DOI QR코드

DOI QR Code

Guided endodontics: a case report of maxillary lateral incisors with multiple dens invaginatus

  • Ali, Afzal (Department of Conservative Dentistry and Endodontics, Pacific Dental College and Hospital) ;
  • Arslan, Hakan (Department of Endodontics, Faculty of Dentistry, Istanbul Health Sciences University)
  • Received : 2019.05.29
  • Accepted : 2019.09.03
  • Published : 2019.11.30

Abstract

Navigation of the main root canal and dealing with a dens invaginatus (DI) is a challenging task in clinical practice. Recently, the guided endodontics technique has become an alternative method for accessing root canals, surgical cavities, and calcified root canals without causing iatrogenic damage to tissue. In this case report, the use of the guided endodontics technique for two maxillary lateral incisors with multiple DIs is described. A 16-year-old female patient was referred with the chief complaint of pain and discoloured upper front teeth. Based on clinical and radiographic findings, a diagnosis of pulp necrosis and chronic periapical abscess associated with double DI (Oehler's type II) was established for the upper left lateral maxillary incisor (tooth #22). Root canal treatment and the sealing of double DI with mineral trioxide aggregate was planned for tooth #22. For tooth #12 (Oehler's type II), preventive sealing of the DI was planned. Minimally invasive access to the double DI and the main root canal of tooth #22, and to the DI of tooth #12, was achieved using the guided endodontics technique. This technique can be a valuable tool because it reduces chair-time and, more importantly, the risk of iatrogenic damage to the tooth structure.

Keywords

References

  1. Hulsmann M. Dens invaginatus: aetiology, classification, prevalence, diagnosis, and treatment considerations. Int Endod J 1997;30:79-90. https://doi.org/10.1111/j.1365-2591.1997.tb00679.x
  2. Chen YH, Tseng CC, Harn WM. Dens invaginatus. Review of formation and morphology with 2 case reports. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;86:347-352. https://doi.org/10.1016/S1079-2104(98)90184-6
  3. Kumar H, Al-Ali M, Parashos P, Manton DJ. Management of 2 teeth diagnosed with dens invaginatus with regenerative endodontics and apexification in the same patient: a case report and review. J Endod 2014;40:725-731. https://doi.org/10.1016/j.joen.2013.10.030
  4. Kirzioglu Z, Ceyhan D. The prevalence of anterior teeth with dens invaginatus in the western Mediterranean region of Turkey. Int Endod J 2009;42:727-734. https://doi.org/10.1111/j.1365-2591.2009.01579.x
  5. Oehlers FA. Dens invaginatus (dilated composite odontome): I. Variations of the invagination process and associated anterior crown forms. Oral Surg Oral Med Oral Pathol 1957;10:1204-1218. https://doi.org/10.1016/0030-4220(57)90077-4
  6. Capar ID, Ertas H, Arslan H, Tarim Ertas E. A retrospective comparative study of cone-beam computed tomography versus rendered panoramic images in identifying the presence, types, and characteristics of dens invaginatus in a Turkish population. J Endod 2015;41:473-478. https://doi.org/10.1016/j.joen.2014.12.001
  7. Torres A, Shaheen E, Lambrechts P, Politis C, Jacobs R. Microguided Endodontics: a case report of a maxillary lateral incisor with pulp canal obliteration and apical periodontitis. Int Endod J 2019;52:540-549. https://doi.org/10.1111/iej.13031
  8. Byun C, Kim C, Cho S, Baek SH, Kim G, Kim SG, Kim SY. Endodontic treatment of an anomalous anterior tooth with the aid of a 3-dimensional printed physical tooth model. J Endod 2015;41:961-965. https://doi.org/10.1016/j.joen.2015.01.016
  9. Mena-Alvarez J, Rico-Romano C, Lobo-Galindo AB, Zubizarreta-Macho A. Endodontic treatment of dens evaginatus by performing a splint guided access cavity. J Esthet Restor Dent 2017;29:396-402. https://doi.org/10.1111/jerd.12314
  10. Connert T, Zehnder MS, Amato M, Weiger R, Kuhl S, Krastl G. Microguided Endodontics: a method to achieve minimally invasive access cavity preparation and root canal location in mandibular incisors using a novel computer-guided technique. Int Endod J 2018;51:247-255. https://doi.org/10.1111/iej.12809
  11. Strbac GD, Schnappauf A, Giannis K, Moritz A, Ulm C. Guided modern endodontic surgery: a novel approach for guided osteotomy and root resection. J Endod 2017;43:496-501. https://doi.org/10.1016/j.joen.2016.11.001
  12. Ackerman S, Aguilera FC, Buie JM, Glickman GN, Umorin M, Wang Q, Jalali P. Accuracy of 3-dimensional-printed endodontic surgical guide: a human cadaver study. J Endod 2019;45:615-618. https://doi.org/10.1016/j.joen.2019.02.005
  13. Chong BS, Dhesi M, Makdissi J. Computer-aided dynamic navigation: a novel method for guided endodontics. Quintessence Int 2019;50:196-202.
  14. Connert T, Krug R, Eggmann F, Emsermann I, ElAyouti A, Weiger R, Kuhl S, Krastl G. Guided endodontics versus conventional access cavity preparation: a comparative study on substance loss using 3-dimensional-printed teeth. J Endod 2019;45:327-331. https://doi.org/10.1016/j.joen.2018.11.006
  15. Fan Y, Glickman GN, Umorin M, Nair MK, Jalali P. A novel prefabricated grid for guided endodontic microsurgery. J Endod 2019;45:606-610. https://doi.org/10.1016/j.joen.2019.01.015
  16. Maia LM, de Carvalho Machado V, da Silva NR, Brito Junior M, da Silveira RR, Moreira Junior G, Ribeiro Sobrinho AP. Case reports in maxillary posterior teeth by guided endodontic access. J Endod 2019;45:214-218. https://doi.org/10.1016/j.joen.2018.11.008
  17. Krastl G, Zehnder MS, Connert T, Weiger R, Kuhl S. Guided Endodontics: a novel treatment approach for teeth with pulp canal calcification and apical pathology. Dent Traumatol 2016;32:240-246. https://doi.org/10.1111/edt.12235
  18. van der Meer WJ, Vissink A, Ng YL, Gulabivala K 3rd. 3D computer aided treatment planning in endodontics. J Dent 2016;45:67-72. https://doi.org/10.1016/j.jdent.2015.11.007
  19. Bishop K, Alani A. Dens invaginatus. Part 2: clinical, radiographic features and management options. Int Endod J 2008;41:1137-1154. https://doi.org/10.1111/j.1365-2591.2008.01469.x
  20. American Association of Endodontists. AAE endodontic case difficulty assessment form and guidelines [Internet]. Chicago (IL): American Association of Endodontists; [cited 2019 Feb 21]. Available from: https://www.aae.org/specialty/wp-content/uploads/sites/2/2017/10/2006casedifficultyassessmentformb_edited2010.pdf.

Cited by

  1. Application of CBCT data and three-dimensional printing for endodontic diagnosis and treatment: Three case reports vol.9, pp.3, 2019, https://doi.org/10.4103/njecp.njecp_20_21