Zoya Asma, Ali Sajid, Alam Sharique, Tewari Rajendra K, Mishra Surendra K, Kumar Ashok, Andrabi Syed Mukhtar-Un-Nisar
Department of Conservative Dentistry and Endodontics, Dr. Z.A. Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
Department of Conservative Dentistry and Endodontics, Dr. Z.A. Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
J Endod. 2015 Nov;41(11):1927-32. doi: 10.1016/j.joen.2015.08.017.
Dens invaginatus is a developmental anomaly that often presents a perplexing challenge to the endodontist. It involves the maxillary central incisor less commonly than the maxillary lateral incisor. Double dens invaginatus is even rarer. Herein a unique case of dens invaginatus in a maxillary central incisor is presented. The tooth had an inadequate previous root canal treatment. On retreatment, multiple canals and double dens invaginatus were found. The invaginations were Oehlers type 3b and type 2. The complex morphology was diagnosed and confirmed with cone-beam computed tomography imaging and managed with a combined surgical and orthograde approach. Four canals and a blind sac along with an open apex were found. There were many intercommunications between the canals. During the treatment, a complication of a separated instrument occurred, which was managed successfully. The 1-year follow-up shows successful outcome of the treatment. Dens invaginatus may be more complicated than it seems. It needs meticulous treatment by a specialist. Failure or a delay in referring the case to a specialty setting may further increase the complications. With the advancements in equipment and materials, it is possible to save even severe cases of dens invaginatus.
牙内陷是一种发育异常，常常给牙髓病医生带来棘手的挑战。它累及上颌中切牙的情况比上颌侧切牙少见。双牙内陷更为罕见。本文报告一例上颌中切牙牙内陷的独特病例。该患牙之前的根管治疗不完善。再治疗时，发现多个根管及双牙内陷。内陷为奥勒斯3b型和2型。通过锥束计算机断层扫描成像诊断并确认了复杂的形态，并采用手术和正行联合方法进行处理。发现了四个根管、一个盲囊以及根尖孔开放。根管之间有许多交通支。治疗过程中发生了器械分离的并发症，但成功处理。1年随访显示治疗结果成功。牙内陷可能比看起来更复杂。它需要专科医生精心治疗。将病例转诊至专科机构失败或延迟可能会进一步增加并发症。随着设备和材料的进步，即使是严重的牙内陷病例也有可能挽救。
