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http://dx.doi.org/10.5933/JKAPD.2022.49.2.158

A Retrospective Study on the Treatment of Dens Evaginatus for the Last 5 Years  

Jonghwa, Lim (Department of Pediatric Dentistry, School of Dentistry, Kyungpook National University)
Gimin, Kim (Department of Pediatric Dentistry, School of Dentistry, Kyungpook National University)
Jaesik, Lee (Department of Pediatric Dentistry, School of Dentistry, Kyungpook National University)
Soonhyeun, Nam (Department of Pediatric Dentistry, School of Dentistry, Kyungpook National University)
Hyunjung, Kim (Department of Pediatric Dentistry, School of Dentistry, Kyungpook National University)
Publication Information
Journal of the korean academy of Pediatric Dentistry / v.49, no.2, 2022 , pp. 158-169 More about this Journal
Abstract
The purpose of this study was to analyze treatment methods, results, timings and clinical signs and symptoms in failed cases of each treatment method of dens evaginatus on the premolar areas. In this study, 151 patients and 417 teeth were included. Resin restoration and direct pulp capping as preventive treatment and pulp revascularization, apexification and conventional endodontic treatment as endodontic treatment were included for treatment methods. In the preventive resin restoration, successful results were shown in the intact tubercles and also effective when the tubercles were fractured. In the direct pulp capping, resolved clinical symptoms and growth of the roots were shown when there was only pain during chewing without apical lesion. Apical lesion was the most common pretreatment signs and symptoms of the pulp revascularization, apexification and conventional endodontic treatment. In the pulp revascularization, successful results was obtained in most cases. But in some cases, root length or root wall thickness was not increased. Effective results were shown both of the apexification and conventional endodontic treatment. In order to increase success rate of preventive treatment of dens evaginatus, resin restoration was required to be done when tubercle did not occluded or in the presence of intact tubercles. When tubercle was fractured, root development stage and pulp condition should be considered for successful treatment.
Keywords
Dens evaginatus; Preventive resin restoration; Direct pulp capping; Pulp revascularization; Apexification; Conventional endodontic treatment;
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Times Cited By KSCI : 1  (Citation Analysis)
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1 Dankner E, Harari D, Rotstein I : Conservative treatment of dens evaginatus of anterior teeth. Dent Traumatol, 12:206-208, 1996.    DOI
2 Richardson DS, Knudson KG : Talon cusp: a preventive approach to treatment. J Am Dent Assoc, 110:60-62, 1985.    DOI
3 Koh ET, Ford TP, Torabinejad M, et al. : Prophylactic treatment of dens evaginatus using mineral trioxide aggregate. J Endod, 27:540-542, 2001.    DOI
4 Reynolds K, Johnson JD, Cohenca N : Pulp revascularization of necrotic bilateral bicuspids using a modified novel technique to eliminate potential coronal discolouration: a case report. Int Endod J, 42:84-92, 2009.    DOI
5 Wen PH, Liou JU, Duh BR : Apexification of nonvital immature mandibular premolars using two different techniques. J Dent Sci, 4:96-101, 2009.    DOI
6 Chen JW, Huang GTJ, Bakland LK : Dens evaginatus: Current treatment options. J Am Dent Assoc, 151:358-367, 2020.    DOI
7 Demirjian A, Goldstein H, Tanner JM : A new system of dental age assessment. Human Biol, 45:211-227, 1973. 
8 European Society of Endodontology : Quality guidelines for endodontic treatment: consensus report of the European Society of Endodontology. Int Endod J, 39:921-930, 2006.    DOI
9 Bose R, Nummikoski P, Hargreaves K : A retrospective evaluation of radiographic outcomes in immature teeth with necrotic root canal systems treated with regenerative endodontic procedures. J Endod, 35:1343-1349, 2009.    DOI
10 Law AS : Considerations for regeneration procedures. Pediatr Dent, 35:141-152, 2013. 
11 Yang J, Zhao Y, Qin M, Ge L : Pulp revascularization of immature dens invaginatus with periapical periodontitis. J Endod, 39:288-292, 2013.    DOI
12 Suksamai S : The prevalence of dens evaginatus and apical periodontitis in dens evaginatus in a group of Thai school children. CU Dent J, 31:43-52, 2008. 
13 Tratman FK : An unrecorded form of the simplest type of dilated composite odontome. Br Dent J, 86:271-275, 1949. 
14 Yong SL : Prophylactic treatment of dens evaginatus. J Dent Child, 41:289-292, 1974. 
15 Bazan MT, Dawson LR : Protection of dens evaginatus with pit and fissure sealant. J Dent for Child, 50:361-363, 1983. 
16 Hill FJ, Bellis WJ : Dens evaginatus and its management. Br Dent J, 156:400-402, 1984. 
17 Shey Z, Eytel R : Clinical management of an unusual case of dens evaginatus in a maxillary central incisor. J Am Dent Assoc, 106:346-348, 1983. 
18 Bedi R, Pitts NB : Dens evaginatus in the Hong Kong Chinese population. Dent Traumatol, 4:104-107, 1988.    DOI
19 Iwaya SI, Ikawa M, Kubota M : Revascularization of an immature permanent tooth with apical periodontitis and sinus tract. Dent Traumatol, 17:185-187, 2001.    DOI
20 Kawata T, Tanne K : Early detection of dens evaginatus appearing on the premolars and clinical management: histological study. J Clin Pediatr Dent, 26:199-201, 2003.    DOI
21 Kim JC : I. Pulp capping. JKDA, 25:1001-1004, 1987. 
22 Tziafas D : The future role of a molecular approach to pulp-dentinal regeneration. Caries Res, 38:314-320, 2004.    DOI
23 Stecker S, DiANGELIS AJ : Dens evaginatus: a diagnostic and treatment challenge. J Am Dent Assoc, 133:190-193, 2002.    DOI
24 Bezgin T, Sonmez H : Review of current concepts of revascularization/revitalization. Dent Traumatol, 31:267-273, 2015.   DOI
25 Echeverri EA, Wang MM, Chavaria C, Taylor DL : Multiple dens evaginatus: diagnosis, management, and complications: case report. Pediatr Dent, 16:314-317, 1994. 
26 Mulyawati E, Santosa P, Nugraheni T : Revascularization of nonvital immature incisor with asymptomatic apical periodontitis. Sci Dent J, 4:134-141, 2020.    DOI
27 Jeong HK, Lee NY, Lee SH : A retrospective study of critical success factors in regenerative endodontic treatment. J Korean Acad Pediatr Dent, 44:47-55, 2017.    DOI
28 Thomas MS, Ankita S, Reddy KS : Dens evaginatus-A hidden pathway to the dental pulp. Int J Clin Dent, 12:299-305, 2019. 
29 Stewart RE, Dixon GH, Graber RB : Dens evaginatus (tuberculated cusps): genetic and treatment considerations. Oral Surg Oral Med Oral Pathol, 46:831-836, 1978.    DOI
30 Yip WK : The prevalence of dens evaginatus. Oral Surg Oral Med Oral Pathol, 38:80-87, 1974.    DOI
31 Oehlers FAC : The tuberculated premolar. Dent Pract Dent Rec, 6:144-148, 1956. 
32 Sim TPC : Management of dens evaginatus: evaluation of two prophylactic treatment methods. Dent Traumatol, 12:137-140, 1996.    DOI
33 Merrill RG : Occlusal anomalous tubercles on premolars of Alaskan Eskimos and Indians. Oral Surg Oral Med Oral Pathol, 17:484-496, 1964.    DOI
34 Oehlers FA : Dens evaginatus (evaginated odontome). Its structure and responses to external stimuli. Dent Pract Dent Rec, 17:239-244, 1967. 
35 Levitan ME, Himel VT : Dens evaginatus: literature review, pathophysiology, and comprehensive treatment regimen. J Endod, 32:1-9, 2006.    DOI
36 Ju Y : Dens evaginatus: a difficult diagnostic problem? J Clin Pediatr Dent, 15:247-248, 1991.