Management of 2 teeth diagnosed with dens invaginatus with regenerative endodontics and apexification in the same patient: a case report and review.
BACKGROUND
This review and case report present the treatment of a 10-year-old boy with both permanent maxillary lateral incisors demonstrating Oehlers type II dens invaginatus and pulpal involvement. Treatment was complicated by dental anxiety, supraventricular tachycardia, immature tooth development, and facial cellulitis.


METHODS
An infected necrotic pulp of the permanent maxillary left lateral incisor was treated by apexification and endodontic treatment with mineral trioxide aggregate. The necrotic pulp of the permanent maxillary right lateral incisor was treated with canal debridement and dressing under general anesthesia.


RESULTS
Periapical healing of both teeth occurred, with the right lateral incisor showing continued root growth, thickening of the dentinal root walls, and completed apex formation. This tooth responded normally to pulp testing. Twenty-eight months after initial treatment, the right lateral incisor displayed progressive sclerosis of the canal.


CONCLUSIONS
This case demonstrates possible pulpal regeneration of an infected maxillary right lateral incisor with dens invaginatus and an immature apex after minimal canal debridement.
Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia.
Harleen
H
Kumar
Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia.
Muna
M
Al-Ali
Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia. Electronic address: parashos@unimelb.edu.au.
Peter
P
Parashos
Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia.
David J
DJ
Manton
D017607:Aluminum Compounds / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D056624:Apexification / Q000379:methods*; D017610:Calcium Compounds / Q000627:therapeutic use; D002648:Child; D002981:Clindamycin / Q000627:therapeutic use; D003719:Dens in Dente / Q000628:therapy*; D016854:Dental Anxiety / Q000150:complications; D003782:Dental Pulp / Q000502:physiology*; D003790:Dental Pulp Necrosis / Q000628:therapy; D003810:Dentinogenesis / Q000502:physiology; D004338:Drug Combinations; D005500:Follow-Up Studies; D006801:Humans; D007180:Incisor / Q000002:abnormalities*; D008297:Male; D010087:Oxides / Q000627:therapeutic use; D010482:Periapical Abscess / Q000628:therapy; D011670:Pulpectomy / Q000379:methods; D012038:Regeneration; D012387:Root Canal Filling Materials / Q000627:therapeutic use; D012388:Root Canal Irrigants / Q000627:therapeutic use; D012598:Sclerosis; D017640:Silicates / Q000627:therapeutic use; D013617:Tachycardia, Supraventricular / Q000150:complications; D019227:Tooth Apex / Q000254:growth & development; D014222:Triamcinolone Acetonide / Q000627:therapeutic use
D017607:Aluminum Compounds; D000900:Anti-Bacterial Agents; D017610:Calcium Compounds; D004338:Drug Combinations; D010087:Oxides; D012387:Root Canal Filling Materials; D012388:Root Canal Irrigants; D017640:Silicates; C086631:mineral trioxide aggregate; D002981:Clindamycin; D014222:Triamcinolone Acetonide
Dens in dente; dens invaginatus; mineral trioxide aggregate; revascularization; revitalization; supraventricular tachycardia; tissue regeneration