A patient reported with a history of pain in left mandibular region. Medical and familial history was noncontributory. The tooth responded to thermal and electrical stimuli; periodontal probing revealed a normal and intact periodontium. The tooth had an enamel projection in the center of its lingual surface with a deep lingual invagination with no evidence of caries . The radiographic examination showed a mature tooth with a dens invaginatus with periapical radiolucency . There was no sinus tract information
Local anesthesia was administered, rubber dam was placed and a wide mesio-distal oval shaped opening was made to provide adequate endodontic access. A central canal and two rudimentary canals on the mesial and distal side were found . There was no direct communication between the mesial and distal canals. Radiopaque dye was placed in the pulp chamber and three separate root canals were located by endogram. The canals were biomechanically prepared with Profile rotary and hand instruments and copiously irrigated with 3% sodium hydrochloride. Calcium hydroxide was inserted in all the canals and the tooth was temporarily sealed. After 3 weeks, tooth was obturated by vertical condensation . The patient returned for clinical and radiographic follow up for 1 year. Apical repair as well as absence of clinical symptoms was observed.
.
