A multidisciplinary management of a type III dens invaginatus in a maxillary permanent canine.

BACKGROUND: Dens invaginatus affects 0.3-10% of the population; however, few reports document its occurrence in maxillary canines. Management of associated periradicular infections is often challenging. The benefits of computed tomography are well documented in these situations, providing greater clinical information for diagnosis, prognosis and practical management. Many previous reports in the literature utilise this technology but often focus on an endodontic management approach. CASE REPORT: Details of the treatment of a complex type III invagination affecting a maxillary canine, combined with hypodontia and malocclusion is described. Endodontic treatment was deemed inappropriate resulting in extraction of the invaginated canine. The multidisciplinary planning and approach, highlighted the need for close teamwork, shared care and a patient-centred approach. FOLLOW-UP: A 5-year follow-up and review recorded a successful outcome.
CONCLUSIONS: This case reinforces the importance of careful investigation and planning in ensuring an optimal outcome when addressing multiple dental anomalies. Extensive consideration of the initial treatment strategy is required, coupled with evaluation of the outcome and longevity of any potential treatment modality to be employed. The consideration of inevitable future restorative treatment is fundamental, highlighting the importance of multidisciplinary planning at diagnosis. Moreover, orthodontic, aesthetic, behavioural and/or social factors may further complicate management in adolescents.