Dens invaginatus

Case contributed by Dr Henry Knipe


Assessment of dental anatomy, tooth 22.

Patient Data

Age: 30 years
Gender: Female



22: Deep invagination along the distal surface of the tooth extending to the cementoenamel junction and this may communicate with the pulpal cavity. Abnormal enamel density at the lingual aspect of the crown. There appears to be an accessory root with periapical lucency around both roots and severe focal alveolar bone loss extending to both the distal surface of 21 and the mesial surface of 23.

Annotated image

Deep invagination (red arrows) along the distal surface of the tooth.

Case Discussion

The notation for teeth in this case is the International/ISO standard, and by Universal standard the case would refer to tooth 10 instead of 22. The findings are in keeping with dens invaginatus of tooth 22 (ISO) with an extensive perioendo lesion. Dens invaginatus is a developmental lesion that results from invagination of the crown or root surface prior to tooth mineralization 1

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