Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China.
BMC Oral Health. 2022 Feb 4;22(1):28. doi: 10.1186/s12903-022-02059-8.
Dens invaginatus (DI) is a developmental anomaly, Oehlers Type III DI is the most complex type and early diagnosis and treatment is complicated and challenging. This report presents a rare case of a type IIIb DI associated with a periapical lesion in bilateral immature permanent mandibular central incisors.
An eight-year-old boy referred to our clinic manifesting with pain along with swelling in the mandibular incisors for the past one month. Radiographic examination showed periapical radiolucency exhibiting a scantly defined border, as well as an invagination which had a central invaginated canal extending from the pulp chamber throughout the apical foramen in both mandibular central incisors. We performed two different treatment procedures on the basis of the condition of the main pulp of the mandibular central incisors. in which only the invagination root canal was treated in the right mandibular central incisor, while the invagination and main root canals were treated in the left mandibular central incisor. During the 18-month follow-up period, the teeth were clinically asymptomatic. Imaging examinations indicated complete healing of the periapical lesion and revealed that the wall of the root canal was thickened and the open apex was closed.
For young permanent teeth with type III Dens invaginatus, it is particularly important to keep pulp vitality, which could maintain root development and allow a good long-term prognosis.
牙内陷（DI）是一种发育异常，Oehlers Ⅲ型 DI 是最复杂的类型，早期诊断和治疗复杂且具有挑战性。本报告介绍了一例双侧未萌下颌中切牙伴根尖病变的罕见 Ⅲb 型 DI 病例。
一名 8 岁男孩因下颌切牙疼痛伴肿胀 1 个月就诊。影像学检查显示根尖周透光区边界模糊，并有内陷，中央内陷管从牙髓腔延伸至两个下颌中切牙的根尖孔。根据下颌中切牙髓腔的状况，我们对其进行了两种不同的治疗方案。右侧下颌中切牙仅对牙内陷根管进行治疗，而左侧下颌中切牙则对牙内陷和主根管进行治疗。在 18 个月的随访期间，牙齿无临床症状。影像学检查显示根尖病变完全愈合，根管壁增厚，根尖开口闭合。
对于年轻的恒牙，保持牙髓活力尤为重要，这可以维持牙根的发育并获得良好的长期预后。
