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Abstract
Dens invaginatus is a defect categorized by a prominent lingual cusp and centrally located fossa. It occurs due to early invagination of the enamel epithelium into dental papilla of the underlying tooth germ. The affected teeth show a deep invagination of enamel as well as dentin initiating from foramen caecum or tip of the cusps and may extend even into the root. The teeth that are most frequently involved teeth are the maxillary lateral incisors, there might also occur a bilateral involvement. In this anomaly there can be seen several morphologic variations and it may lead to early pulpal involvement from the caries progressing into the pulp from lingual pit. The treatment varies from a preventive restoration to endodontic therapy, depending on the severity of the case. The present case report refers to one such case having a deep lingual pit bilaterally in both the maxillary permanent lateral incisors.
Introduction
Dens Invaginatus is a developmental anomaly which arises as a result of an invagination into the surface of the tooth crown before calcification has occurred. Dens Invaginatus (DI) in a human tooth was first described by Socrates in 1856 [1]. Anomalous cavities in human teeth were reported by Mühlreiter in 1873, Baume in 1874 and Busch in 1897 reported about this anomaly as well. In 1887, Tomes described the dens invaginatus as: The enamel of the coronal portion is generally well developed but we tend to find a small depression in its centre that appears to be a dark spot [2].
The term Dens Invaginatus was proposed by Oehler in 1957 and is the most widely accepted. Synonyms for this anomaly reported in literature are dens in dente (Busch 1897), invaginated odontome, dilated gestant odontome, dilated composite odontome (Hunter 1951), tooth inclusion, telescopic tooth, and gestant anomaly [3]. The teeth most affected are the maxillary lateral incisors. There are rare case reports of DI in the posterior, deciduous, and supernumerary teeth [4]. The reported prevalence of adult teeth affected by DI is between 0.3 and 10%. This variation in reported prevalence is attributed to methodological differences in cohort studies, the identification criteria used, and diagnostic difficulties [5, 6].
The majority of dens in dente cases are discovered by routine imaging exams. Radiographically, it...