Nonsurgical endodontic treatment of Type II dens invaginatus by removal of the internal structure of the tooth : a case report

Dens invaginatus is a developmental anomaly that occurs when the enamel organ is invaginated into the dental papilla before the process of calcification during tooth development. Dens invaginatus exhibits various anatomical variations, and these structural changes can complicate treatment. For effective management of dens invaginatus, it is crucial to accurately understand the internal structure of the tooth and to establish an appropriate treatment plan. Cone-beam computed tomography (CBCT) has proven to be a valuable tool for three-dimensional reconstruction of the tooth. This case report presents a maxillary lateral incisor with pulpal necrosis and periapical periodontitis. The case involves dens invaginatus characterized by a separate tooth structure, diagnosed using CBCT, and a treatment plan was established accordingly. For treatment, a dental microscope was used to remove the internal structure of the tooth, followed by filling with mineral trioxide aggregate (MTA).