Sachdeva Anshul, Gill Gurdeep Singh, Al Obied Adel, Arora Suraj, Alsaeed Ali Y, Alanesi Waled Abdulmalek, Das Gotam
Department of Pedodontics and Preventive Dentistry, D.J College of Dental Sciences and Research, Meerut, UP, India.
Department of Conservative Dentistry and Endodontics, Jan Nayak Choudhary Devilal (JCD) Dental College, Sirsa, India.
Medicine (Baltimore). 2025 Aug 1;104(31):e42725. doi: 10.1097/MD.0000000000042725.
Dens invaginatus (DI) is a rare condition with a prevalence of only 0.3% to 10% mainly affecting the maxillary lateral incisors. In the present case, we describe management of the rarest variant of DI, that is, Oehler type III DI.
Patient complained of severe pain in upper left front teeth since 1 month which aggravated on taking hot liquids. Patient had visited a general dentist who did emergency access opening on #9 and #10 and referred the patient.
Oehler type III DI with apical periodontitis w.r.t.#10 (maxillary left lateral incisor).
Nonsurgical root canal treatment of the main canal and apexification of pseudo canal with mineral trioxide aggregate.
At 6 months follow-up, the patient was asymptomatic, and the clinical evaluation revealed no sensitivity to percussion or palpation on tooth #10 and mobility within normal limits. The radiograph examination displayed significant periapical healing.
The unusual morphological appearance of the crown in the maxillary lateral incisor or the radiographic appearance should alert the dentist to the possibility of DI. Knowledge of tooth anatomy and its variations, correct diagnosis, and use of magnification and advanced materials like mineral trioxide aggregate can help in managing rare variations.
牙中牙（DI）是一种罕见病症，患病率仅为0.3%至10%，主要影响上颌侧切牙。在本病例中，我们描述了DI最罕见变体即奥勒III型牙中牙的治疗。
患者自1个月以来一直抱怨左上前牙剧痛，喝热饮时疼痛加剧。患者曾就诊于一位普通牙医，该牙医对9号和10号牙进行了急诊开髓，并转诊了患者。
关于10号牙（上颌左侧侧切牙）的奥勒III型牙中牙伴根尖周炎。
对主根管进行非手术根管治疗，并用三氧化矿物凝聚体对假根管进行根尖诱导成形术。
在6个月的随访中，患者无症状，临床评估显示10号牙叩诊或触诊无敏感，松动度在正常范围内。X线片检查显示根尖周有明显愈合。
上颌侧切牙冠部异常的形态外观或X线表现应提醒牙医注意牙中牙的可能性。了解牙齿解剖结构及其变异、正确诊断以及使用放大设备和三氧化矿物凝聚体等先进材料有助于处理罕见变异。
