In vitro analysis of extracted dens invaginatus using various radiographic imaging techniques.

AIM Dens Invaginatus (DI) is a rare malformation of the teeth, showing a broad spectrum of morphologic variations. The aim of this study was to perform in vitro radiographic analyses of three extracted dens invaginatus (DI) teeth with complex root anatomy using plain radiographs, CBCT, MRI and micro CT techniques. MATERIALS AND METHODS Study design: Three maxillary lateral incisors (A, B and C) from two patients were extracted due to poor prognosis and were radiographically analysed. Initially, conventional two dimensional digital radiographs were taken. Subsequently CBCT, micro CT and MRI analyses were performed. RESULTS According to the Schulze and Brand system of classification, teeth A, B and C were classified as A2, B3 and B2 respectively. To detect the relationship between the invagination to the oral cavity and pulp chamber, conventional two dimensional radiographs were of no help. CBCT and MRI images were found to be complementary to each other but provided lesser structural detail than micro CT images. CONCLUSION Reporting on these three DI teeth, normal conventional radiographs did not provide detailed structural information about the malformation due to geometric distortion and lack of information. Even though Oehlers classification system is the most widely used, classification by Schulze and Brand is more applicable in rare and deviant teeth.

[1]  Z Metzger,et al.  The diagnosis and conservative treatment of a complex type 3 dens invaginatus using cone beam computed tomography (CBCT) and 3D plastic models. , 2013, International endodontic journal.

[2]  A. Sigurdsson,et al.  Comparative micro-computed tomographic evaluation of two carrier-based obturation systems , 2012, Clinical Oral Investigations.

[3]  Mahdi Niknami Dental Magnetic Resonance Imaging:Making the Invisible Visible , 2012 .

[4]  T. Okiji,et al.  Clinical management of dens invaginatus in a maxillary lateral incisor with the aid of cone-beam computed tomography--a case report. , 2011, Dental traumatology : official publication of International Association for Dental Traumatology.

[5]  S. Patel,et al.  The use of cone beam computed tomography in the management of dens invaginatus affecting a strategic tooth in a patient affected by hypodontia: a case report. , 2011, International endodontic journal.

[6]  H. Arslan,et al.  Assessment of the prevalence and characteristics of dens invaginatus in a sample of Turkish Anatolian population. , 2010, Medicina oral, patologia oral y cirugia bucal.

[7]  S. Patel The use of cone beam computed tomography in the conservative management of dens invaginatus: a case report. , 2010, International endodontic journal.

[8]  V. Crincoli,et al.  Dens Invaginatus: A Qualitative-Quantitative Analysis. Case Report of An Upper Second Molar , 2010, Ultrastructural pathology.

[9]  K. Bishop,et al.  Dens invaginatus. Part 1: classification, prevalence and aetiology. , 2008, International endodontic journal.

[10]  S. Patel,et al.  The use of cone beam computed tomography in the management of external cervical resorption lesions. , 2007, International endodontic journal.

[11]  I. Mejàre,et al.  Dens invaginatus: a retrospective study of prophylactic invagination treatment. , 2008, International journal of paediatric dentistry.

[12]  M. Hülsmann Dens invaginatus: aetiology, classification, prevalence, diagnosis, and treatment considerations. , 1997, International endodontic journal.

[13]  M. Hülsmann,et al.  Severe dens invaginatus malformation: report of two cases. , 1996, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[14]  S R Matteson,et al.  Advanced imaging methods. , 1996, Critical reviews in oral biology and medicine : an official publication of the American Association of Oral Biologists.

[15]  A. Ruprecht,et al.  The clinical significance of dental invagination. , 1987, The Journal of pedodontics.

[16]  C. Flaitz,et al.  Dens invaginatus with partial coronal agenesis: report of case. , 1985, ASDC journal of dentistry for children.

[17]  J. Wilcox,et al.  Frequency of palatal invagination in permanent maxillary anterior teeth. , 1978, ASDC journal of dentistry for children.

[18]  J. Vincent-Townend Dens invaginatus. , 1974, E -journal of dentistry.

[19]  C. Schulze,et al.  [Dens invaginatus (dens in dente). I]. , 1972, ZWR.

[20]  C. Schulze,et al.  [Dens invaginatus (dens in dents)]. , 1972, ZWR.

[21]  M. Ulmansky,et al.  DOUBLE DENS IN DENTE IN A SINGLE TOOTH. REPORT OF A CASE AND RADIOLOGIC STUDY OF THE INCIDENCE OF SMALL DENS IN DENTE. , 1964, Oral surgery, oral medicine, and oral pathology.

[22]  G. A. Morgan,et al.  Bilateral dens in dente. , 1960, Oral surgery, oral medicine, and oral pathology.

[23]  F. Oehlers Dens invaginatus (dilated composite odontome). I. Variations of the invagination process and associated anterior crown forms. , 1957, Oral surgery, oral medicine, and oral pathology.

[24]  F. Oehlers Dens invaginatus (dilated composite odontome). II. Associated posterior crown forms and pathogenesis. , 1957, Oral surgery, oral medicine, and oral pathology.

[25]  G. Hallett,et al.  The Incidence, Nature, and Clinical Significance of Palatal Invaginations in the Maxillary Incisor Teeth , 1953, Proceedings of the Royal Society of Medicine.

[26]  I. Kramer The Pathology of Pulp Death in Non-Carious Maxillary Incisors with Minor Palatal Invaginations , 1953, Proceedings of the Royal Society of Medicine.

[27]  P. Kitchin Dens in dente. , 1949, Oral surgery, oral medicine, and oral pathology.