Dens invaginatus

Dens invaginatus
Classification and external resources
ICD-10 K00.2
ICD-9-CM 520.2

Dens invaginatus, also known as dens in dente ("tooth within a tooth") is a condition found in teeth where the outer surface folds inward. There are coronal and radicular forms, with the coronal form being more common.

Dens invaginatus is a malformation of teeth most likely resulting from an infolding of the dental papilla during tooth development or invagination of all layers of the enamel organ in dental papillae. Affected teeth show a deep infolding of enamel and dentine starting from the foramen coecum or even the tip of the cusps and which may extend deep into the root. Teeth most affected are maxillary lateral incisors and bilateral occurrence is not uncommon. The malformation shows a broad spectrum of morphologic variations and frequently results in early pulp necrosis. Root canal therapy may present severe problems because of the complex anatomy of the teeth. Aetiology, prevalence, classification, and therapeutic considerations including root canal therapy, apical surgery and prevention of pulpal involvement are reviewed.

Etiology 1-increased localised pressure. 2- focal growth retardation and stimulation.

Types 1-coronal 2-radicular


Type 1-That is confined to the crown
Type 2-Extend below CEJ and ends in a blind sac that may or may not communicate with adjacent dental pulp
Type 3-Extend to the root and perforate in the apex or lateral radicular area without communicating the pulp

Clinical case

A patient presents with symptoms of an acute abscess on the maxillary left lateral incisor. There are no clinical signs of decay or restoration. The cause can be evaluated radiographically.


Invaginatus is an anomaly resulting from invagination forming within the enamel organ. Invagination ranges pitting occupying most of the crown and root. Although examination may reveal a fissure on the surface of anterior tooth, radiographic examination is the way.[1]


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