(TC51) Dental Pulp Preservation in the Management of Bilateral Dens Evaginatus

Title: Dental Pulp Preservation in the Management of Bilateral Dens Evaginatus with 1-yr Follow-up.
 
Authors: Ethan Do, DDS, Jeff Buizastrow, DDS

Dens evaginatus (DE) is a relatively rare dental anomaly, historically more prevalent among individuals of Asian, Alaska Native, Inuit, and American Indian descent. Patients with DE are prone to complications such as tubercle fractures, which can lead to pulp exposure, infection, and necrosis. This case report presents the management of a significant case of bilateral dens evaginatus using a pulp preservation approach. A 16-year-old male patient of Latin American descent presented with pulp necrosis and a chronic apical abscess affecting his maxillary premolars. Rather than employing conventional root canal therapy, the treatment protocol focused on preserving the remaining pulp tissue using sodium hypochlorite, calcium hydroxide, and mineral trioxide aggregate. At the one-month follow-up, the patient showed resolution of clinical symptoms, including the absence of pain and sinus tract. Radiographic evaluations over one year demonstrated significant healing of the periapical region. This case underscores the potential of pulpal preservation techniques to maintain the long-term health and functionality of teeth affected by dens evaginatus. 

Keywords:
Dens Evaginatus, Odontoblasts, Pulp Preservation, Regenerative Endodontics