Department of Endodontics, Faculty of Dentistry, Inönü University, Malatya, Turkey.
Int Endod J. 2010 Jul;43(7):608-14. doi: 10.1111/j.1365-2591.2010.01736.x. Epub 2010 May 11.
To report the healing of a periradicular lesion and maintaining vitality of the pulp following endodontic treatment of the invaginated canal of a dental invagination.
Dens invaginatus is a developmental malformation resulting from invagination of the tooth crown or root before calcification has occurred. A case of type III dens invaginatus, an invagination that extends from the crown to the apex, in the maxillary right lateral incisor with a healthy pulp and large peri-invagination periodontitis is reported. Non-surgical root canal treatment of the invagination was performed. There appeared to be no communication between the main root canal and the invaginated canal. The invaginated canal was filled by lateral condensation of gutta-percha and a calcium hydroxide sealer. The final restoration of the tooth was completed using composite, and the tooth was reviewed after 1 and 2 years. Non-surgical root canal treatment of the invagination retained the pulp in a health condition and resulted in resolution of a substantial peri-invagination lesion.
Even though there are no symptoms, radiography should be performed in teeth that exhibit anatomical differences from the contralateral tooth. Even if there is extensive apical pathology in a tooth with type III dens invaginatus, pulp sensibility tests should be performed. Correct diagnosis and treatment planning are fundamental when treating dens invaginatus.
报告一例牙内陷的内陷管的牙髓活力保存及根尖周病变愈合。
牙内陷是一种牙冠或牙根在矿化前发生内陷的发育畸形。本文报告一例上颌右侧侧切牙的 III 型牙内陷，内陷从牙冠延伸至根尖，牙髓活力正常，伴有较大的牙周袋。对该患牙进行了非手术根管治疗。主根管和内陷管之间似乎没有相通。使用侧向加压法将牙胶和氢氧化钙封闭剂填充入内陷管。最后用复合树脂完成了牙齿的修复，并在 1 年和 2 年后对牙齿进行了复查。非手术根管治疗保留了牙髓的活力，并且解决了较大的牙周袋病变。
即使牙齿没有症状，也应该对与对侧牙齿解剖结构不同的牙齿进行影像学检查。即使 III 型牙内陷的牙齿存在广泛的根尖病变，也应该进行牙髓活力测试。正确的诊断和治疗计划是治疗牙内陷的基础。
