Dens evaginatus

Dens evaginatus is a rare odontogenic anomaly that is characterized by the presence of an extra cusp, known as a tubercle, on the occlusal surface of the tooth. This condition is most commonly seen in the premolar teeth, particularly the mandibular premolars. The tubercle of dens evaginatus is composed of enamel, dentin, and a variable amount of pulp tissue.

Etiology

The exact cause of dens evaginatus is unknown. However, it is believed to be a result of outward folding of the inner enamel epithelium and dental papilla during tooth development. This results in the formation of an extra cusp or tubercle on the occlusal surface of the tooth.

Clinical Features

Clinically, dens evaginatus presents as a tubercle on the occlusal surface of the tooth. This tubercle is typically composed of enamel and dentin, and may contain pulp tissue. The presence of pulp tissue within the tubercle can lead to complications such as pulp necrosis and periapical abscess if the tubercle is fractured or worn down.

Diagnosis

Diagnosis of dens evaginatus is typically made through clinical examination and radiographic imaging. On a radiograph, the tubercle of dens evaginatus appears as a radiopaque structure on the occlusal surface of the tooth.

Treatment

Treatment of dens evaginatus depends on the presence and extent of pulp involvement. If the pulp is not involved, the tubercle can be left untreated. However, if the pulp is involved, treatment options may include pulp capping, pulpotomy, root canal treatment, or extraction of the tooth.

Epidemiology

Dens evaginatus is a rare condition, with a reported prevalence of 0.06% to 0.9% in the general population. It is more commonly seen in individuals of Asian descent.

See Also

• Dens invaginatus
• Tooth development
• Tooth abnormalities