.
11. Gallacher A, Ali R, Bhakta S. Dens invaginatus: diagnosis and management strategies. Br dent J. 2016;221(7):383-7.
12. Jitaru S, Hodisan I, Timis L, Lucian A, Bud M. The use of bioceramics in endodontics-literature review. Clujul Med. 2016;89(4):470.
13. van der Sluis LW, Versluis M, Wu MK, Wesselink PR. Passive ultrasonic irrigation of the root canal: a review of the literature. Int Endod J. 2007;40(6):415-26.
14. Kim J-H, Choi N-K, Kim S-m. A retrospective study of association between peg-shaped maxillary lateral incisors and dental anomalies. J Clin Pediatr Dent. 2017;41(2):150-3.
15. Różyło TK, Różyło-Kalinowska I, Piskórz M. Cone-beam computed tomography for assessment of dens invaginatus in the Polish population. Oral radiol. 2018;34(2):136-42.
16. Sjögren U, Figdor D, Persson S, Sundqvist G. Influence of infection at the time of root filling on the outcome of endodontic treatment of teeth with apical periodontitis. Int Endod J. 1997;30(5):297-306.
17. Silveira AMV, Lopes HP, Siqueira Jr JF,
Macedo SB, Consolaro A. Periradicular repair after two-visit endodontic treatment using two different intracanal medications compared to single-visit endodontic treatment. Braz Dent J. 2007;18(4):299-304.
18. Mohammadi Z, Dummer PMH. Properties
and applications of calcium hydroxide in endodontics and dental traumatology. Int Endod J. 2011;44(8):697-730.
19. Sinha N, Patil S, Dodwad PK, Patil AC, Singh B. Evaluation of antimicrobial efficacy of calcium hydroxide paste, chlorhexidine gel, and a combination of both as intracanal medicament: An in vivo comparative study. J Conserv Dent. 2013;16(1):65.
20. Sabrah AH, Yassen GH, Gregory RL. Effectiveness of antibiotic medicaments against biofilm formation of Enterococcus faecalis and Porphyromonas gingivalis. J Endod. 2013;39(11):1385-9.
21. Hameed MH, Gul M, Ghafoor R, Badar SB. Management of immature necrotic permanent teeth with regenerative endodontic procedures—a review of literature. J Pak Med Assoc [Internet]. 2019;69(10):1.
22. Torabinejad M, Nosrat A, Verma P, Udochukwu O. Regenerative endodontic treatment or mineral trioxide aggregate apical plug in teeth with necrotic pulps and open apices: a systematic review and meta-analysis. J Endod. 2017;43(11):1806-20.
| Issue | Vol 18 (Continuously Published Article-Based) | |
| Section | Case Report | |
| DOI | https://doi.org/10.18502/fid.v18i42.8014 | |
| Keywords | ||
| Anti-Bacterial Agents; Dens in Dente; Periapical Abscess; Root Canal Therapy | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Bolhari B, Noori F, Assadian H. Endodontic Management of a Maxillary Lateral Incisor with Dens Invagination and Periapical Lesion: A Case Report and Mini Review of the Literature. Front Dent. 2021;18.
