Prevalence and distribution of dens invaginatus in the western black sea region of Turkey: a retrospective radiographic study

Dens invaginatus (DI) is a developmental anomaly that complicates endodontic treatment and increases the risk of pulpal pathology. The purpose of this study was to assess the prevalence of DI and to classify the types of DI in a large sample of patients attending the Faculty of Dentistry at Zonguldak Bülent Ecevit University between 2022 and 2024. In this retrospective study panoramic and periapical radiographs of 10,000 patients (4588 females, 5412 males) aged 15-65 years were analyzed. Oehlers' classification was used to categorize DI. Data analysis included descriptive statistics and chi-square tests to assess gender differences and DI classification distribution. DI was detected in 707 patients (7.07%), involving 731 teeth. Females had a higher DI prevalence (7.7%) compared to males (6.5%) (p = 0.017). Type I DI was most common (88.6%), followed by type II (9.4%), and type III (1.9%). Maxillary lateral incisors were predominantly affected (65.8%). No mandibular involvement was observed. The prevalence of DI in the western black sea region of Turkey is remarkable, affecting mostly women and mostly occurring as Type I. Routine radiographic screening for DI is recommended to avoid clinical complications. Especially in early adolescence, it may be useful to support panoramic radiograph follow-up of maxillary lateral incisors with periapical radiograph. Additionally the frequent bilateral occurrence of this malformation, the contralateral teeth must also be included in the clinical examination. Regular radiographic examinations are essential for early diagnosis and management.