Translated Abstract
Purpose:
The prevalence of densinvaginatus is low, but the corresponding case report has been increasing in recent years. This paper intends to make a comprehensive and detailed review of the epidemiology, clinical feature, diagnosis and treatment of this disease through comprehensive literature search and analysis. To update previous literature reviews, through summarizing previous case reports and literatures.
Method:
A comprehensive search was conducted for all the related cases reported from 1998 to April 2017 through MEDLINE/PubMed, Web of Science and Wanfangdatabase.
Including: case reportsin Chinese or English articles; Objects of the studies was dens invaginatus; having detailed basic information, medical history and clinical examination; Articles including definite diagnosis and treatment. Exclusion: non-English articles;Reports with Incomplete records; the length of follow-upswere insufficient or missing; In vitro experiments or animal experiments.
All available literature references were searched repeatedly, until no new literatures appeared, to ensure all case reports which fitted the standard werenot missing in the search process. The information in the article was extracted and collected. The classification, clinical features, image findings, treatment options and prognosis were summarized. Statistical analysis was performed using frequency analysis method, SPSS was used.
Result:
Between 1998 and April 2017, a total of 195 English texts were collected, 4 of which were duplicated and 68 were not retrieved. A total of 49 Chinese literatures were collected, 1 of which was duplicated and 6 were not retrieved. A total of 165 cases (188 teeth) were recorded, among which 9 cases were invalid. Finally, 156 cases (179 teeth) were reported. The main results of this study are as follows:
1.During the recent 20 years, the number of case reports has been increasing gradually, but the trend is relatively gentle.
2. The distribution of dental invagination was evenly distributed between the sexes. Most of them occur in permanent dentition,while rarely occur in primary dentition. Dens invagination occurs most frequently in the maxillary lateral incisors, followed by the maxillary central incisors. Epidemiologically,the incidence of Oehlers dens invagination type Ⅲ is rare, and type Ⅰ is more common. However, the most reported cases are type Ⅲ, typeⅠ are the least.
3. In accordance of the clinical crowns,dens invaginatus can be divided into four types: abnormal depression, abnormal tooth profile, abnormal tip or protuberance and multiple malformations. Deformity of dens invaginatus is mainly abnormal depression. TheOehlers typeⅠ and the radicular type were the most obvious. The proportion of type Ⅰ to Ⅲ type is gradually reduced. The proportion of abnormal tooth profile increased gradually from typeⅠ to Ⅲ. In type Ⅲ, the abnormal depression andabnormal tooth profile teeth are similar in proportion.
4.Most patients with dens invagination visit for treatment because of periapical leision. The proportion increased with the complexity of the tooth invagination. On the contrary, the percentage of patients whoaccidentally found gradually decreased with the increase of the complexity. Oehlerstype Ⅰhas the largest proportion of teeth with normal pulp vitality. When patents came to visit, 77 cases (43%) of the apex were still unclosed, accounting for nearly half of the total number of teeth.
5. Treatment methods: the use of remove caries/preventive filling in the Oehlerstype Ⅰ was more than that of other types of teeth. Root canal treatmentwhich filling all root canals were more frequently used in Oehlers type Ⅲ than in type Ⅱ. Root canal treatmentafter removal of all invagination tissueswere more frequently used in Oehlerstype Ⅱ than in type Ⅲ. Root planning / open stenosis and root depressionfilling were used more frequently in radicular type than in various types. The treatment: root apexification,apex barrier, apex filling, intentional replantation and extraction arebalanced among various types of dens invagination.
Conclusion:
By extracting the data of patients’ basic information, clinical feature, diagnosis, treatment methods and follow-ups, analyzingresultsare as follows:
1. Through the analysis and summary of the clinical manifestations and characteristics of dens invagination collected in the cases, the results of previous studies were re-verified: the distribution of dens invagination was balanced among sexes; The upper permanent incisors were the most often occrence tooth postion, followed by the upper central incisors.
2.The clinical crown of the teeth was mainly abnormaldepression, especially theOehlers type I and the root type. With the aggravation of the internal subsidence, the proportion of theabnormal depression decreased and the proportion of the abnormal contour increased. The overall onset of the tooth is early, and it is easy to develop periapical periodontitis early.
3. The main points of diagnosis and treatment for various types of tooth invagination are as follows:Oehlers type Ⅰ is to preserve the vital pulp and restore beauty.Oehlers type Ⅱ is early detection and facilitatesapex development. Oehlers type Ⅲ is to thoroughly understand the root canal system and choose the appropriate treatment. Accurate diagnosis and localization of offended teeth are the key points for the treatment of radicular type dens invaginatus.
Translated Keyword
[Case Report, Clinical Feature, Dens Invaginatus, Literature Review, Treatment]
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