Abstract
Dens invaginatus (DI) is a developmental anomaly which rarely occurs. It is the result of invagination of enamel organ into the dental papilla during the soft tissue stage of tooth development. As the hard tissues are formed, the invaginated enamel produces a small tooth within the pulp chamber. It begins at the crown and sometimes extends into the root. Maxillary lateral incisors are the most affected teeth. The malformation shows a morphologic variation and results in pulp necrosis. Root canal treatment may present a severe problem because of the complex anatomy of teeth. Etiology, histology, classification, prevalence, diagnosis, clinical features, radiographic features, and treatment options are reviewed. A case of DI is reported in this article. A 10-year-old girl was referred for a persistent infection and pain from the maxillary left lateral incisor. On examination clinically, the diagnosis of DI was carried out. The canal contained an invaginated central cylindrical mass of hard tissue which limited the access to the canal system and challenged the cleaning and sealing of the canal spaces. A modification of the internal anatomy of the canal system was achieved under the operating microscope. The conventional chemo-mechanical preparation was done, and the root canal was obturated with mineral trioxide aggregate. Two-year follow-up showed the regression of the lesion.