The treatment of a maxillary lateral incisor with unusual morphology with long-term follow-up

Aim To report the treatment of an unusual combination of one dens evaginatus and two dens invaginatus in a single tooth and its healing outcome after 10 years. Summary The long-term outcome of a maxillary lateral incisor with dens evaginatus combined with two Oehlers type II dens invaginatus and a large periradicular lesion in an 11-year-old female treated endodontically and restoratively is described. The endodontic treatment included intracanal medication with calcium hydroxide and canal filling using a thermoplastic root canal filling technique. The crown was restored with conventional composite resin. During periodic clinical and radiographic follow-up, the patient remained symptom free, and the periradicular region was completely healed, meeting both aesthetic and functional expectations after 10 years. Key learning points The co-occurrence of dens evaginatus and two dens invaginatus in the same tooth is an unusual finding that compromises aesthetics and predisposes the patient to dental pulp infection. The complex morphology observed in this case represented both endodontic and restorative challenges.