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Abstract
It is not unusual to find unexplained or unusual dental abscesses in our routine dental practice. There are certain dental anomalies than can go unnoticed, which can potentially be pathways for pulpal disease. Dens evaginatus (DE) is one such aberration that results in an extra tubercle on the occlusal surface of and hence becomes a hidden pathway for infection to traverse. This article presents a case of a young female patient undergoing orthodontic treatment who developed a periradicular pathosis in a seemingly intact tooth. On careful investigation the reason for pulp necrosis and subsequent sequela was attributed to DE. Thus DE can be considered as a potential cause for endodontic diseases. An early identification of these aberrations will help us provide prophylactic care and also aid in formulating a proper treatment plan.teeth, mostly the premolars. It has an extension of the pulp which connects the main pulp chamber.
Clinical significance: The case report highlights the importance for the clinician to identify and manage developmental aberration as soon as the teeth is erupted into the oral cavity to avoid any pulpal complications
Keywords: cone beam computer tomography, Dens evaginatus, pulp necrosis
Introduction
There are times in our clinical practice where we come across teeth with necrotic pulp with no apparent reason for the same. The cause frequently directs us towards microbial invasion of the pulp space [1]. Microbial access into the dental pulp normally occurs due to the loss in continuity of the hard tissue protective encasement. This may occur either due to diseases like dental caries, tooth wear or trauma [2]. Apart from these situations, one potential risk for pulpal contamination that is frequently overlooked is Dens Evaginatus [3].
Dens evaginatus (DE) is a developmental anomaly of the tooth that occurs due to the atypical proliferation and folding of the inner enamel epithelium and adjacent dental papilla into the stellate reticulum during crown morphogenesis. This leads to formation of a tubercle which may be seen clinically as an extra cusp, bulge, protuberance or extrusion
[4]. This aberration is usually seen on the occlusal surface of premolars (referred to as Leongs' premolar) and on the lingual aspect of upper incisors (commonly known as Talons' cusp) [5].
This protuberance is covered by a thin layer...