title: Use of cone beam computed tomography in the diagnosis, planning and follow up of a type III dens invaginatus case.
abstract: OBJECTIVE
  To present the case of a maxillary left lateral incisor with Oehlers' type III dens invaginatus in which cone beam computed tomography (CBCT) was used as an adjunctive resource in the diagnosis as well as in the planning and 2-year follow-up of the nonsurgical/surgical treatment.
  
  
  CONCLUSIONS
  The tooth had two root canals: a primary (main) canal with vital pulp that appeared to be closed apically and an invaginated canal that was necrotic, wide-open at the portal of exit and associated with a large chronic periapical lesion extending to the apex of the maxillary left central incisor. Radiographic tracking of a sinus tract in the labial gingiva of the affected tooth with a gutta-percha point revealed its origin to be the invagination. The CBCT scans revealed that the periapical radiolucency was significantly larger than seen radiographically as well as an increased thickness of the buccal cortical plate. Conventional root canal treatment of the primary canal was undertaken. As nonsurgical access to the invaginated canal was not possible, endodontic surgery was performed for curettage of the lesion, root-end cavity preparation using ultrasonic tips and root canal filling with white mineral trioxide aggregate (MTA). CBCT scanning after 17 months and clinical and radiographic follow-up after 24 months revealed complete periapical repair and absence of symptoms.
  
  
  CONCLUSIONS
  The combination of nonsurgical and surgical treatments produced periapical repair in a tooth with type III dens invaginatus with two root canals. CBCT may aid the diagnosis as well as the management plan and follow-up of teeth with this developmental anomaly.
authors: Post-Graduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul - PUCRS, Porto Alegre, RS, Brazil. endopelisser@gmail.com
authors: F V
authors: FV
authors: Vier-Pelisser
authors: A
authors: A
authors: Pelisser
authors: L C
authors: LC
authors: Recuero
authors: M V R
authors: MV
authors: Só
authors: M G
authors: MG
authors: Borba
authors: J A P
authors: JA
authors: Figueiredo
mesh_terms: D017607:Aluminum Compounds / Q000627:therapeutic use; D017610:Calcium Compounds / Q000627:therapeutic use; D002648:Child; D054893:Cone-Beam Computed Tomography; D003719:Dens in Dente / Q000000981:diagnostic imaging* / Q000628:therapy; D003751:Dental Fistula / Q000000981:diagnostic imaging / Q000628:therapy; D003786:Dental Pulp Cavity / Q000002:abnormalities / Q000000981:diagnostic imaging; D003790:Dental Pulp Necrosis / Q000000981:diagnostic imaging / Q000628:therapy; D004338:Drug Combinations; D005500:Follow-Up Studies; D006801:Humans; D007180:Incisor / Q000002:abnormalities* / Q000000981:diagnostic imaging; D008297:Male; D010087:Oxides / Q000627:therapeutic use; D010347:Patient Care Planning; D010485:Periapical Periodontitis / Q000000981:diagnostic imaging / Q000628:therapy; D012184:Retrograde Obturation / Q000379:methods; D012387:Root Canal Filling Materials / Q000627:therapeutic use; D018915:Root Canal Preparation / Q000379:methods; D012390:Root Canal Therapy / Q000379:methods; D017640:Silicates / Q000627:therapeutic use
chemical_list: D017607:Aluminum Compounds; D017610:Calcium Compounds; D004338:Drug Combinations; D010087:Oxides; D012387:Root Canal Filling Materials; D017640:Silicates; C086631:mineral trioxide aggregate