Integrated Endodontic Therapy and Cyst Enucleation in Dens Invaginatus Type II: A Case Report

Abstract

Dens invaginatus Type II poses endodontic challenges due to its complex anatomy and early pulpal involvement. This case describes the management of a tooth with Type II dens invaginatus complicated by external root resorption and a periapical cyst. Nonsurgical endodontic treatment was performed with careful debridement and disinfection of the intricate canal system, and calcium hydroxide was placed as an intracanal medicament to enhance microbial control and arrest resorptive activity thorough canal disinfection. After adequate disinfection, the canal was obturated to achieve a hermetic seal. Due to the persistent periapical cyst and associated fenestration, surgical enucleation was carried out, followed by placement of platelet-rich fibrin (PRF) to enhance healing. A Periocol membrane was used to manage the bony defect and support tissue regeneration. This combined approach resulted in successful management and favorable healing outcomes.