Liu J, Zhang YR, Zhang FY, Zhang GD, Xu H. Microscopic removal of type III dens invaginatus and preparation of apical barrier with mineral trioxide aggregate in a maxillary lateral incisor: A case report and review of literature. World J Clin Cases 2020; 8(6): 1150-1157 [PMID: 32258086 DOI: 10.12998/wjcc.v8.i6.1150]
Corresponding Author of This Article
Hai Xu, PhD, Associate Chief Physician , Department of Conservative Dentistry and Endodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Han-Zhong Road 136th, Nanjing 210029, Jiangsu Province, China. xh1982@njmu.edu.cn
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Mar 26, 2020; 8(6): 1150-1157 Published online Mar 26, 2020. doi: 10.12998/wjcc.v8.i6.1150
Microscopic removal of type III dens invaginatus and preparation of apical barrier with mineral trioxide aggregate in a maxillary lateral incisor: A case report and review of literature
Jie Liu, Yue-Rong Zhang, Fu-Yu Zhang, Guang-Dong Zhang, Hai Xu
Jie Liu, Yue-Rong Zhang, Fu-Yu Zhang, Guang-Dong Zhang, Department of General Dentistry, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Jie Liu, Yue-Rong Zhang, Fu-Yu Zhang, Guang-Dong Zhang, Hai Xu, Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Hai Xu, Department of Conservative Dentistry and Endodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Author contributions: Xu H designed the treatment plan and treated the patient; Liu J, Zhang YR, Zhang FY, and Zhang GD reviewed the literature and drafted the manuscript.
Supported bythe Priority Academic Program Development of Jiangsu Higher Education Institutions, No. PAPD2018-87.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The author denies any conflict of interest related to this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Hai Xu, PhD, Associate Chief Physician , Department of Conservative Dentistry and Endodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Han-Zhong Road 136th, Nanjing 210029, Jiangsu Province, China. xh1982@njmu.edu.cn
Received: November 26, 2019 Peer-review started: November 26, 2019 First decision: January 19, 2020 Revised: February 1, 2020 Accepted: February 28, 2020 Article in press: February 28, 2020 Published online: March 26, 2020 Processing time: 120 Days and 15.4 Hours
Abstract
BACKGROUND
Invaginated teeth pose greater challenges in clinical management because of their complex configuration. With advancements in equipment and materials, such as the dental operation microscope, cone-beam computed tomography and mineral trioxide aggregate, the preservation rate of type III dens invaginatus could be greatly increased.
CASE SUMMARY
This case report presented a 31-year-old woman with complaints of spontaneous swelling and pain in the right maxillary lateral tooth. With the aid of cone-beam computed tomography, type III dens invaginatus with apical periodontitis was diagnosed and confirmed. Three-visit endodontic treatment was performed. In the first visit, the invagination was carefully removed under the dental operation microscope, and chemomechanical preparation was done. In the second visit, mineral trioxide aggregate apical barrier surgery was performed in this tooth. In the third visit, the canal was finally obturated with thermoplastic gutta-percha to recover the crown morphology. A 26-mo follow-up revealed a satisfied outcome both in the radiographic and oral examinations.
CONCLUSION
In this case, removal of the entire abnormal structure provided great convenience for the follow-up treatment. When confronted with the same clinical case in the future, we can take a similar approach to address it.
Core tip: Type III dens invaginatus poses great challenges when conducting clinical operations. This article reported an upper right lateral incisor with type III dens invaginatus using the method that removed the invagination under the dental operation microscope, and then mineral trioxide aggregate apical barrier was made for the convenience of next treatment. The 26-mo follow-up revealed a satisfactory therapeutic effect.
