title: Pulp revascularization of immature dens invaginatus with periapical periodontitis.
abstract: BACKGROUND
  Dens invaginatus is a rare developmental malformation of a tooth caused by the invagination of the tooth crown before biological mineralization occurs. The complex anatomy of these teeth makes nonsurgical endodontic treatment difficult and more so when there is presence of periapical periodontitis with open apex. The endodontic treatment of dens invaginatus is a challenge, especially in the case of periapical periodontitis with open apex. Pulp revascularization is a conservative endodontic treatment that has been introduced in recent years. Presented here is a variant approach for the treatment of immature dens invaginatus type II with periapical periodontitis, which combines filling of the invagination and pulp revascularization.
  
  
  METHODS
  After accessing the pulp chamber, the main canal and the invagination were explored. The root was thoroughly disinfected by irrigating and medication, invagination was filled, and the main canal was revascularized. Then the coronal sealing was made by glass ionomer cement and composite resin. Radiograph taken regularly and computed tomography scan were used to investigate the healing of the periapical lesion and development of the root.
  
  
  RESULTS
  In the subsequent follow-up, the periapical lesion was completely eliminated, the open apex was closed, and the wall of the root was thickened.
  
  
  CONCLUSIONS
  For type II immature dens invaginatus with large periapical lesion, conservative endodontic treatment should be considered before periapical surgery. With sufficient infection control, pulp revascularization can be an effective alternative method.
authors: Department of Pediatric Dentistry, School and Hospital of Stomatology, Peking University, Beijing, China. denyj78@gmail.com
authors: Jie
authors: J
authors: Yang
authors: Yuming
authors: Y
authors: Zhao
authors: Man
authors: M
authors: Qin
authors: Lihong
authors: L
authors: Ge
mesh_terms: D056624:Apexification / Q000379:methods*; D002648:Child; D003188:Composite Resins / Q000737:chemistry; D054893:Cone-Beam Computed Tomography; D003719:Dens in Dente / Q000628:therapy*; D003764:Dental Materials / Q000737:chemistry; D003786:Dental Pulp Cavity / Q000473:pathology; D003790:Dental Pulp Necrosis / Q000628:therapy; D003793:Dental Restoration, Permanent / Q000379:methods; D005500:Follow-Up Studies; D005899:Glass Ionomer Cements / Q000627:therapeutic use; D006801:Humans; D007180:Incisor / Q000002:abnormalities* / Q000473:pathology; D008297:Male; D010485:Periapical Periodontitis / Q000628:therapy*; D016300:Radiography, Bitewing; D012389:Root Canal Obturation / Q000379:methods; D018915:Root Canal Preparation / Q000379:methods; D012390:Root Canal Therapy / Q000379:methods*; D019227:Tooth Apex / Q000473:pathology; D019228:Tooth Crown / Q000002:abnormalities; D014092:Tooth Root / Q000002:abnormalities
chemical_list: D003188:Composite Resins; D003764:Dental Materials; D005899:Glass Ionomer Cements