• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.1
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• pp.110-115
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• 2003

Dens evaginatus is an anomalous tooth development arising during morphodifferentiation. It is most often reported in premolar, and familial occurrence has been reported. The primary dental complication of dens evaginatus is fracture or wear of the tubercle which leads to pulp exposure, pulpal necrosis and periapical infection. Pathosis of the pulp can occur before complete root formation with cessation of root development. A rational and conservative approach to the management of dens evaginatus in vital teeth includes early diagnosis and treatment to prevent fracture or attrition of the tubercle. This treatment would include careful sequential grinding, pulp capping, preventive resin restoration. When presented with a case of dens evaginatus in a nonvital tooth with incomplete root development, the treatment of choice has been extraction, apexification. We report two cases of dens evaginatus that appear in two sisters. In the elder, a periapical lesion on radiographs is shown, and it is treated by calcium hydroxide apexification. The other sister is early recognized of dens evaginatus, it is treated using glass ionomer cement reinforcing with sequential grinding.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.11 no.1
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• pp.59-66
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• 1981

The dens evaginatus was a developmental variation which has arisen as a result of an evagination of inner enamel epithelium into the enamel organ. It has been given various. names by authors and was thought to be confined to Mongolian race. This study was performed to observe the incidence of dens evaginatus, and its ill-effects on the teeth and surrounding structures in 6356 Korean students and 10227 Korean adults. In plaster model, analysis was performed in accordance with forms and location of dens evaginatus on the. occlusal surface in the premolars. The pathologic changes caused by dens evaginatus were observed in paralleling periapical radiograms The results were as follows: 1. The prevalence of dens evaginatus in the student's group was 2.6%, and showed no sex predilection in the occurrence of evaginated teeth. 2. The sequence of dens evaginatus was in order of mandibular 2nd premolar, mandibular 1st premolar, maxillary 2nd premolar, and maxillary 1st premolar, respectively. 3. Of the cases with dens evaginatus, 73.5 % occured bilaterally. 4. The nipple form was the most frequent in respect of elevation of tubercle on the, occlusal surface. 5. In the base form of the tubercle, the occurrence of grooved form was the highest. 6. In the maxilla, those cases which the tubercle arose from the lingual ridge of the buccal cusp were most predominant. And in the mandible, those cases which the tubercle arose from the center of the occlusal surface were the most frequent. 7. The pulpal and periapical complications were shown in 24.4% of evaginated teeth in. periapical radiogram.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.2
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• pp.310-317
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• 2009

Dens evaginatus is a dental anomaly involving an extra cusp or tubercle that protrudes from the occlusal surface of the affected tooth. The prevalence of dens evaginatus is 1 to 4 percent, and dens evaginatus is observed most commonly in premolars. It can be worn or fractured easily, resulting in pulpal exposure, pulpal infection, loss of vitality, facial infection and osteomyelitis. Since the tooth frequently has the immature apex when the tubercle is fractured, there is difficulty in treatment. Although calcium hydroxide is widely used for pulp treatment of an immature permanent tooth, several alternatives have been suggested to reduce patient's appointments. Mineral trioxide aggregate is considered biocom-patible and has excellent marginal sealing ability. In addition, it can minimize patient's visits. In this case report, apexification with MTA was attempted on the immature premolars in patients with cellulitis patient, caused by pulp necrosis due to dens evaginatus. Favorable clinical and radiologic results were achieved. In one case, continued root formation was observed.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.24 no.1
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• pp.39-46
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• 1994

The purpose of this study was to evaluate the prevalence and distribution according to the types of tooth shape anomalies in permanent teeth of 6,082 persons by means of analysis of the full mouth periapical radiographs. And the following results were obtained ; 1. Among tooth shape anomalies, the highest incidence was observed on dilaceration (20.14%), foll owed by dens invaginatus(3.02%), peg lateralis(1.48%), taurodontism (0.34%), dens evaginatus (0.33%), talon cusp(0.20%), fusion(0.07%) and gemination(0%) in descending order of frequency. 2. Peg lateralis, dens invaginatus and dilaceration occurred more prevalent in females, and other types of tooth shape anomalies occurred more prevalent in males. 3. Dens evaginatus and taurodontism occurred with bilateral tendency, but other anomalies occur- ed with unilateral tendency. 4. As to the involved teeth, maxillary lateral incisors were the most frequently involved teeth on peg lateralis, dens invaginatus and talon cusp. And the mandibular premolars were the most frequently involved teeth on dens evaginatus, the maxillary first molars were on taurodontism, the maxillary second premolars were on dilaceration, and the mandibular incisors and canines were on fusion.

• The Journal of the Korean dental association
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• v.22 no.2 s.177
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• pp.96-96
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• 1984

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.2
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• pp.305-309
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• 2009

Dens evaginatus is a dental anomaly most commonly seen in premolar teeth in which a tubercle or protuberance projects from either the center of the occlusal surface or the buccal triangular ridge. These tubercles are easily fractured from mastication as the tooth erupts and frequently leads to pulp necrosis as a common complication. To prevent these sequelae, prophylactic treatment soon after the tooth starts erupting is essential. These preventive treatments include, selective grinding and protection of the tubercle by pit and fissure sealant. When the tooth does shows signs of pulp necrosis and apical periodontitis, endodontic procedures are needed. Apexification and apexogenesis are usually the treatment of choice for the affected teeth which have immature apices. Apexogenesis is a vital pulp therapy procedure performed to encourage continued physiological development and formation of the root end. It involves removal of the inflamed pulp and the placement of calcium hydroxide on the remaining healthy pulp tissue. This case report describes an atypical apexogenesis of a mandibular premolar which showed to be a dens evaginatus. The tooth which was treated with calcium hydroxide shows good results and is planned for permanent root canal filling.

• The Journal of the Korean dental association
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• v.28 no.11 s.258
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• pp.929-930
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• 1990

• The Journal of the Korean dental association
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• v.21 no.10 s.173
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• pp.766-766
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• 1983

• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.2
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• pp.158-169
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• 2022

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.

• Proceedings of the KACD Conference
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• 2007.05a
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• pp.295-295
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• 2007