Type III dens in dente (dens invaginatus) as a reason for endodontic treatment failure - case report

Introduction. Dens invaginatus is an infrequent developmental anomaly of teeth with an unknown etiology. The prevalence rate ranges from 0.25% to 10%. The most affected teeth are lateral maxillary incisors. Various classifications have been proposed to categorize the different types of dens in dente. However, the Oehlers classification, named after the dentist who first described it, is the most commonly used for this malformation. This classification has three primary types and was introduced in 1957. Case Report. A 17-yearold female patient appeared at the Dentistry Clinic of Vojvodina, Novi Sad with a lateral maxillary incisor exhibiting dens invaginatus (Oehlers type IIIA). The pulp was necrotic, accompanied by a large periradicular lesion. The patient had previously been prescribed penicillin antibiotics, and we initiated endodontic therapy. The patient returned for the scheduled check-up appointment with swelling in the area of the canine fossa above the upper left lateral incisor. In consultation with an oral surgeon, the tooth was extracted with purulent content. Four days after the extraction, the patient received a resin bonded bridge. Conclusion. The clinical significance and importance of dens in dente lie primarily in its potential to manifest with various symptomatic indications and its association with the occurrence and development of dental caries. It is crucial for clinicians and dental professionals to remain highly attentive, vigilant, and alert to the potential presence of dens in dente. This involves considering and acknowledging the wide array of diverse presentations and manifestations that this anomaly can exhibit.