DENS EVAGINATUS FROM AN ORTHODONTIC PERSPECTIVE - REPORT OF SEVERAL CLINICAL CASES AND REVIEW, OF THE LITERATURE

The anomaly of dens evaginatus manifests itself as an innocuous-lookin g tubercle of enamel on the occlusal surface of a premolar tooth, Prob lems can arise when the tubercle is either worn, ground, or fractured off, resulting in pulpal exposure and possible loss of vitality of the tooth. Orthodontists should be particularly aware of this dental anom aly, which occurs in at least 2% of the Asian and Native Indian popula tion. Premolar extraction cases should be planned to include extractio n of the anomalous premolars instead of the normal ones. In addition, the orthodontist should be wary of occlusal changes during treatment o r occlusal equilibration that might jeopardize the vitality of teeth w ith dens evaginatus. Pulp-capping or partial pulpotomy has been postul ated as the most reliable form of treatment to prevent loss of vitalit y of the affected teeth and to allow continued root maturation where n ecessary.