Dens Evaginatus Case Study

Abstract: Dens evaginatus is an uncommon developmental anomaly of human dentition characterized by the presence of tubercle on the occlusal surface of mandibular premolars and lingual surface of anterior teeth. Due to occlusal trauma this tubercle tends to fracture thus exposing the pathway to the pulp chamber of teeth. This case report is about the presentation of dens evaginatus in mandibular premolars bilaterally, among them tooth 44 was associated with chronic apical periodontitis. Fractured tubercle of three premolars were sealed with composite resin. Root canal treatment was performed with tooth 44. Routine endodontic treatment did not result in remission of infection. Therefore, culture and sensitivity tests were performed to identify the cause and modify treatment plan accordingly. Triple antibiotic paste used as an intracanal medicament to disinfect the root canal that …show more content…
It consists of enamel covering a dentinal core that usually contains pulp tissue. The presence of pulp within the cusp-like tubercle has clinical significance and distinguishes it from supplemental cusps, such as cusp of carabelli.1 Early detection and management of this condition is important because trauma during mastication causes fracture or wear of the tubercle that leads to necrosis of pulp and periapical infection. This condition is predominantly found on the occlusal surface of mandibular premolars2, lingual surface of anterior teeth (mainly maxillary lateral incisors).3 Prevalence of DE studied in several population ranges from 1% to 4%,4 the prevalence was found to approximately 2% of Asian descent population.5 Higher rates of occurrence were reported among the Chinese population. 1.29%–3.6%.6 It is usually observed as bilateral, symmetric distribution, with a slight sexual predilection for