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Background <p>Dens invaginatus (DI) is a developmental anomaly that most commonly affects maxillary lateral incisors, typically presenting as Oehlers type I or II. Its occurrence in molars is extremely rare. This case presents a type IIIb DI in a maxillary second molar, analyzed post-extraction using micro-computed tomography (micro-CT) and hematoxylin–eosin (H&amp;E) staining.</p> Case presentation <p>A 22-year-old female presented with persistent gingival swelling and a sinus tract near tooth 16 despite prior root canal therapy. A cone-beam computed tomography scan identified a type IIIb DI in tooth 17 with extensive periapical pathology extending to tooth 16. Tooth 17 was extracted due to a poor prognosis. Subsequent micro-CT imaging identified a concealed orifice of the invagination connecting to both the oral cavity and the apical. H&amp;E staining revealed detailed developmental anomalies. The three-month follow-up revealed favorable clinical and radiographic outcomes.</p> Conclusions <p>Micro-CT and histopathological analysis of the extracted DI-affected molar provided clear insights into its complex anatomy and developmental anomalies, potentially aiding more precise clinical assessment and evidence-based therapeutic decision-making in future cases.</p>

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Type IIIb dens invaginatus in a maxillary second molar and its microscopic anatomical features: a case report

  • 期刊论文

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  • 发表日期：

    2025年12月1日

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  • Mingming Li,
  • Zhiwu Wu,
  • Shaoying Duan,
  • Yuling Zuo

摘要

Background

Dens invaginatus (DI) is a developmental anomaly that most commonly affects maxillary lateral incisors, typically presenting as Oehlers type I or II. Its occurrence in molars is extremely rare. This case presents a type IIIb DI in a maxillary second molar, analyzed post-extraction using micro-computed tomography (micro-CT) and hematoxylin–eosin (H&E) staining.

Case presentation

A 22-year-old female presented with persistent gingival swelling and a sinus tract near tooth 16 despite prior root canal therapy. A cone-beam computed tomography scan identified a type IIIb DI in tooth 17 with extensive periapical pathology extending to tooth 16. Tooth 17 was extracted due to a poor prognosis. Subsequent micro-CT imaging identified a concealed orifice of the invagination connecting to both the oral cavity and the apical. H&E staining revealed detailed developmental anomalies. The three-month follow-up revealed favorable clinical and radiographic outcomes.

Conclusions

Micro-CT and histopathological analysis of the extracted DI-affected molar provided clear insights into its complex anatomy and developmental anomalies, potentially aiding more precise clinical assessment and evidence-based therapeutic decision-making in future cases.