Published online Mar 26, 2020. doi: 10.12998/wjcc.v8.i6.1150
Peer-review started: November 26, 2019
First decision: January 19, 2020
Revised: February 1, 2020
Accepted: February 28, 2020
Article in press: February 28, 2020
Published online: March 26, 2020
Invaginated teeth pose greater challenges in clinical management because of their complex configuration. With advancements in equipment and materials, such as the dental operation microscope, cone-beam computed tomography and mineral trioxide aggregate, the preservation rate of type III dens invaginatus could be greatly increased.
This case report presented a 31-year-old woman with complaints of spontaneous swelling and pain in the right maxillary lateral tooth. With the aid of cone-beam computed tomography, type III dens invaginatus with apical periodontitis was diagnosed and confirmed. Three-visit endodontic treatment was performed. In the first visit, the invagination was carefully removed under the dental operation microscope, and chemomechanical preparation was done. In the second visit, mineral trioxide aggregate apical barrier surgery was performed in this tooth. In the third visit, the canal was finally obturated with thermoplastic gutta-percha to recover the crown morphology. A 26-mo follow-up revealed a satisfied outcome both in the radiographic and oral examinations.
In this case, removal of the entire abnormal structure provided great convenience for the follow-up treatment. When confronted with the same clinical case in the future, we can take a similar approach to address it.
Core tip: Type III dens invaginatus poses great challenges when conducting clinical operations. This article reported an upper right lateral incisor with type III dens invaginatus using the method that removed the invagination under the dental operation microscope, and then mineral trioxide aggregate apical barrier was made for the convenience of next treatment. The 26-mo follow-up revealed a satisfactory therapeutic effect.