Clinical Management of Dens Evaginatus on Premolars

Abstract

Clinical Management of Dens Evaginatus on Premolars

Siwaporn  Sukaram B.Sc., D.D.S., Grad.Dip.In Clin.Sc. (Pediatric Dentistry)

Dental Department, Ratchaphiphat Hospital

The purpose of this article is to report the success in clinical management of twenty two dens evaginatus teeth (DE) in eleven patients. Twenty non-pathological DE teeth were identified, all of which were asymptomatic and viable. Several types of clinical management were delivered as follows: sealant (6 teeth), sealant with indirect pulp capping (1 tooth), indirect pulp capping (10 teeth), direct pulp capping (1 tooth) and selective grinding (2 teeth). Follow up of these teeth revealed that all 20 teeth had no sign and no pathology, the pulps remained viability. In addition, two pathological DE teeth, secondary to fracture of the evagination, were treated. One had necrotic pulp and received apexification treatment to induce closure of the root apex. The other tooth received root canal treatment. Early diagnosis and prompt management should be sought to provide the greatest opportunity for complete root development and pulpal viability.

Key Words: Dens evaginatus, pulp capping, apexification treatment, root canal treatment

Vajira Med J 2004 ; 48 : 57 - 65