The patient had been complaining of pain associated with recurrent palatal swelling on the right side of the palate for 6 months.

The patient had priorly received an endodontic treatment by a general practitioner. Case PresentationĪ 34-year-old male patient, with good general health, was referred for endodontic treatment of the maxillary lateral right incisor (tooth #12). In addition, it demonstrated that the use of the orthograde conservative approach alone allowed the healing of the periapical lesion despite the complexity of the root canal anatomy and the wide extension of the periapical lesion. This case report showed the importance of the use of Cone Beam Computer Tomography (CBCT) evaluation to facilitate the exploration and accessibility of the complicated root canal system of the invaginated tooth. Thus, the diagnosis and treatment planning are considered difficult. The root canal system is characterized by anatomic complexity. The maxillary lateral incisor is the most commonly affected tooth. According to the most widely accepted theory, it results in an invagination of the enamel organ into the dental papilla prior to the calcification of dental tissues.

Introductionĭens invaginatus (DI), also known as dens in dente, is a dental malformation found mostly in the permanent dentition and has been reported to affect 0.3% to 10% of the population. Additionally, active nonsurgical decompression was performed and the follow-up visits revealed a favorable outcome. Conservative orthograde endodontic treatment was performed by combining mechanical and chemical action. In the present case report, clinical and radiographic examinations were supplemented by CBCT examination to identify the root canal configuration and the extension of the periapical lesion. This dental malformation is characterized by the complexity of root canal anatomy, which when associated with a periapical lesion complicates the performance of conventional endodontic treatment, hence resulting to the difficulty of obtaining the optimal disinfection of the root canal system, which is an essential element for the success of any endodontic treatment. This case report illustrated the conservative management of an invaginated type II tooth with a large periapical lesion.

Rabaty endo