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Single-visit Treatment of Non-vital Type 2 Dens Invaginatus: A Case Report

Antônio Henrique Braitt, Maria Luiza Gioster, Daniela Melandes da Silva, Camila Almeida Andrade, Gladyvam Rabelo Braitt, Carlos Eduardo da Silveira Bueno, Augusto Shoji Kato, Fábio Silveira de Souza, Yanessa Santos Muniz and Ana Grasiela da Silva Limoeiro

Dens invaginatus(DI) is a developmental malformation resulting from invagination of the crown or root of the tooth before its calcification. It is associated with a complex internal anatomy. The most affected teeth are the upper incisors. Early diagnosis is beneficial, because teeth with this malformation are more susceptible to decay and pulp necrosis, often requiring surgical or non-surgical endodontic therapy. This case describes the diagnosis and management of a type 2 DI in a maxillary lateral incisor of a 16-year-old female aided by the use of cone-beam computed tomography (CBCT) and a dental operating microscope. CBCT was performed to assess canal anatomy and periapical lesion size. The tooth had no response to cold with pulp testing and was diagnosed as an Oehlers type 2 DI with necrotic pulp and periapical abcess. The treatment was planned and performed based on CBCT imaging. CBCT was performed to assess canal anatomy and periapical lesion size. Root canal treatment was completed in a single visit. Filling of the canals was performed using Tagger’s hybrid technique. At the 1-year follow-up session, the patient was asymptomatic, and the tooth had remained functional since treatment completion. Radiographic assessment of the tooth showed significant osseous healing of the preoperative lesion. The treatment of DI reported herein was greatly enhanced by the use of CBCT and a dental operating microscope.