title: Double Dens Invaginatus with Multiple Canals in a Maxillary Central Incisor: Retreatment and Managing Complications.
abstract: Dens invaginatus is a developmental anomaly that often presents a perplexing challenge to the endodontist. It involves the maxillary central incisor less commonly than the maxillary lateral incisor. Double dens invaginatus is even rarer. Herein a unique case of dens invaginatus in a maxillary central incisor is presented. The tooth had an inadequate previous root canal treatment. On retreatment, multiple canals and double dens invaginatus were found. The invaginations were Oehlers type 3b and type 2. The complex morphology was diagnosed and confirmed with cone-beam computed tomography imaging and managed with a combined surgical and orthograde approach. Four canals and a blind sac along with an open apex were found. There were many intercommunications between the canals. During the treatment, a complication of a separated instrument occurred, which was managed successfully. The 1-year follow-up shows successful outcome of the treatment. Dens invaginatus may be more complicated than it seems. It needs meticulous treatment by a specialist. Failure or a delay in referring the case to a specialty setting may further increase the complications. With the advancements in equipment and materials, it is possible to save even severe cases of dens invaginatus.
authors.affiliation: Department of Conservative Dentistry and Endodontics, Dr. Z.A. Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
authors.forename: Asma
authors.initials: A
authors.lastname: Zoya
authors.affiliation: Department of Conservative Dentistry and Endodontics, Dr. Z.A. Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India. Electronic address: sajid.bds.amu@gmail.com.
authors.forename: Sajid
authors.initials: S
authors.lastname: Ali
authors.affiliation: Department of Conservative Dentistry and Endodontics, Dr. Z.A. Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
authors.forename: Sharique
authors.initials: S
authors.lastname: Alam
authors.affiliation: Department of Conservative Dentistry and Endodontics, Dr. Z.A. Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
authors.forename: Rajendra K
authors.initials: RK
authors.lastname: Tewari
authors.affiliation: Department of Conservative Dentistry and Endodontics, Dr. Z.A. Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
authors.forename: Surendra K
authors.initials: SK
authors.lastname: Mishra
authors.affiliation: Department of Conservative Dentistry and Endodontics, Dr. Z.A. Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
authors.forename: Ashok
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Conservative Dentistry and Endodontics, Dr. Z.A. Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
authors.forename: Syed Mukhtar-Un-Nisar
authors.initials: SM
authors.lastname: Andrabi
mesh_terms: D000293:Adolescent; D054893:Cone-Beam Computed Tomography; D003719:Dens in Dente / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007180:Incisor / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D019233:Retreatment; D016896:Treatment Outcome
keywords: Double dens invaginatus; maxillary central incisor; multiple canals; open apex; type 2 dens invaginatus; type 3b dens invaginatus