A Case Report on Maxillary Canine Management of a Type II Dens Invaginatus with an Open Apex and a Large Periapical Lesion

Dens in dente was suggested by Busch in1897 implying the radiographic appearance of a tooth within a tooth. The term dens invaginatus, currently used, was introduced by Hallet 1953.The present report highlights a case of a type II Dens invaginatus involving a maxillary left canine associated with a large chronic periapical lesion treated with conventional endodontic treatment after ultrasonic removal of the invaginated tissue. These tissues were removed to better perform disinfection and instrumentation of the necrotic root canal system. Indeed Cone Beam Computed Tomography examination showed an evident communication from the dens invaginatus with the main root canal pulp. A post operative radiographic control revealed a dense and hermetic root filling, but infortunately, an apical shortage, due to an excessive use of collagen matrix was also evident.