Dens Invaginatus

Definition: A developmental anomaly characterized by an infolding of enamel from the occlusal or incisal surface into the tooth interior.

Radiographic Features:

  • Location: Most commonly in maxillary lateral incisors’ root canals
  • Edge: Well-defined
  • Shape: Inverted teardrop appearance
  • Internal structure: Radiopaque, with enamel-like density
  • Number: Usually singular per tooth, but multiple teeth may be affected

Key points:

  • Severity classification:
    1. Dens invaginatus: Minor infolding
    2. Dens in dente: Infolding ≥50% of canal space; tooth retains general shape
    3. Dilated odontome: Most severe; tooth loses general shape
  • May cause enlargement of the root canal

Clinical significance:

  • Increased risk of pulpal pathology due to communication with oral environment
  • May complicate endodontic treatment
  • Can affect tooth eruption and alignment
  • Early detection crucial for appropriate management

Note: Thorough radiographic examination is essential for accurate diagnosis and treatment planning. Advanced imaging (e.g., CBCT) may be necessary in complex cases.