Nonsurgical Management of a Dilacerated Maxillary Lateral Incisor with Type III Dens Invaginatus: A Case Report

Type III dens invaginatus is a developmental anomaly characterized by an enamel-lined channel that originates on the coronal surface and passes apically through part or all of the root and exits into the periodontal ligament. In this case report, a 13-yr-old male had a Type III dens that exited at the midroot level of tooth #7. At that same level, the root dilacerated severely to the mesial, and a periradicular radiolucency was present on the distal. A 12-mm periodontal defect was present on tooth #6 and a sinus tract was present. All maxillary anterior teeth responded normally to pulp vitality testing, and no other abnormal probing depths were present. The channel opening in the crown was located, and the channel was negotiated, enlarged, and filled with calcium hydroxide. Thirteen weeks later, the probing was normal and the canal was obturated with gutta-percha and restored. Two- and 6-yr recalls showed complete healing of the bony defects and continued normal responses to vitality testing.