Article: Volume 47 Number 9 Page 706 - October 2020

  Dent Update 2020; 47: 706-712  Read article

Restorative dentistry:  Dens Evaginatus – ‘Addition Beats Subtraction’

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Abstract: This case describes the presentation of dens evaginatus on a maxillary central incisor in an 8-year-old Caucasian male, its subsequent monitoring and later management. Dens evaginatus is a dental anomaly most commonly noted as an accessory tubercle on the occlusal surface of premolars and the palatal aspect of incisors as a talon cusp. Complications can result in loss of pulp vitality, sometimes causing periapical periodontitis. Clinicians should be aware of the presentation and the advantages of different approaches to the management of dens evaginatus.

Clinical relevance: To raise awareness of dens evaginatus in dental professionals working in primary and secondary care.

Author notes: Khawer Ayub, BDS, MFDS RCPS(Glas), Specialty Registrar in Restorative Dentistry, King’s College Hospital Dental Institute and William Harvey Hospital, (email:, Sadia Khan, BDS, MFDS RCPS(Glas), Dental Core Trainee, Birmingham Dental Hospital and Martin Kelleher, BDS, MSc, FDS RCS(Ed), FDS RCS, FDS RCS(Eng), Consultant in Restorative Dentistry, Department of Restorative Dentistry and Traumatology, King’s College Hospital Dental Institute, London, UK.

Objective: To explain the problems of dens evaginatus and of modern management strategies.