Conservative pulp treatment for Oehlers type III dens invaginatus: A case report

Figure 4 The operating process. A: Pre-operative radiograph showing the presence of dens invaginatus associated with an open apex and a large periapical lesion. The middle part of the bulge was suspected to be connected to the main root canal; B: The position of the invagination was located under a microscope and access-opening was performed; C: A root ZX mini apex locator and a periapical radiograph were used to determine the working length before conducting complete debridement; D: Considering the interconnections between the root canals in the middle segment, a mineral trioxide aggregate (MTA) sealer was used to fill and seal the pseudo root canal and perform pulp capping in the main canal; E: The MTA filling as observed under the microscope; F: At the one-year follow-up, the apical lesion had healed well (the tooth wall had thickened and the apical foramen was closed). The tooth still responded normally to the pulp vitality test.