Multidisciplinary management of a tooth with severe root dilaceration and enamel hypoplasia: a case report.

Dental trauma in primary teeth can cause irreversible changes in the development of permanent tooth germs, including enamel hypoplasia, crown dilaceration, and root dilaceration. This article discusses multidisciplinary treatment of enamel hypoplasia and root dilaceration in the maxillary left central incisor of an 11-year-old girl. A 10-year follow-up is reported to demonstrate the long-term clinical outcomes. At the initial presentation, the patient's mother reported that the child had an accident at the age of 2 years, resulting in intrusive luxation of the primary maxillary left central incisor. After the accident, the patient was monitored for eruption of the permanent successor tooth, and different approaches were proposed during each period of the patient's development on the basis of the clinical diagnosis of root dilaceration and enamel hypoplasia. The crown was restored with composite resin, and the root defect was restored with resin-modified glass ionomer cement. After 10 years, the clinical outcomes highlight that the multidisciplinary approach was successful in preserving the natural tooth with good periodontal health conditions.

X-linked hypohidrotic ectodermal dysplasia management with removable prosthesis in a pediatric patient: case report / Manejo de displasia ectodérmica hipohidrótica ligada al cromosoma X con prótesis removible en un paciente pediátrico: reporte de caso

Introduction: Ectodermal dysplasia is a rare genetic disorder that affects structures derived from ectoderm such as teeth, hair, nails, and sweat glands. Oligodontia is a common finding that affects the chewing, smiling and self- esteem of these pediatric patients. Case Report: We present a case report of a 7-years-old pediatric patient who consulted with his mother, showing the same condition. The intervention consisted of a removable prosthesis with satisfactory results. Conclusion: The X-linked hypohidrotic ectodermal dysplasia represents a challenge for a pediatric dentist who offers rehabilitation to the patient according to craniofacial development, age, socioeconomic status, and the number of missing teeth.

Introducción: La oligodoncia es un hallazgo común que afecta la masticación, la sonrisa y la autoestima de estos pacientes pediátricos. Case Report: Presentamos un reporte de caso de un paciente pediátrico de 7 años que consultó con su madre presentando la misma condición. La intervención consistió en una prótesis de remoción con resultados satisfactorios. Conclusión: La displasia ectodérmica hipohidrótica ligada al cromosoma X representa un desafío para un odontopediatra que ofrece rehabilitación al paciente de acuerdo con el desarrollo craneofacial, la edad, el nivel socioeconómico y el número de dientes faltantes.

Endodontic treatment of hypertaurodontic teeth with anatomical variations: case reports.

Taurodontism, usually associated with genetic disorders, is an anomaly in dental development in which the tooth presents with a vertically elongated pulp chamber due to an invagination failure of the Hertwig epithelial sheath. This article presents 2 case reports describing the endodontic treatment of permanent taurodontic molars in systemically healthy patients. In case 1, a maxillary left first molar presented with hypertaurodontism and 5 root canals. In case 2, a mandibular left second molar presented with hypertaurodontism and a C-shaped canal. Treatment of both teeth was based on careful radiographic evaluation with magnification, which allowed the root canal orifices to be identified and the endodontic treatment to be performed. Chemical-mechanical preparation was performed with mechanized instruments and a 2.5% sodium hypochlorite solution. As an auxiliary protocol to finish cleaning, passive ultrasonic irrigation was performed, and a thermoplastic filling technique was used. When complex internal anatomy and accessory root canals are present, endodontic treatment of a tooth presenting with hypertaurodontism can be challenging. Given the complexities of the present cases, the positive outcomes can be attributed to the use of magnification during endodontic procedures and meticulous attention to tooth preparation and obturation techniques.

Generalised hypomineralisation of enamel in oculodentodigital dysplasia: comprehensive dental management of a case.

Oculodentodigital dysplasia (ODDD) is a rare congenital disorder characterised by developmental abnormalities of the eye, dentition and digits of the hands and feet, with neurological symptoms reported in 30% of individuals. Dental anomalies associated with ODDD include enamel hypoplasia and subsequent caries, microdontia, missing teeth, amelogenesis imperfecta, pulp stones and delayed tooth development. Here, we describe the comprehensive dental management of a 3-year-old girl who presented with rapid deterioration of the primary dentition due to generalised enamel hypomineralisation. Conservative, comprehensive restorative management was performed under general anaesthesia. Within 6 months, further breakdown of the remaining unrestored enamel was noted. This case documents the challenges of conservative management in dental anomalies that are not well documented due to the extreme rarity of the disorder.

Anomalías dentales en personas con discapacidad / Dental Anomalies in People with Disabilities

RESUMEN Introducción: Durante la odontogénesis se pueden producir malformaciones congénitas que afectan la forma, el número, el tamaño, la estructura, la posición, el color y la erupción de los dientes. En las personas con discapacidades como parálisis cerebral, trastorno del desarrollo intelectual, síndrome de Down y trastorno del espectro autista, pueden presentarse variedad de anomalías dentales. Objetivo: Describir las anomalías dentales en las condiciones de discapacidad de parálisis cerebral, trastorno del desarrollo intelectual, síndrome de Down y trastorno del espectro autista. Métodos: Se realizó una búsqueda bibliográfica en las bases de datos Clinical Key, Medline, Dialnet y SciELO. Se aplicó la lista de comprobación PRISMA. Análisis e integración de la información: Posterior al proceso de lectura y análisis de la información, se recuperaron 800 artículos de las bases de datos, se eliminaron 590 por encontrarse repetidos. Luego de la discriminación, quedaron para revisar 210, a estos restantes se hizo la revisión de texto completo. Se eliminaron 193 no hacían referencia a anomalías dentales y/o a los trastornos o síndromes. De los 17 restantes, solo 15 cumplieron con los criterios de inclusión. Conclusiones: No se encontraron diferencias para afirmar que algunas de las anomalías y alteraciones presentadas correspondan de manera individual a cada tipo de discapacidad. Sin embargo, el síndrome de Down presenta anomalías dentales relacionadas al estado del paciente. La parálisis cerebral reporta otros hallazgos como bruxismo, debido al deficiente desarrollo muscular, lo que afecta la cavidad bucal y sus estructuras(AU)

ABSTRACT Introduction: During odontogenesis, congenital malformations can occur that affect teeth shape, number, size, structure, position, color and eruption. In people with disabilities such as cerebral palsy, intellectual development disorder, Down syndrome, and autism spectrum disorder, a variety of dental abnormalities can occur. Objective: To describe dental anomalies in such disability conditions as cerebral palsy, intellectual development disorder, Down syndrome and autism spectrum disorder. Methods: A bibliographic search was performed in the databases Clinical Key, Medline, Dialnet and SciELO. The PRISMA checklist was applied. Information analysis and integration: After reading and analyzing the information, 800 articles were retrieved from the databases, of which 590 were deleted because they were repeated. After the discrimination, 210 were pending to review; the remaining ones were reviewed full-text. 193 were deleted because they did not do any reference to dental anomalies and/or disorders or syndromes. Of the remaining 17, only 15 met the inclusion criteria. Conclusions: No differences were found to affirm that some of the anomalies and alterations presented correspond individually to each type of disability. However, Down syndrome has dental abnormalities related to patient condition. Cerebral palsy coincides with other findings such as bruxism, due to poor muscle development, which affects the oral cavity and its structures(AU)

Disostosis cleidocraneal a tres años de tratamiento ortopédico / Cleidocraneal dysostosis at three years of orthopedic treatment

Introducción: La disostosis cleidocraneal es un trastorno genético raro con patrón hereditario. Sus rasgos patognomónicos son la aplasia clavicular, fontanelas y suturas abiertas, múltiples anomalías dentales. Su origen se relaciona con alteraciones en el gen RUNX2, importante para la síntesis de CBFA1, que a su vez funciona como un conformador óseo y un diferenciador de osteoblastos. Caso clínico: Paciente de 11 años con características clínicas de CCD, se corroboran los antecedentes genéticos hereditarios y alteraciones dentales relacionados con disostosis cleidocraneal. Resultado: A tres años de tratamiento se observa mejor definición facial, la erupción de piezas permanentes retenidas y mejor función masticatoria. Conclusión: Mejorar la calidad de vida del paciente con tratamientos interceptivos y el conocimiento de las alteraciones causadas por el síndrome, así como el trabajo interdisciplinario (AU)

Introduction: Cleidocranial dysostosis is a rare genetic disorder with a hereditary pattern. Its pathognomonic features are clavicular aplasia, fontanelles and open sutures, multiple dental anomalies. Its origin is related to alterations in the RUNX2 gene, important for the synthesis of CBFA1, which in turn functions as a bone conformer and an osteoblast differentiator. Clinical case: Patient with eleven years old with clinical characteristics of CCD, hereditary genetic background, and dental alterations related to cleidocranial dysostosis are corroborated. Result: After three years of treatment, the facial definition is better, the eruption of permanent pieces retained and better chewing function. Conclusion: Improve the quality of life of the patient with interceptive treatments and the knowledge of the alterations caused by the syndrome, as well as the interdisciplinary work (AU)

[Summary of 61 cases of removable denture restoration in children with congenital tooth deficiency].

PURPOSE: To explore the methods and characteristics of removable denture restoration in children with congenital missing teeth. METHODS: From 1998 to 2018, 61 children aging 3 to 12 years old with congenital dental deficiency were treated with removable dentures. There were 59 males and 2 females. Removable denture prostheses were designed according to the characteristics of the children and the residual teeth in the mouth. There were 42 complete dentures in 21 cases, 40 single jaw complete dentures and maxillary removable partial dentures in 20 cases and 40 removable partial dentures in upper and lower jaw, totally 61 cases and 122 dentures. RESULTS: After wearing the removable denture, the appearance, chewing and pronunciation of the children were improved significantly. CONCLUSIONS: Although the etiology of congenital tooth defect is not completely clear, children can have early denture restoration. It solves the difficulty of eating, improves appearance and pronunciation, and promotes growth and physical and mental health of children.

Corono-radicular dilaceration of a maxillary central incisor: A case report.

Coronoradicular dilaceration is a particular abnormality of the permanent incisors, usually maxillary, and usually occurs around the age of 4 to 5 when the crown is formed and the root is still growing. It follows acute mechanical trauma affecting the temporary incisor. This anomaly of shape is characterized by an angulation between the crown and the root of the permanent tooth. The prognosis may be serious because the affected tooth may not erupt normally. It also compromises possible orthodontic treatment later. Our clinical case is that of a young patient (ES) aged 8 years and 4 months, in good general health condition, consulted for the absence 21 on the arch while the contralateral tooth was present. Interrogation revealed that the patient suffered trauma with severe luxation of the 61 at the age of 3 years. Radiographic examination showed the presence of the germ of 21 with an atypical sickle-shaped position and an image of a hand of a traffic policeman with a crown in a horizontal position. Three-dimensional imaging using a CT scan shows the shape of the 21 with a root angulation. The therapeutic attitude allowed the correction of its axis by an orthodontico-surgical treatment.

Radiological imaging and orthodontic treatment in the case of growing patients after oncological treatment: Case reports.

According to the classification of the World Health Organization (WHO), the most common childhood malignant neoplasms include leukemia, lymphomas, and neoplasms of the central nervous system (CNS) and the sympathetic nervous system. Cancer diseases themselves as well as their treatment carry a high risk of both early and distant effects. The most common dentition disorders resulting from the radiotherapy of the head area and chemotherapy in patients up to the age of 6 years include root agenesis, V-shaped roots, microdontia, hypoplasia of the maxilla and the jawbone, hypodontia, and enamel hypoplasia and hypomineralization. Patients undergoing oncological treatment at the age of <6 years should receive adequate and long-term monitoring due to the possible distant effects of the underlying disease and its treatment. The radiotherapy of the head and neck region performed on a growing patient significantly worsens the patient's prognosis and results in a number of irreversible complications. Planning appropriate orthodontic treatment in such patients contributes to increased comfort later in the patients' lives. Oncology patients do not require special orthodontic procedures; however, the high risk of complications does encourage the planning of orthodontic treatment with the least burden. Dental care for a young patient with a history of oncological disease requires the interdisciplinary cooperation of a pedodontist, orthodontist, prosthetist, and dental surgeon.

Salvaging a Periodontally Compromised and Endodontically Involved Three-Rooted Mandibular First Molar With Cervical Enamel Projection.

This case report describes the management of a mandibular first molar with an additional distolingual root (radix entomolaris) and grade III cervical enamel projection through a multidisciplinary approach. Diagnosis for the case was endodontic-periodontal lesion due to non-vitality and associated advanced periodontal destruction. The patient was treated with drainage of the periodontal abscess with adjunct antibiotics, phase I periodontal therapy, endodontic therapy, radiculoplasty, regenerative periodontal therapy, replacement of the missing right mandibular second molar, and long-term maintenance. Follow-up of the patient up to 9 months has been uneventful. Cases of advanced periodontal destruction typically show some degree of tooth mobility, which was absent in this case. The article discusses the tripod effect as well as the increased surface area for periodontal attachment provided by the additional root contributing to the non-mobility of the involved tooth.

Prevalência de anomalias dentárias em radiografias panorâmicas / Prevalence of dental anomalies in panoramic radiographies / Prevalencias de anomalías dentales en radiografías panorámicas

Introdução: As anomalias de desenvolvimento dentário ocorrem devido a distúrbios que acontecem durante a formação e a diferenciação celular. Dentre as radiografias odontológicas, a panorâmica se destaca por ser um exame radiográfico mais abrangente, que auxilia no diagnóstico e no planejamento terapêutico dos processos patológicos dos dentes e dos ossos da face. Objetivo: O objetivo desse estudo é determinar a prevalência de anomalias dentárias em radiografias panorâmicas de pacientes em tratamento no Centro Universitário Católica de Quixadá-CE e no Centro de Especialidades Odontológicas de Quixeramobim-CE. Métodos: A análise radiográfica foi realizada por um único pesquisador e os achados radiográficos foram escritos em uma ficha devidamente desenvolvida para este estudo. Resultados: Foram analisadas 500 radiografias panorâmicas de pacientes que possuíam entre 5 e 50 anos de idade. Desses, 67% (n=333) pertenciam ao sexo feminino e 33% (n=167) ao masculino. Foi encontrado um total de 1150 anomalias, correspondentes a: dentes não irrompidos 41,7% (n=480), giroversão 24,4% (n=281), dilaceração radicular 20,3% (n=234), microdontia 6,7% (n=77), agenesia 3,9% (n=45), dentes supranumerários 2,4% (n=28), taurodontia 0,3% (n=4) e a macrodontia 0,1% (n=1). As radiografias também foram divididas pelo tipo de arcada ocorrendo 48% (n=307) na maxila e 52% (n=330), na mandíbula. As anomalias dentárias hiperplasiantes foram encontradas em 2,9% (n=33) da amostra, as hipoplasiantes em 10,6% (n=122) e as heterotópicas em 86,5% (n=995). Desta forma conclui-se que na população estudada a maior prevalência correspondeu ao sexo feminino, à anomalia de desenvolvimento heterotópica e ao dente não irrompido(AU)

Introduction: Dental developmental anomalies occur due to disorders that occur during formation and cell differentiation. Among the dental radiographs, the panoramic view stands out as a more comprehensive radiographic examination, which assists in the diagnosis and therapeutic planning of the pathological processes of teeth and facial bones. Objective: The objective of this study is to determine the prevalence of dental anomalies in panoramic radiographs of patients undergoing treatment at the Catholic University of Quixadá-CE and the Quixeramobim-CE Center for Dental Specialties. Methods: The radiographic analysis was performed by a single investigator and the radiographic findings were written in a form properly developed for this study. Results: 500 panoramic radiographs were analyzed of patients who were between 5 and 50 years of age. Of these, 67% (n = 333) were female and 33% (n = 167) were male. A total of 1150 anomalies were found, corresponding to: unbroken teeth 41.7% (n = 480), rotation 24.4% (n = 281), root laceration 20.3% (n = 234), microdontia 6, 7% (n = 77), agenesis 3.9% (n = 45), supernumerary teeth 2.4% (n = 28), taurodontia 0.3% (n = 4) and macrodontia 0.1% = 1). The radiographs were also divided by the type of arcade occurring 48% (n = 307) in the maxilla and 52% (n = 330), in the mandible. Hyperplastic dental anomalies were found in 2.9% (n = 33) of the sample, hypoplastic in 10.6% (n = 122) and heterotopic in 86.5% (n = 995). In this way, it was concluded that in the population studied the greatest predominance was female gender, the anomaly of heterotopic development and the non-erupted tooth(AU)

Introducción: Las anomalías de desarrollo dentario ocurren debido a disturbios que ocurren durante la formación y la diferenciación celular. Entre las radiografías dentales, la panorámica se destaca por ser un examen radiográfico más amplio, que auxilia en el diagnóstico y en la planificación terapéutica de los procesos patológicos de los dientes y de los huesos de la cara. Objetivo: El objetivo de este estudio es determinar la prevalencia de anomalías dentales en radiografías panorámicas de pacientes en tratamiento en el Centro Universitario Católica de Quixadá-CE y en el Centro de Especialidades Odontológicas de Quixeramobim-CE. Métodos: El análisis radiográfico fue realizado por un único investigador y los hallazgos radiográficos fueron escritos en una ficha debidamente desarrollada para este estudio. Resultados: Se analizaron 500 radiografías panorámicas de pacientes que tenían entre 5 y 50 años de edad. De ellos, el 67% (n = 333) pertenecía al sexo femenino y el 33% (n = 167) al masculino. Se ha encontrado un total de 1150 anomalías, correspondientes a: dientes no irrompidos 41,7% (n = 480), giroversión 24,4% (n = 281), dilaceración radicular 20,3% (n = 234), microdoncia 6, (N = 28), agonismo 3,9% (n = 45), dientes supernumerarios 2,4% (n = 28), taurodoncia 0,3% (n = 4) y la macrodoncia 0,1% (n = = 1). Las radiografías también fueron divididas por el tipo de arcada ocurriendo 48% (n = 307) en la mandíbula y 52% (n = 330), en la mandíbula. Las anomalías dentales hiperplasitivas se encontraron en el 2,9% (n = 33) de la muestra, las hipoplasiantes en el 10,6% (n = 122) y las heterotópicas en el 86,5% (n = 995). De esta forma se concluye que en la población estudiada las mayores predominancias correspondieron al sexo femenino, a la anomalía de desarrollo heterotópica y al diente no irrompido(AU)

Reabilitação com coroas metal free em dentes anteriores traumatizados e com rizogênese incompleta: relato de caso / Rehabilitation with metal free crowns in traumatized anterior teeth with incomplete rhizogenesis: case report

Objetivo: rizogênese incompleta refere-se a dentes permanentes em que não houve a formação completa do ápice radicular, ocasionando perda da vitalidade pulpar e, consequentemente, incapacidade da bainha epitelial de Hertwig para induzir a formação completa da raiz. Devido ao traumatismo e escurecimento dental, se faz necessário em certos casos a confecção de coroas em porcelana pura para reabilitar a paciente em estética e função. O presente trabalho tem como objetivo demonstrar um caso de reabilitação estética e funcional em dente com rizogênese incompleta, onde se consideraram as perdas estruturais e alteração de cor, para que seja possível estabelecer o tratamento mais adequado. Relato de caso: paciente de 16 anos, gênero feminino, atendida na Clínica de Odontologia de uma instituição privada, insatisfeita com a estética do seu dente devido ao escurecimento do elemento 21, pois quando tinha 5 anos o dente foi traumatizado juntamente com o elemento 11. O plano de tratamento adotado para ambos os elementos foi a confecção de peças protéticas em porcelana e cimentação. Considerações finais: esse caso demonstrou que a confecção de coroas estéticas em porcelana é considerada uma boa conduta na rotina clínica em casos de escurecimento dental, devolvendo estética e função para o paciente.(AU)

Objective: incomplete rhizogenesis refers to permanent teeth with incomplete formation of the root apex, causing loss of pulp vitality and the consequent inability of the Hertwig epithelial sheath to induce complete root formation. Due to dental trauma and darkening, some cases require the production of pure porcelain crowns to rehabilitate the aesthetics and function of patients. The present study aims to show a case of aesthetic and functional rehabilitation in a tooth with incomplete rhizogenesis, in which structural losses and color change were considered to establish the most appropriate treatment. Case report: a 16-year-old female patient treated at the Dental Clinic of a private institution. The patient was not satisfied with the aesthetics of her tooth due to the darkening of element 21, because at 5 years old the tooth was traumatized along with element 11. The treatment used for both elements was the production of prosthetic porcelain crowns and cementation. Final considerations: this case showed that the production of aesthetic porcelain crowns is considered a good conduct in the clinical routine in cases of tooth darkening, returning aesthetics and function to the patient.(AU)

Manejo clínico del talón cuspídeo en bebés: reporte de un caso / Clinical management of talon cusp in babies: report of a case

El talón cuspídeo es considerado como una rara anomalía de desarrollo de los dientes anteriores. Si bien afecta a ambas denticiones, suele darse con mayor frecuencia en la permanente. Esta anomalía de desarrollo puede causar problemas estéticos, dificultad en la higiene con el consecuente riesgo de caries y gingivitis, interferencias oclusales, entre otros. Por lo que el diagnóstico temprano y su tratamiento oportuno resultan de fundamental importancia. Se reporta un caso donde se describe el manejo clínico de un bebé de 16 meses de vida con talón cuspídeo sobre la superficie palatina de los incisivos centrales superiores y caries (AU)

Talon cusp is a rare developmental dental anomaly of the anterior teeth. While it may affect both dentitions, talon cusp occurs more frequently in permanent than in primary dentition. This developmental anomaly may cause esthetic problems, difficulties of oral hygiene hence favoring the development of caries and gingivitis, occlusal interferences, among others. Therefore, early diagnosis and prompt treatment are of the utmost importance. The present case report describes the clinical management of a 16-month old baby with talon cusp on the palatine surface of maxillary central incisors together with carious lesion (AU)

Contemporary endodontic treatment choices for adult patients with dens evaginatus and apical periodontitis: a case report with a 2-year follow-up.

Dens evaginatus (DE) frequently leads to pulp exposure and subsequent pulpal inflammation, pulpal necrosis, and periapical inflammation. This case report describes the application of regenerative endodontic therapy and mineral trioxide aggregate (MTA) apexification in a 22-year-old man with mandibular second premolars affected by DE and apical periodontitis. Regenerative endodontic therapy was performed after thorough debridement and placement of calcium hydroxide in the root canal of the left premolar. In contrast, an apical plug of MTA was placed prior to gutta percha compaction in the root canal of the right premolar. Both teeth were restored with adhesive composite resin. A 2-year follow-up examination revealed complete periapical healing.

The orthodontic-oral surgery interface. Part two: diagnosis and management of anomalies in eruption and transpositions.

The orthodontic-oral surgery interface is important for the multidisciplinary management of patients presenting with complex dental anomalies. This article provides an overview of anomalies of eruption and transpositions, their diagnosis, aetiology, presenting features and the different management options. It also highlights the role of the general dental practitioner (GDP) in identifying such anomalies and the importance of timely referral to specialist care.

Iridogoniodysgenesis: A Challenging Case.

Iridogoniodysgenesis is a rare autosomal dominant disorder affecting anterior segment of the eye. Fifty percent cases of iridogoniodysgenesis have glaucoma, which is particularly difficult to manage. We report here a case of 40 years old man with this rare disorder, presenting to our glaucoma department. It was characterised by iris hypoplasia and juvenile glaucoma. To stop fluctuation in his intraocular pressure (IOP) and to save his vision from glaucomatous damage, our team had to do three different surgical procedures, i.e. trabeculectomy with F5U, diode laser cycloablation and aqueous shunt procedure, over a period of 10 months. This case report discusses management of glaucoma in this particular patient and challenges faced during the treatment. Regular follow-up and timely intervention can save such patients from complete blindness. To authors' knowledge, this is the first reported case of iridogoniodysgenesis in Pakistan.

Endodontic management of taurodontism with a complex root canal anatomy in mandibular posterior teeth.

One of the biggest challenges in endodontic treatment is to comprehensively understand the variation of tooth root canal anatomy. To a large degree, the anatomy and furcation distribution of teeth, which vary from nationality and ethnic groups, will influence the clinical diagnosis, treatment plan and even prognosis. Taurodontism, as one of anatomic variation in tooth structures, is relatively hard to be seen in dental clinics. Two special cases of taurodontism with varied root canal anatomies in mandibular second premolar and first molar are reported in this paper.

Talón cuspídeo en incisivo central superior y tratamiento endodóntico integral: informe de caso clínico / Talon cusp in maxillary central incisor and comprehensive endodontic treatment: report of a case

Objetivo: describir el tratamiento endodóntico integral de un incisivo central superior con una anomalía inusual de talón cuspídeo y su posterior rehabilitación. Caso clínico: se presenta un incisivo central superior con talón cuspídeo, fracturado por un odontólogo en un intento de extracción, al ser confundido con un diente supernumerario en la cara palatina, con sintomatología dolorosa. Al análisis con cone beam, se observan dos conductos radiculares, uno de ellos perteneciente a la cúspide anómala y con tejido necrótico en su interior y la pulpa del conducto principal inflamada. Se realiza tratamiento endodóntico con sistema WaveOne Gold de cada conducto radicular y obturación con técnica híbrida. Posteriormente, se hacen los desgastes selectivos de acuerdo a la oclusión del paciente y la reconstrucción con resinas, con inicio de terapia ortodóntica, para su rehabilitación. Conclusiones: en un tratamiento endodóntico, siempre deben considerarse las diversas anomalías anatómicas de los dientes.