This patient in early 20s visited our clinic with pain on lower left jaw.
General oral hygiene seemed fine with no visual caries.
Teeth #36, #35, #34 showed response to percussion and #35 showed pain to bite test. Looking close to #35, it seemed to be a dens evaginatus with a broken tip with history of resin restoration around the broken tip.
Let`s check x-ray.
Radiograph shows large periapical lesion over the teeth #35 with lower margin close to the mental nerve.
CT shows a lesion. We can tell this is a dens evaginatus with necrotic pulp.
What is dens evaginatus?
Dens evaginatus is an odontogenic developmental anomaly of a tooth where the outer surface appears to form an extra bump or cusp. Premolars are more likely to be affected. The extra cusp can cause occlusal interference, irritates on tongue and decay the developmental grooves. The cusp can be worn wary or fractured easily which could lead to infection, pulpal necrosis and periapical pathosis.
So, the patient agreed to do a root canal treatment immediately.
Once the chamber was opened, we could see dead pulp tissue floating.
Canal obturation was done.
The patient came in for regular check-up. After 9 months of canal obturation, we took an x-ray photo. Significant decrease in lesion size is shown. Also, patient was free of pain.
Conclusion : If you feel pain, visit our dental clinic ASAP. Its okay if you dont speak korean. We can always help you!