Non-Surgical Endodontic Management of Type II Dens Invaginatus with Closed and Open Apex

Dens invaginatus (DI) is a developmental anomaly that poses a significant challenge to the clinician if endodontic treatment is required. The type II (as per Oehlers) form exhibits complex internal anatomy and is frequently associated with incomplete root and apex formation. The purpose of this study is to present two cases of type II DI in the maxillary lateral incisors. In the first case, non-surgical endodontic therapy was performed utilizing calcium hydroxide as an intracanal dressing, showing significant periapical healing of the apical radiolucent area at the six month follow-up. In the second case, the development of the root and apex were affected by pulp necrosis, and the revascularization procedure was performed. Complete resolution of the pre-existing apical radiolucency, apical closure, thickening of the root canal walls, and increase in root length, after 32 months was observed. Early detection of teeth with DI type II and proper exploration of their internal anatomy are key factors for their successful management. As demonstrated in this report, conservative non-surgical endodontic treatment should be the first line of treatment for these cases. The use of revascularization protocols in teeth that develop pulp necrosis and exhibit early stage of root development could be a better alternative than traditional apexification techniques.Keywords: Calcium Hydroxide; Close Apex; Dens Invaginatus; Open Apex; Revascularizatio

A Comparison of Files and Solvents to Remove Endodontic Materials

Objective. The objective of this study was to compare the effectiveness of two file systems with two solvents for the removal of endodontic obturation materials from teeth. Background. Gutta percha and RealSeal are two common endodontic obturation materials that must be removed to retreat teeth, however, the effectiveness of file systems and solvents to remove these materials is controversial. Methods. Human extracted teeth (n = 80) were instrumented and obturated with either Gutta- percha/ AH Plus cement (Dentsply DeTrey, Konstanz, Germany) or RealSeal (SybronEndo, Orange, CA) bonded obturation material according to manufacturer instructions. Each tooth was retreated using either one of two rotary instrumentation file systems: Protaper Retreatment Files (Dentsply, Tulsa, OK) or EndoSequence Files (Brasseler, Savannah, GA). Each of the file systems was tested using Chloroform Solvent or Orange Solvent retreatment agents. The teeth were processed for scanning electron microscopy and micrographs were categorized using a double blind scale for obturation material removal at 2000x magnification. Data was analyzed by Chi-square at a significance of 95%. Results. We found that Chloroform and Agent Orange are equally effective solvents to remove the obturation materials from the root canals of teeth (p \u3e 0.05). Both the Protaper Retreatment and EndoSequence file systems were also similarly effective (p \u3e 0.05). Conclusion. The use of the retreatment solvents: Chloroform and Agent Orange, and the Brassler Sequence and ProTaper files are equally effective to remove Gutta percha and RealSeal obtuation materials from the root canals of teeth. Grants. This research was sponsored by the NSU Health Professions Division