Isaltino Mariana da Cunha, de Oliveira Natália Gomes, de Melo Júnior Paulo Maurício Reis, Lyra Carolina Viana Vasco, Fernandes Pedro Henrique de Freitas, de Albuquerque Diana Santana
Dental School, Universidade de Pernambuco (FOP/UPE), Professor Luis Freire Avenue, 700, Cidade Universitária, Recife/PE, Brazil.
Iran Endod J. 2024;19(3):232-236. doi: 10.22037/iej.v19i3.45099.
Dens invaginatus (DI) is one of the developmental dental anomalies that results in an invagination of the enamel organ into the dental papila during odontogenesis. The purpose of this study is to report a case of nonsurgical endodontic treatment of an Oehlers type II DI in a right maxillary lateral incisor with an extensive periapical damage, along with the two-year clinical and tomographic follow-up. A 30-year-old patient was referred for endodontic treatment of tooth #12. On clinical examination, a change in the shape and color of the crown was observed. The tooth responded negative to pulp sensibility, percussion, palpation and mobility tests. After tomographic evaluation, an Oehlers type II DI was visualized, in addition to an extensive periradicular lesion. The diagnosis was asymptomatic apical periodontitis. The treatment was carried out in two sessions, through intense enhancement of the auxiliary chemical substance with passive ultrasonic irrigation, XP-Endo Finisher and the use of hydroxide-based intracanal medication. Appropriate treatment in cases with anatomic variations requires an accurate and early diagnosis based on clinical examination and radiographic images. A two-year follow-up of the present case showed that the correct diagnosis associated with appropriate instrumentation techniques, supplementary disinfection, and adequate three-dimensional sealing of the canal with filling material, resulted in regression of the periradicular lesion and bone repair.
牙内陷（DI）是一种牙齿发育异常，在牙胚形成过程中导致成釉器陷入牙乳头。本研究旨在报告一例右上颌侧切牙Oehlers II型牙内陷伴广泛根尖周损害的非手术根管治疗病例，以及两年的临床和断层扫描随访情况。一名30岁患者因12号牙的根管治疗前来就诊。临床检查时，发现牙冠形状和颜色改变。该牙对牙髓敏感性、叩诊、触诊和松动度测试均呈阴性反应。断层扫描评估后，除了广泛的根尖周病变外，还发现了Oehlers II型牙内陷。诊断为无症状性根尖周炎。治疗分两个阶段进行，通过强化辅助化学物质并结合被动超声冲洗、XP-Endo Finisher以及使用氢氧化物类根管内药物。对于存在解剖变异的病例，适当的治疗需要基于临床检查和影像学图像进行准确、早期的诊断。本病例的两年随访显示，正确的诊断结合适当的器械操作技术、辅助消毒以及用充填材料对根管进行充分的三维封闭，导致根尖周病变消退和骨质修复。
