Cone-Beam Computed Tomography (CBCT) Diagnosis of Dens Invaginatus: a Case Series

Authors

  • Maria José Fernández-Siguencia Universidad Católica de Cuenca
  • Geovanny Mauricio Vanegas-Abad Universidad de Chile

DOI:

https://doi.org/10.17533/udea.rfo.v38n1e362074

Keywords:

dens invaginatus, cone-beam computed tomography, tooth anomalies, diagnostic imaging

Abstract

Dens invaginatus, also known as dens in dente, is a developmental anomaly caused by the invagination of the enamel organ into the dental papilla prior to calcification. This malformation shows wide morphological variability and represents a diagnostic and therapeutic challenge, especially when it is not clinically evident. Three-dimensional imaging, such as cone-beam computed tomography (CBCT), enables precise and detailed identification of the anomaly. This study described the radiographic and tomographic characteristics of four clinical cases of dens invaginatus diagnosed by CBCT at a radiology center in Cuenca, Ecuador. An observational, descriptive, and retrospective study was conducted on four clinical cases diagnosed with dens invaginatus. Information was collected from existing tomographic records using CBCT scans obtained for routine clinical purposes. Images were analyzed to determine the type of invagination according to the Oehlers classification, as well as anatomical findings and potential clinical implications. Four cases of dental invagination were identified in maxillary lateral incisors (three cases) and one maxillary canine (one case). Three corresponded to Oehlers type II and one to type IIIA. No patients presented associated periapical lesions. CBCT enabled precise definition of the extent, morphology, and relationship with the pulp chamber. Early diagnosis of dens invaginatus using CBCT allows detailed characterization of the anomaly and the planning of conservative therapeutic approaches, helping to to prevent of complications such as pulp infections or invasive treatments.

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Author Biographies

Maria José Fernández-Siguencia, Universidad Católica de Cuenca

Odontóloga. Docente, Universidad Católica de Cuenca, Ecuador

Geovanny Mauricio Vanegas-Abad, Universidad de Chile

Especialista en Radiología Dento Máxilo Facial, Universidad de Chile. Práctica Privada

References

Hülsmann M. Dens invaginatus: aetiology, classification, prevalence, diagnosis and treatment considerations. Int Endod J. 1997; 30(2): 79–90. DOI: https://doi.org/10.1046/j.1365-2591.1997.00065.x

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(11): 1204–18. DOI: https://doi.org/10.1016/0030-4220(57)90077-4

Kusch-Noelke A, Zapata-Betancour D, Ruiz-García de Cahcón V. Dens invaginatus: revisión de literatura y reporte de cuatro casos. Revista OACTIVA UC Cuenca. 2018; 3(3): 33–6. DOI: https://doi.org/10.31984/oactiva.v3i3.275

Barzuna-Pacheco M. Dens in dente: anomalía dental difícil de tratar. Reporte de un caso clínico. Rev Cient Odontol. 2013; 9(2): 35–8.

Roldán MF, Jiménez BI, Xilotl P. Tratamiento endodóntico de un diente con Dens Invaginatus Oehlers tipo I: reporte de caso. Canal Abierto Rev Cient. 2019; 41(1): 28–32.

Dineshshankar J, Sivaraman S, Yasmeenahamed S, Tamilthangam P. Dens invaginatus: history, etiology, classification, clinical and radiographic features, histological findings and management. Saudi J Oral Dent Res. 2016; 1(3):151–5.

Kristoffersen Ø, Nag OH, Fristad I. Dens invaginatus and treatment options based on a classification system: report of a type II invagination. Int Endod J. 2008; 41(8): 702–9. DOI: https://doi.org/10.1111/j.1365-2591.2008.01399.x

Vier-Pelisser FV, Pelisser A, Recuero LC, Só MVR, Borba MG, Figueiredo JAP. Use of cone beam computed tomography in the diagnosis, planning and follow-up of a type III dens invaginatus case. Int Endod J. 2012; 45(2): 198–208. DOI: https://doi.org/10.1111/j.1365-2591.2011.01956.x

Zengin AZ, Sumer AP, Celenk P. Double dens invaginatus: report of three cases. Eur J Dent. 2009; 3(1): 67–70.

Domingos PM, Omokeji BA, Martins JNR, Quaresma SA, Pereira da Costa R, Ginjeira A. Endodontic management of developmental anomalies: conservation of invaginated tissues in type II dens invaginatus. Case series. Rev Port Estomatol Med Dent Cir Maxilofac. 2019; 60(1): 18–26. DOI: http://doi.org/10.24873/j.rpemd.2019.03.442

Alani A. Dens invaginatus: a problem from the outside in. Int Dent J. 2009; 59(6): 343–8.

Gound TG. Dens invaginatus: a pathway to pulpal pathology: a literature review. Pract Periodontics Aesthet Dent. 1997; 9(5): 585–94.

Gangwar A, Singal D, Giri KY, Agarwal A, Keerthi SS. Immature Type II dens invaginatus in a mandibular lateral incisor with talon cusp: a clinical dilemma. Case Rep Dent. 2014; 2014: 826294. DOI: https://doi.org/10.1155/2014/826294

Al-Mutairi LM, Khan AM. Cone-beam computed tomography versus rendered panoramic images in determination of dens invaginatus characteristics: retrospective cohort study. J Pharm Res Int. 2022; 34(40B): 20–8. DOI: https://doi.org/10.9734/jpri/2022/v34i40B36263

González-Mancilla S, Montero-Miralles P, Saúco-Márquez JJ, Areal-Quecuty V, Cabanillas-Balsera D, Segura-Egea JJ. Prevalence of Dens Invaginatus assessed by CBCT: systematic review and meta-analysis. J Clin Exp Dent. 2022; 14(11): 959–66. DOI: https://doi.org/10.4317/jced.59849

Sarı AH, Mağat G. Prevalence of dens invaginatus and its association with periapical lesions: a study using cone-beam computed tomography. J Endod Restor Dent. 2024; 2(2): 36–40. DOI: https://doi.org/10.5281/zenodo.13623834

LaLonde L, Askar M, Paurazas S. A novel diagnostic and treatment approach to an unusual case of dens invaginatus in a mandibular lateral incisor using CBCT and 3D printing technology. Dent J (Basel). 2024; 12(4): 107. DOI: https://doi.org/10.3390/dj12040107

Published

2026-02-25

How to Cite

Fernández-Siguencia, M. J., & Vanegas-Abad, G. M. (2026). Cone-Beam Computed Tomography (CBCT) Diagnosis of Dens Invaginatus: a Case Series. Revista Facultad De Odontología Universidad De Antioquia, 38(1), e362074. https://doi.org/10.17533/udea.rfo.v38n1e362074