Root canal treatmentof a maxillary lateralincisor with type II DensInvaginatus

Aim: To report a case of endodontic treatment of an upper lateral incisor with type II Dens Invaginatus with the aid of operative microscopy and ultrasonic tips. Case Report: A 16 years-old female patient was referred for endodontic treatment of the left maxillary lateral incisor with diagnosis of symptomatic apical periodontitis and type II Dens Invaginatus. Removal of the intracanal calcified structure was carried out using long-shaft high-speed drills in conjunction with diamond-coated ultrasonic tips. Instrumentation was performed alternating between reciprocating and manual files up to the K 80 file. Intracanal medication based on 2% chlorhexidine gel and calcium hydroxide powder remained inside the canal for 14 days. Filling was executed by creating an apical plug with bioceramic sealer (Bio-C Repair, Angelus) and a Mineral trioxide aggregate (MTA, Angelus) backfill up to the cervical third. In the 14 months follow-up the periapical radiograph and CBCT showed signs of periapical bone repair. Conclusion: This report highlights the critical role of CBCT and the use of UT combined with microscopy in comprehensive treatment planning and execution. Additionally, it provides valuable clinical evidence demonstrating the feasibility and effectiveness of this approach.