Clinical Effect Observation For 22 Cases Of Dens Invaginatus

Objective To observe the clinical efficacy of dens invaginatus（DI）and provide reference and medical records for the clinical treatment of DI.Methods A total of 22 patients who were diagnosed as DI in the Department of Dentistry and Endodontics of Stomatological Hospital Affiliated with Anhui Medical University from 2016 to 2021 were included.The clinical and radiographic data of each patient were analyzed in detail.Recording the type of DI,the treatment options,and the prognosis,and then evaluating the postoperative clinical effect.Results In this study,a total of 22 patients including 24 teeth,aged 10-53 years were included,and the observation time was 3-39 months.The number of Type Ⅰ DI teeth was 8,and there were 4 teeth with Type Ⅱ DI,1 tooth with Type Ⅲa DI.Among them were performed conservative treatment,including direct resin filling,root canal therapy,and apical barrier,and with the success rate of 100%.11 cases of Type Ⅲb DI with periapical lesions were treated with intentional replantation（IR）.During the follow-up period,9 teeth were functioning properly with no clinical and radiological signs of pathology,with a total survival rate of 81.8%.The other two teeth had complications after IR comprising recurrence of periapical radiolucency and sinus tract formation in one patient,and development of a mucosal fenestration in another.Both of these patients received additional surgery and showed marked improvements.Conclusion 1.The prognosis of conservative treatment of Type Ⅰ,Type Ⅱ,and Type Ⅲa DI was good,all the affected teeth were preserved and/ or maintained pulp vitality as far as possible.2.IR may be a reliable alternative for Type IIIb DI with a periapical lesion.However,some important concerns related to the procedure needed to be addressed to decrease the risks of adverse effects.