Extraradicular communicating dens invaginatus.

ABSTRACT

The morphologic occurrence of dens invaginatus often results in pathologic involvement of the pulp and associated periodontal tissues. Treatment must include endodontic therapy to reduce the organic and infectious content of the pulp and invaginated tract. Concervative therapy, however, is frequently insufficient to eliminate the irritant force to a level that is biologically acceptable to the host. Therefore, surgical intervention has been considered by most authors to be the most acceptable approach for correction of the deformity and associated alveolar defects. Both cases reviewed here represent the dens invaginatus type of malformations that have primary zones of irritation within the anomalous tract. A report similar to our Case 2 appeared in the literature 2 weeks after initial therapy of the nonpupally involved lateral incisor. These cases are published to document the occurrence of these forms of dens invaginatus and their associated periradicular pathosis, to recommend treatment, and to note the apparent favorable response to the involved tissues.