Endodontic Non-Surgical Management of Dens Invaginatus Type Two with Open Apex and Separate Root Sheath: A Case Report and Literature Review

Dens invaginatus (DI) is a rare developmental anomaly with an unknown etiology and different complexity. It is classified into three types according to Oehler’s classification 1957 based on the extent of invagination. This case involves an upper lateral tooth demonstrating Dens invaginatus type 2, an open apex, and a separate root sheath and diagnosis of necrotic pulp with symptomatic apical periodontitis. A cone beam computed tomography (CBCT) assessment was conducted prior to nonsurgical root canal treatment, which included apexification with bio ceramic material and internal bleaching to address both healing potential and aesthetics. The procedure was performed under an operating microscope, and a 6-month follow-up was conducted with both clinical and radiographic signs of healing.