Rct Of Type Iiia Dens Invaginatus In Maxillary Second Molar

The present case report describes the endodontic treatment and peridontal treatment of Type IIIa Dens Invaginatus in Maxillary Second Molar. A 41-year-old female patient complainted spontaneous pain at night of ten days. Pain aggravated on chewing food and hot stimulation. On intraoral examination, the patient was in poor periodontal condition. The crown of tooth #15 was intact. Pain aggravated on percussion and cold stimulation. Radiographic appearance of the tooth suggested the presence of a dens invaginatus which linked the root furcation area and the oral environment. There was radiolucency around both MB root apex and root furcation area. The tooth was diagnosed with symptomatic irreversible pulpitis, symptomatic peri-invagination periodontitis and recieved RCT. In two-year follow-up, the patient has no clinical symptoms and the periapical radiolucency has healed. The first point is to identify the source of infection. The periodontal lesion was not connected to the apical lesion, so it's from the DI. The second point is the treatment plan. Intentional replantation is better for the preservation of dental tissue, but it needs apical resection and has bad effect on peridontal tissue. The roots of the tooth in this case were only about 15mm with significant loss of attachment, so we made RCT my first choice. The present case report aims to raise awareness of the existence of DI on the maxillary second molar and provide a viable treatment plan.