Management of internal root resorption in permanent tooth with dens invaginatus Type II: A clinical approach

Dens invaginatus (DI) is a developmental anomaly of variable prevalence, with Type II representing about 15% of cases. Its complex anatomy predisposes teeth to pulpal pathology and associated complications. Internal root resorption (IRR), though uncommon, can arise in such anatomically compromised teeth. This report presents the management and follow-up of a maxillary lateral incisor with IRR in association with DI Type II. A 42-year-old female patient presented with pain and a sinus tract in relation to the maxillary right lateral incisor. Clinical and radiographic examinations revealed DI Type II with IRR. Nonsurgical root canal treatment was performed, and the apical portion was sealed with mineral trioxide aggregate (MTA). The patient was asymptomatic during follow-up and exhibited periapical healing. Although a direct causal relationship between DI and IRR is not established, DI may predispose to pulpal changes that can complicate endodontic management. Early diagnosis, use of advanced imaging, and contemporary materials such as MTA are critical for successful outcomes.