فهرست نشریات علمی دسترسی آزاد ایران

Background: Dens invaginatus (DI) is a developmental anomaly that presents both diagnostic and therapeutic challenges due to its complex internal anatomy and potential complications, such as caries and pulpal pathology. Often missed during initial orthodontic evaluations, DI can lead to early caries formation and pulpal necrosis, particularly in individuals with poor oral hygiene. Early detection is crucial for assessing its impact on orthodontic treatment planning, highlighting the need for a multidisciplinary approach. This study aimed to report the clinical efficacy of the non-surgical management of type II DI with a blunderbuss apex associated with a large periapical lesion.Case presentation: A 16-year-old female undergoing orthodontic treatment was referred to the endodontic department with a history of trauma from a bicycle fall four years earlier. She reported swelling and a dull, persistent ache in the maxillary left anterior region. The diagnosis was Oehlers' type II DI with pulp necrosis and a periapical abscess. Treatment included endodontic access, drainage, copious irrigation, ultrasonic activation, calcium hydroxide dressing, and obturation with mineral trioxide aggregate.Discussion: Nonsurgical endodontic management of type II DI with a periapical abscess resulted in successful long-term healing and functional restoration.