case_images: PMC11808325_01
case_images: A) Intrusion of primary right central incisor during early childhood; B) Delayed eruption of a permanent right central incisor; C) Erupted permanent right central incisor with an unusual morphology
case_images: IEJ-20-e9-g001.jpg
case_images: PMC11808325_01_IEJ-20-e9-g001.jpg
case_images: F1
case_images: There was a history of trauma to the primary right central incisor at the age of five (Figure 1A), which did not receive any treatment until it led to the delayed eruption of a permanent successor (Figure 1B). Afterward, the patient continued to be monitored by a pediatric dentist until his maxillary right central incisor erupted with an unusual form (Figure 1C).
case_images: A) Preoperative photograph indicating the sinus tract and unusual anatomy; B) The exaggerated cingulum in the palatal aspect of the right maxillary central incisor; C) Preoperative periapical radiograph indicating invagination and associated periapical pathosis; D) Periapical radiograph of tracing of the sinus tract; E) CBCT images (axial sections); F) CBCT images (coronal sections)
case_images: IEJ-20-e9-g002.jpg
case_images: PMC11808325_01_IEJ-20-e9-g002.jpg
case_images: F2
case_images: A sinus tract was also found in the mucosa adjacent to the tooth. (Figures 2A and 2B). A periapical lesion was found in the area where the gutta-percha was inserted (Figures 2C and 2D). of the CBCT images, a type IIIa dens invaginatus was identified, with a pseudo canal extending into the root and associated with the periapical lesion (Figures 2E and 2F).
case_images: PMC11808325_02
case_images: A) Access cavity preparation demonstrating two distinct canal orifices; B) K-files in both canals; C) Intraoperative periapical radiograph of length determination; D) Postoperative periapical radiograph immediately after obturation; E) Postoperative photograph after restoration and reshaping of the crown; F) Orthodontic forces were applied to the tooth three months after treatment; G) Six-month follow-up periapical radiograph; H) Fifteen-month follow-up periapical radiograph
case_images: IEJ-20-e9-g003.jpg
case_images: PMC11808325_02_IEJ-20-e9-g003.jpg
case_images: F3
case_images: After tooth isolation with a rubber dam, a small round bur (Jota, Ruthi, Switzerland) was used to prepare two access cavities to the main and pseudo canal (Figure 3A). Morita, Kyoto, Japan) and confirmed radiographically (Figures 3B and 3C). Finally, the composite resin (3M ESPE, St Paul, MN, USA) was used to restore the access cavity (Figures 3D and 3E). Three months following the treatment, the radiographic examination indicated the initial signs of healing, so orthodontic forces were applied to the tooth (Figure 3F). Radiographic assessment at the six-month follow-up revealed significant healing of the periapical lesion (Figure 3G). At the fifteen-month follow-up, cementogenesis and precipitate of cementum were observed at the root end adjacent to the CEM cement (Figure 3H).