Dens invaginatus is a developmental anomaly resulting from epithelial invagination of the tooth crown before calcification. Endodontic treatment of teeth affected by dens invaginatusmay be difficult and complex due to aberrant anatomy. Combined orthograde and surgical approaches for successful treatment of dens invaginatus are effective. This report describes the successful treatmentand results atthe 12-month follow-up of a maxillary lateral incisor showing dens invaginatus type II, a large periapical lesion and an open apex by using combined surgical and endodontic treatment.