PMC3906661_01
22-old-year male with pain and tenderness in the right maxillary lateral incisor diagnosed with dens invaginatus Type 2 in tooth 22 and double dens invaginatus in tooth 12. Clinical picture shows tooth 12, which is wider both mesiodistally and buccolingually with prominent cingulum and a palatal groove. Tooth 22 shows a palatal groove and no significant alteration in the dimensions of the crown.
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F1
Crown portion of tooth 12 was wider both mesiodistally and buccolingually with prominent cingulum and a palatal groove [Figure 1]. A palatal groove was observed in tooth 22 with no significant alteration in the dimensions of the crown [Figure 1].
22-old-year male with pain and tenderness in the right maxillary lateral incisor diagnosed with dens invaginatus Type 2 in tooth 22 and double dens invaginatus in tooth 12. Intra-oral radiograph of tooth 12 shows the double dens invaginatus and the presence of two enamel lined invaginations (arrows).
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F2
On radiographic examination, two enamel-lined invaginations were observed for tooth 12, but the extent of invaginations was unclear [Figure 2].
22-old-year male with pain and tenderness in the right maxillary lateral incisor diagnosed with dens invaginatus Type 2 in tooth 22 and double dens invaginatus in tooth 12. Intra-oral radiograph of tooth 22 with Oehlers Type 2 dens invaginatus shows presence of a single pear shaped enamel lined invagination extending on to the root surface.
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F3
A single pear shaped enamel-lined invagination extending on to the root surface was observed for tooth 22 [Figure 3].
22-old-year male with pain and tenderness in the right maxillary lateral incisor diagnosed with dens invaginatus Type 2 in tooth 22 and double dens invaginatus in tooth 12. (a) Cone beam computed tomography (CBCT) of maxilla shows axial sections of teeth 12 and 22. Cross-sectional image of tooth 12 (white arrow) shows two invaginated canals and tooth 22 (white arrow) shows single invagination. (b) CBCT of maxilla shows coronal sections of teeth 12 and 22. Cross-sectional image of tooth 12 shows large invagination of Oehlers Type 1 extending toward the root and communicating with the pulp (red arrow) and the other invagination of Type 2 with no communication with the pulp (white arrow). Cross-sectional image of tooth 22 confirms Type 2 invagination extending apically beyond the cemento-enamel junction and ending as a blind sac without communicating with the dental pulp.
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F4
After obtaining written informed consent, a CBCT (CS 3D Imaging Software) of the maxilla was performed with the following exposure parameters: 70 kV, 10 mA and 10.8 s [Figure 4]. Careful examination of cross-sectional images of tooth 22 revealed invagination extending apically beyond the cemento-enamel junction and ending as a blind sac without communicating with the dental pulp, confirming it as Oehlers Type 2 variant [Figure 4]. Cross-sectional images of tooth 12 revealed large Type 2 invagination as it was extending toward the root and communicating with the pulp and the second invagination was Type 1 with no communication with the pulp [Figure 4a and b].