Minimally Invasive Endodontic Treatment of a Maxillary Lateral Incisor With Invasive Cervical Resorption and Dens in Dente: A Case Report.

Abstract

Aim: This case report describes the conservative endodontic treatment of a maxillary lateral incisor affected by both dens invaginatus and invasive cervical resorption.

Case presentation: A maxillary lateral incisor (tooth 1.2), presenting with dens invaginatus and invasive cervical resorption, was diagnosed with irreversible acute pulpitis. Following 3D reconstruction using cone-beam computed tomography (CBCT), a minimally invasive root canal treatment was planned with a vestibular access through the resorption site to preserve as much tooth structure as possible. After removing the external resorptive tissue and placing a dental dam, the root canal system was shaped using modern rotary files in the martensitic phase. Subsequently, an effective irrigant activation protocol was implemented, and the canal was obturated with gutta-percha and a biosealer. After addressing the main root canal, the invaginated portion of the tooth was carefully treated to ensure complete disinfection and sealing.

Results: The treatment, guided by a suite of advanced diagnostic and endodontic technologies, achieved optimal care and preservation of the affected tooth. This use of cutting-edge tools in the field informs us of the possibilities for advanced care and preservation.

Conclusions: A one-year clinical and radiographic follow-up confirmed the treatment's success, demonstrating excellent clinical outcomes and tooth stability.