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Case Reports
. 2022 Feb 4;12(2):94-98.
doi: 10.4103/jmau.jmau_50_21. eCollection 2024 Apr-Jun.

Radicular Cyst Associated with Type 3B Dens Invaginatus in a Permanent Maxillary Lateral Incisor

D B Nandini  1 , Bhoomika Devi Wairokpam  2 , Koijam Sashikumar Singh  3 , Braj Bhushan Mall  4
Affiliations
Case Reports

Radicular Cyst Associated with Type 3B Dens Invaginatus in a Permanent Maxillary Lateral Incisor

D B Nandini et al. J Microsc Ultrastruct. .

Abstract

Dens invaginatus (DI) is a developmental abnormality of the tooth resulting in the invagination of the enamel organ into the dental papilla before the calcification of dental tissues. DI is one of the common dental deformities, but its association with the radicular cyst (RC) is still very uncommon. Oehler's Type 3B DI has a deep invagination that extends apically communicating with the apical area. This allows the entry of irritants predisposing for dental caries, periapical lesions, and pulp pathology if there is a communication with pulp. The sequelae of undiagnosed and untreated coronal invaginations include abscess formation, retention of neighboring teeth, displacement of teeth, cysts, and internal resorption. Identifying this anomaly early will prevent further complications. This presentation describes a case of RC associated with Type 3B DI in a permanent maxillary lateral incisor in a 9-year-old girl. A brief review of both pathologies is also discussed.

Keywords: Complications; Type 3B; dens invaginatus; inflammation; periapical cyst; pulpitis; radicular cyst.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Extraoral photograph showing mild swelling and elevation of left ala of the nose and upper lip
Figure 2
Figure 2
Intraoral photograph showing (a) slight swelling in the left front tooth region, (b) left permanent maxillary lateral incisor with a deep palatal pit and slight discoloration
Figure 3
Figure 3
Radiographic examination revealed (a) orthopantomograph showing Type 3B dens invaginatus and periapical radiolucency in relation to left permanent maxillary lateral incisor and root resorption of left deciduous maxillary canine, (b) intraoral periapical radiograph. (c and d) Computed tomography showing an expansile hypodense lesion with thinning of cortical bone in relation to left permanent maxillary lateral incisor and displacement of permanent maxillary canine superiorly
Figure 4
Figure 4
Intraoperative photograph showing (a) elevation of mucoperiosteal flap and (b) complete enucleation of the cyst
Figure 5
Figure 5
Photomicrographs showing (a) cystic lumen, epithelial lining, and connective tissue capsule. (b) Nonkeratinized stratified squamous epithelium showing arcading pattern with connective tissue cores. (c) Connective tissue capsule showing dense inflammatory cell infiltrate predominantly comprising of lymphocytes, collagen fibers, blood vessels, and few extravasated red blood cells
Figure 6
Figure 6
Coronal and radicular variety of dens invaginatus
See this image and copyright information in PMC

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