Smitha T, Venkatesh D, Veeresh M The cusp of Carabelli: Frequency, distribution and type in the Bengaluru population. J Oral Maxillofac Pathol. 2018; 22:418-422 https://doi.org/10.4103/jomfp.JOMFP_254_18
Mallineni SK, Panampally GK, Chen Y, Tian T. Mandibular talon cusps: A systematic review and data analysis. J Clin Exp Dent. 2014; 6:e408-13 https://doi.org/10.4317/jced.51476
Mavrodisz K, Rózsa N, Budai M Prevalence of accessory tooth cusps in a contemporary and ancestral Hungarian population. Eur J Orthod. 2007; 29:166-169 https://doi.org/10.1093/ejo/cjl084
Welbury R., 5th edn. Oxford: Oxford University Press; 2018
Rao YG, Guo LY, Tao HT. Multiple dens evaginatus of premolars and molars in Chinese dentition: a case report and literature review. Int J Oral Sci. 2010; 2:177-180 https://doi.org/10.4248/IJOS10052
Levitan ME, Himel VT. Dens evaginatus: literature review, pathophysiology, and comprehensive treatment regimen. J Endod. 2006; 32:1-9 https://doi.org/10.1016/j.joen.2005.10.009
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; 10:1204-1218 https://doi.org/10.1016/0030-4220(57)90077-4
Ridell K, Mejàre I, Matsson L. Dens invaginatus: a retrospective study of prophylactic invagination treatment. Int J Paediatr Dent. 2001; 11:92-97 https://doi.org/10.1046/j.1365-263x.2001.00234.x
Alani A, Bishop K, Knox J. Dens invaginatus as a microsymptom of canine ectopia: a case series. Orth Update. 2009; 2:90-93
Ash MM, Nelson SJ. Wheeler's Dental Anatomy, Physiology, and Occlusion, 8th edn. St Louis, MO, USA: Elsevier; 2003
Orton-Gibbs S, Crow V, Orton HS. Eruption of third permanent molars after the extraction of second permanent molars. Part 1: assessment of third molar position and size. Am J Orthod Dentofacial Orthop. 2001; 119:226-238 https://doi.org/10.1067/mod.2001.111556
Dens invaginatus occurs in varied forms with potential impact on the restorability, potential for pulpal infection of the tooth and difficulty in undertaking endodontic treatment of the tooth. Diagnosis of dens invaginatus and the particular type of dens invaginatus can be challenging. This article describes abnormality of crown morphology, a classification of dens invaginatus, and its pathology and illustrates the diagnosis and management of an unusual case of dens invaginatus in a maxillary left second permanent molar diagnosed with the help of CBCT.
CPD/Clinical Relevance: Dens invaginatus is a common occurrence and therefore all dentists need to have an appreciation of it.
Article
Anomalies of tooth formation can be difficult to decipher clinically. Teeth can be anomalous in size, structure, number and shape. Anomalies of the cuspal morphology can take the form of accessory cusps, dens evaginatus, and dens invaginatus (Figure 1).
Additional cusps are common and usually affect molar teeth. The most common is the cusp of Carabelli on the mesio-palatal line angle of the upper first permanent molar, which is present in 87% of the population1 and thus, may be considered normal. Incisors can have additional cusps from the palatal cingulum, ‘talon cusps’. These have a prevalence of 0.06–7.7%2 and occur most commonly in maxillary lateral incisors. The aetiology of accessory cusps is unknown. Genetic and exogenous factors may combine together to cause the cusp to develop.3 Additional cusps may be problematic for occlusal interference and aesthetics. They are often treated by repeatedly grinding the cusp over an extended period to reduce the height and allow reactionary dentine to form,4 but careful radiographic examination, ideally CBCT, should be carried out to find the exact extent of pulpal involvement and avoid an exposure. Selective grinding can have varied success, depending on the size of the cusp.
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