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©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
Conservative pulp treatment for Oehlers type III dens invaginatus: A case report
Hui-Na Lee, Yuk-Kwan Chen, Cheng-Hui Chen, Chun-Yin Huang, Ying-Hui Su, Ying-Wei Huang, Fu-Hsiung Chuang
Hui-Na Lee, Cheng-Hui Chen, Ying-Hui Su, Ying-Wei Huang, Fu-Hsiung Chuang, Division of Conservative Dentistry, Dental Department, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung 80756, Taiwan
Hui-Na Lee, Dental Department, Kaohsiung Municipal CiJin Hospital, Kaohsiung 80756, Taiwan
Yuk-Kwan Chen, Division of Oral Pathology and Radiology, Dental Department, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung 80756, Taiwan
Yuk-Kwan Chen, Cheng-Hui Chen, Fu-Hsiung Chuang, School of Dentistry, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
Yuk-Kwan Chen, Oral and Maxillofacial Radiology Center, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
Chun-Yin Huang, Department of Nuclear Medicine, E-DA Hospital, Kaohsiung 80756, Taiwan
Ying-Wei Huang, Dental Department, Kaohsiung Municipal Hsiao Kang Hospital, Kaohsiung 80756, Taiwan
Author contributions: The first two authors made equal contributions; Lee HN, Chuang FH, Chen YK, and Chen HC contributed to the conception and design of the procedure; Lee HN and Chen YK wrote and edited the manuscript; Su YH and Huang YW contributed to cone-beam computed tomography imaging; Huang YH contributed to the reconstruction of three-dimensional pictures; Chuang FH and Chen YK supervised the study and revised the manuscript before submission; all authors read and approved the final manuscript.
Supported by a grant from the Kaohsiung Medical University, No. KMUH106-6M52.
Informed consent statement: Written informed consent was obtained from the patient’s parents for the publication of personal details and accompanying images in this manuscript.
Conflict-of-interest statement: The authors declare that they have no competing interests in relation to the present work.
CARE Checklist (2016) statement: The manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Fu-Hsiung Chuang, PhD, Research Assistant Professor, Division of Conservative Dentistry, Dental Department, Kaohsiung Medical University Chung-Ho Memorial Hospital, No. 100, Tzyou 1st Rd, Kaohsiung 80756, Taiwan. nana1628@yahoo.com.tw
Telephone: +886-7-3121101 Fax: +886-7-3157024
Received: June 11, 2019
Peer-review started: June 19, 2019
First decision: August 1, 2019
Revised: August 7, 2019
Accepted: August 20, 2019
Article in press: August 20, 2019
Published online: September 26, 2019
BACKGROUND
Diverse presentations of dens invaginatus (DI) and root canal treatment with an immature open apex often pose challenges to dentists. Adequate treatment planning for DI is the main reason for successful approach, i.e., we should consider the shape and depth of the concave folding, the condition of the original pulp, and the growth stage of the root formation.
CASE SUMMARY
A 9-year-old girl complained of severe pain of the right maxillary incisor (tooth 12) when chewing for two weeks. Following clinical and radiographic examinations, Oehlers type III DI of tooth 12, with an immature open apical foramen and a symptomatic periapical pathosis, was diagnosed. Cone-beam computed tomography verified the specific spatial and stereoscopic data regarding the communication between the main root canal and pseudo root canal of the involved tooth. After removing the source of infection, a mineral trioxide aggregate was selected to fill and seal the pseudo root canal; additionally, pulp capping of the main canal was performed through the interconnections between the root canals in the middle segment to preserve pulp vitality and enable continual root formation and eventual root apex closure.
CONCLUSION
We propose to conduct main root canal pulp capping for DI with communication between the main and pseudo root canals.
Core tip: The present case report is the first paper describing a case of dens invaginatus with an apical lesion and communication between the main root canal and pseudo root canal managed using nonsurgical endodontic treatment of the infected pseudo root canal, and only employing pulp capping on the main root canal to retain pulp vitality, thus enabling continual root formation with closure of the open root apex.
