Nonsurgical endodontic management of maxillary lateral incisor with dens invaginatus and periradicular lesion

Dens invaginatus is a developmental malformation resulting from invagination of the tooth crown or root before calcification has occurred. It can range from a deep fissure or pit on the lingual surfaces of anterior teeth to an occlusal pit on the posterior teeth. This article presents a case of type II dens in dente in a 14-year-old female patient, where the invagination extends beyond the cementoenamel junction in maxillary lateral incisor with a large periradicular lesion. Usually, an anomaly such as dens invaginatus remains unnoticed by the patient until any clinical sign appears. Root canal treatment of such teeth with complex root canal anatomy can be difficult because infected pulpal tissues may remain in inaccessible areas of the canal. Hence, it is important to identify this anomaly and manage it as early as possible. In the present case, a nonsurgical root canal treatment of the invagination was performed. The treatment of invagination resulted in resolution of a substantial periradicular lesion.