A Rare Case of a Radicular Dens Invaginatus Associated with an Inflammatory Periapical Cyst

Abstract

Radicular Dens Invaginatus (RDI) represent a rare form of dens invaginatus which develops in the root of the tooth after the crown development is completed that can sometimes cause complex pathological conditions that are difficult to diagnose. This case report describes a case of a RDI associated with an inflammatory periapical cyst. A 17-year-old female complained of mobility in tooth 22. The tooth showed gyroversion and colour change and no evidence of caries or root fracture. Axial slices and tridimensional reconstruction of the cone-beam computed tomography revealed the presence of a RDI on the distal surface of the root that extended from cervical to the apical third. The diagnostic hypothesis was symptomatic infectious apical periodontitis, and conventional root canal treatment was performed. Subsequently, it was opted for a complementary surgical approach, which involved an aspiration puncture bulletin with a collection of yellow-citrus liquid, periapical curettage, apicectomy, retro-preparation and retrofilling with Mineral Trioxide Aggregate (MTA). Histopathological examination revealed was inflammatory periapical cyst. After 3-years, repair of the area was evident. Surgical management of this rare condition can be favourable for resolving endodontic infection related to this dental anomoly.

Keywords

• cone-beam computed tomography
• dens in dente
• palatogingival groove
• radicular cyst
• root canal treatment