Dens in dente. Report of three cases

Abstract

Dens in dente (dens invaginatus, dilated odontoma, invaginated odontoma, dilated composite odontoma) is a relatively rare dental anomaly which can occur in the crown or root of a tooth.l-s Tomes, in 1859, was the first to describe a case of this condition. The accepted and usual term dens in dente means literally (‘a tooth within a tooth, ” but this has never been reported.4 The condition is, rather, an enamel organ invagination of variable degree, for which reason Oehlers has proposed the more logical and descriptive name, dens invaginatus.3 PATHOGENESIS The coronal type of dens in dente is caused by an enamel organ invagination during the developmental period of the tooth. It occurs by projection of that invagination into the dentine papilla6 or, as another author5 states, “by the retarded growth of a portion of a single tooth germ.” The result is an enamellined central cavity with a small external opening. The radicular type is caused by “proliferation of the epithelial cells causing an apical ingrowth into the dentine papilla,“l and the result is a radicular invagination limited by cementum.z Different authors classify coronal dens in dente according to the degree of invagination, but recently Ulmansky and Hermel have suggested the term incipient for minor involvement. The most frequently affected teeth are the permanent upper lateral incisors. Negroes are almost free of this anomaly.8