CODS Journal of Dentistry

Register      Login

VOLUME 10 , ISSUE 1 ( January-June, 2018 ) > List of Articles

CASE REPORT

Occurrence of Type III Dens Invaginatus and Type I Talon Cusp in Maxillary Lateral Incisor: A Rare Case Report

Shruti Singh, Safina Masroor

Keywords : Dens invaginatus, Developmental anomaly, Root canal treatment, Talon cusp,Apicectomy

Citation Information : Singh S, Masroor S. Occurrence of Type III Dens Invaginatus and Type I Talon Cusp in Maxillary Lateral Incisor: A Rare Case Report. CODS J Dent 2018; 10 (1):16-20.

DOI: 10.5005/jp-journals-10063-0041

License: CC BY-NC 4.0

Published Online: 00-06-2018

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim: To present a case report of concomitant occurrence of dens invaginatus and talon cusp in a single tooth with clinical management using cone-beam computed tomography (CBCT). Background: Developmental dental anomalies are an important category of dental morphogenic variants. Developmental anomalies of the permanent dentition are most frequently encountered in the maxillary lateral incisor. Talon cusp is an additional cusp that projects predominately from the lingual or occasionally from the labial surface of anterior teeth. This accessory crown structure is composed of enamel, dentine, and varying degrees of pulp tissue. Dens invaginatus is defined as a deep surface invagination of the crown or root that is lined by the enamel. Case description: A 12-year-old female patient reported with complaint of small swelling in the upper front region of gums. Clinical examination revealed presence of the sinus tract with respect to the permanent maxillary left lateral incisor with morphologic alteration with associated talon cusp. Intraoral periapical radiographic and CBCT examination revealed malformation of the root with the enamel-lined tract mesial to and separate from the main root canal. Large periapical radiolucency approximately sized 1–1.5 cm was associated with the tract. Root canal treatment of the main root canal as well as of dens invagination followed by apicectomy and cyst enucleation was done. Conclusion: Co-occurrence of a talon cusp and double dens invaginatus is an extremely rare developmental dental anomaly. This case report represents a talon cusp with dens invaginatus on the maxillary left lateral incisor with associated cyst. Early identification is needed for prevention of potential problems on the affected or opposing tooth. Clinical significance: This case report presents a management of unusual clinical case of dens invaginatus and talon cusp associated with periapical cyst because of deep infected dens invaginatus using CBCT examination.


PDF Share
  1. Gupta SK, Saxena P, Jain S, et al. Prevalence and distribution of selected developmental dental anomalies in Indian population. J Oral Sci 2011;53(2):231–238. DOI: 10.2334/josnusd.53.231.
  2. Tiku A, Nadkarni U, Damle SG. Management of two unusual cases of dens invaginatus and talon cusp associated with other dental anomalies. J Indian Soc Ped Prev Dent 2004;22(3):128–133.
  3. Nagaveni NB, Umashankar KV. A clinical and radiographic retrospective analysis of talon cusps in ethnic Indian children. I Cranio Max Den 2014;3:79–84. DOI: 10.4103/2278-9588.138214.
  4. Kasat VO, Singh M, Saluja H, et al. Coexistence of two talon cusps and two dens invaginatus in a single tooth with associated radicular cyst-a case report and review of literature. J Clin Exp Dent 2014;6(4):430–434. DOI: 10.4317/jced.51421.
  5. Nagaveni NB, Shah R, Poornima P, et al. An unusual presentation of mesiodens tooth with talon cusp—report of four cases and literature review. J Res Pract Dent 2014;2014:1836911–1836917. DOI: 10.5171/2013.183691.
  6. Nagaveni NB, Umashankar KV, Sreedevi, et al. Multilobed mesiodens with a palatal talon cusp—a rare case report. Braz Dent J 2010;21(4):375–378. DOI: 10.1590/S0103-64402010000400016.
  7. de Sousa SMG, Tavano SMR, Bramante CM. Unusual case of bilateral talon cusp associated with dens invaginatus. Int Endo J 1999;32(6):494–498. DOI: 10.1046/j.1365-2591.1999.00243.x.
  8. Siraci E, Gungor HC, Cehreli ZC. Dens invaginatus and talon cusp co-occurring in a mandibular central incisor: a case report. J Dent Child 2008;75(2):177–180.
  9. Nagaveni NB, Umashankara KV, Vidyullatha BG, et al. Permanent mandibular incisor with multiple anomalies—report of a rare clinical case. Braz Dent J 2011;22(4):346–350. DOI: 10.1590/S0103-64402011000400015.
  10. Nagaveni NB, Pathak S, Anitha P, et al. An overview of dens invaginatus with report of 2 cases. J Clin Exp Pathol 2015;5(4):238. DOI: 10.4172/2161-0681.1000238.
  11. Fukuta Y, Totsuka M, Takeda Y, et al. A central tubercle on the lingual surface of the upper lateral incisor: report of a case. J Nihon Univ Sch Dent 1997;39(2):86–88. DOI: 10.2334/josnusd1959.39.86.
  12. McNamara CM, Garvey MT, Winter GB. Root abnormalities, talon cusps, dens invaginati with reduced alveolar bone levels: case report. Int J Paediatr Dent 1998;8(1):41–45. DOI: 10.1046/j.1365-263X.1998.00060.x.
  13. Lorena SC, Oliveira DT, Odellt EW. Multiple dental anomalies in the maxillary incisor region. J Oral Sci 2003;45(1):47–50. DOI: 10.2334/josnusd.45.47.
  14. Mupparapu M, Singer SR, Goodchild JH. Dens evaginatus and dens invaginatus in a maxillary lateral incisor: report of a rare occurrence and review of literature. Aust Dent J 2004;49(4):201–203. DOI: 10.1111/j.1834-7819.2004.tb00074.x.
  15. Anthonappa RP, Yiu CK, King NM. A novel combination of dens evaginatus and dens invaginatus in a single tooth—review of the literature and a case report. J Clin Pediatr Dent 2008;32(3):239–242. DOI: 10.17796/jcpd.32.3.ex27q2022065pt48.
  16. Sarraf-Shirazi A, Rezaiefar M, Forghani M. A rare case of multiple talon cusps in three siblings. Braz Dent J 2010;21(5):463–466. DOI: 10.1590/S0103-64402010000500015.
  17. Gangwar A, Singal D, Giri KY, et al. An immature type II dens invaginatus in a mandibular lateral incisor with talon's cusp: a clinical dilemma to confront. Cas Rep Dent 2014;2014:826294, 1–5. DOI: 10.1155/2014/826294.
  18. Lwin HNN, Yaw PP, Thu SWYM. Coexistence of true talon cusp and double dens invaginatus in a single tooth: a rare case report and review of the literature. Clin Cas Rep 2017;5(12):2017–2021. DOI: 10.1002/ccr3.1252.
  19. Hallett GE. Incidence, nature, and clinical significance of palatal invaginations in the maxillary incisor teeth. Proc R Soc Med 1953;46(7):491–499. DOI: 10.1177/003591575304600703.
  20. Oehlers FA. Dens invaginatus (dilated composite odontome). I. Variations of the invagination process and associated anterior crown forms. Oral Surg Oral Med Oral Pathol 1957;10(11):1204–1218. DOI: 10.1016/0030-4220(57)90077-4.
  21. Schulze C, Brand E. Über den dens invaginatus (dens in dente). ZWR 1972;81(12):569–573, 613–620, 653–660, 699–703.
  22. Hülsmann M. Dens invaginatus: aetiology, classification, prevalence, diagnosis, and treatment considerations. Int Endod J 1997;30(2): 79–90. DOI: 10.1111/j.1365-2591.1997.tb00679.x.
  23. Alani A. Dens invaginatus: a problem from the outside in. Int Dent J 2009;59(6):343–348.
  24. Steffen H, Splieth C. Conventional treatment de dens invaginatus in maxillary lateral incisor with sinus tract: one year follow-up. J Endod 2005;31(2):130–133. DOI: 10.1097/01.don.0000137637. 94281.82.
  25. Pawar AM, Kokate SR, Shah RA. Management of a large periapical lesion using Biodentine (™) as retrograde restoration with eighteen months evident follow up. J Conserv Dent 2013;16(6):573–575. DOI: 10.4103/0972-0707.120934.
  26. Vier-Pelisser FV, Pelisser A, Recuero LC, et al. Use of cone beam computed tomography in the diagnosis, planning and follow up of a type III dens invaginatus case. Int Endod J 2012;45(2):198–208. DOI: 10.1111/j.1365-2591.2011.01956.x.
  27. Kaneko T, Sakaue H, Okiji T, et al. Clinical management of dens invaginatus in a maxillary lateral incisor with the aid of cone-bean computed tomography: a case report. Dent Traumatol 2011;27(6):478–483. DOI: 10.1111/j.1600-9657.2011.01021.x.
  28. Hattab FN, Hazza'a AM. An unusual case of talon cusp on geminated tooth. J Can Dent Assoc 2001;67(5):263–266.
  29. Rocha Neto PCR, Oliveira LC, Oliveira MDC, et al. Dens invaginatus: case report. RGO 2015;63(2):219–226. DOI: 10.1590/1981-863720150002000132564.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.