Bılateral Type I Dens Invagınatus in Maxıllary Lateral Incısors: A Case Report

Abstract

Aim and Background: Dens invaginatus (DI), also referred to as dens in dente, is a developmental dental anomaly characterised by the invagination of the enamel organ into the dental papilla during the morphodifferentiation stage of tooth development. DI is a rare congenital dental anomaly characterised by the infolding of enamel or cementum into the dentin. The case report aims to describe bılateral type I Dens Invagınatus in maxıllary lateral incisors. This structural irregularity predisposes the tooth to caries, pulp infection, necrosis, and periradicular lesions due to its complex anatomy.  Management strategies are determined by the type of DI and the presence or absence of infection, ranging from conservative sealing techniques to root canal therapy or intentional replantation. Case Description: A 9-year-old female pediatric patient presented with a complaint of food lodgment in the maxillary right lateral incisor. Clinical and radiographic evaluation revealed a Type I dens invaginatus with #12 and #22, which is limited to the crown and does not extend beyond the cemento-enamel junction. As the invagination was non-infected and localised, a conservative approach was chosen. The affected area was debrided and sealed using flowable composite resin to prevent further bacterial ingress, thereby reducing the risk of caries progression and associated complications. Conclusion: Early diagnosis and minimally invasive management of Type I dens invaginatus can prevent the progression to more severe complications, preserving tooth vitality and function. Advances in imaging technology and a better understanding of the molecular mechanisms underlying tooth development offer promising avenues for more effective diagnosis and management of this condition, such as an operating microscope and ultrasonic instrument. Clinical Significance: This case highlights the importance of early detection of dens invaginatus in pediatric patients. Conservative sealing using flowable composite resin is an effective method for managing non-infected Type I DI, helping to prevent pulp pathosis and maintain oral health.