468:
For teeth with normal pulp and mature apex, reduce the opposing occluding tooth. Reinforce the tubercle by applying flowable composite. Occlusion, restoration, pulp and periapex assessment should be done yearly. When there is adequate pulp recession, tubercle can be removed and tooth can be restored.
472:
For teeth with normal pulp and immature apex, reduce the opposing occluding tooth. Apply flowable composite to the tubercle. Occlusion, restoration, pulp and periapex assessment should be done every 3–4 months until the apex matures. When there are signs of adequate pulp recession, tubercle can be
316:
The anterior DE tubercles have an average width of 3.5mm and length of 6.0mm, while posterior tubercles have an average 2.0mm in width and length of up to 3.5mm. If the cusp of
Carabelli is present, the tooth associated are often larger mesiodistally and it is not uncommon that a DE involved tooth
492:
If there is occlusal interference, the opposing projection should be reduced. Make sure that the tubercle does not contact other teeth in all excursive movement. This is usually done over a few appointments, 6 to 8 weeks apart to allow the formation of reparative
307:(usually periapical) - a V-shaped radiopaque structure could be seen superimposing on top of the affected crown. It could detect DE before tooth eruption. However, DE presentation on the radiograph can be quite similar to a mesiodens or a compound odontoma.
153:/occlusal surface of the teeth. The extra cusp can cause occlusal interference, displace of the affected tooth and/or opposing teeth, irritates the tongue when speaking and eating and decay the developmental grooves.
258:
The cause of DE is still unclear. There is literature indicating that DE is an isolated anomaly. During the bell stage of tooth formation, DE may occur as a result of an unusual growth and folding of the inner enamel
994:
979:
69:
are more likely to be affected than any other tooth. It could occur unilaterally or bilaterally. Dens evaginatus (DE) typically occurs bilaterally and symmetrically. This may be seen more frequently in
287:
Diagnosis of DE can be difficult when there is no signs and symptoms of necrotic or infected pulp. It is a challenging task to differentiate between a true periapical lesion and a normal periapical
454:
Perform direct or indirect pulp capping in cases with pulpal extension, to try increase the rate of reparative dentin formation (but may result in obliteration of the canal)
1037:
392:, a well defined additional cusp that projects palatally and extends at least half the distance from the cementoenamel junction (CEJ) to the incisal edge
718:"Bilateral dens evaginatus (talon cusp) in permanent maxillary lateral incisors: a rare developmental dental anomaly with great clinical significance"
925:
Koh ET, Ford TR, Kariyawasam SP, Chen NN, Torabinejad M (August 2001). "Prophylactic treatment of dens evaginatus using mineral trioxide aggregate".
360:
Oehlers classification, teeth categorized depending on the pulp contents within the tubercle (histological appearance of the pulps were examined)
550:
Echeverri EA, Wang MM, Chavaria C, Taylor DL (July 1994). "Multiple dens evaginatus: diagnosis, management, and complications: case report".
479:
For teeth with inflamed pulp and immature apex, shallow MTA pulpotomy could be performed and then restore with glass ionomer and composite.
168:
This cusp could be worn away or fractured easily. In 70% of the cases, the fine pulpal extension were exposed which can lead to infection,
1030:
101:
The prevalence of DE ranges from 0.06% to 7.7% depending on the race. It is more common in men than in women, more frequent in the
816:
Levitan ME, Himel VT (January 2006). "Dens evaginatus: literature review, pathophysiology, and comprehensive treatment regimen".
1253:
476:
For teeth with inflamed pulp and mature apex, conventional root canal treatment could be carried out and restored accordingly.
642:
HĂĽlsmann M (March 1997). "Dens invaginatus: aetiology, classification, prevalence, diagnosis, and treatment considerations".
30:
Tuberculated cusp, accessory tubercle, occlusal tuberculated premolar, Leong's premolar, evaginatus odontoma, occlusal pearl
1023:
425:
If the tooth involved is asymptomatic or small, no treatment is needed and a preventative approach should be taken.
114:
395:
Type 2 - Semitalon, an additional cusp that extends less than half the distance from the CEJ to the incisal edge
110:
122:
295:
Pulp tests (test results of immature teeth can be misleading, as they are known to give unreliable results)
482:
For teeth with necrotic pulp and mature apex, conventional root canal therapy could be done and restored.
324:
Schulge (1987) classification, teeth falls into 5 categories according to the location of the tubercles
501:
should be applied onto the ground surface. Recall the patient for follow-up after 3, 6 and 12 months.
1201:
126:
895:
Bazan MT, Dawson LR (September 1983). "Protection of dens evaginatus with pit and fissure sealant".
1211:
1160:
1196:
247:
154:
52:
1015:
1165:
79:
486:
485:
For teeth with necrotic pulp and immature apex, MTA root-end barrier could be carried out.
298:
Check and see if there is an elevated, flat wear facet on the occlusal surface of the tooth
8:
1124:
998:
138:
301:
Test cavity which has an absence of pain sensation and has an empty pulp chamber/ canal.
1139:
742:
717:
655:
272:
137:
It is important to diagnose DE early and provide appropriate treatment to help prevent
1003:
1170:
1051:
942:
938:
904:
874:
833:
747:
659:
559:
505:
200:
35:
869:
852:
1227:
1206:
1114:
1100:
934:
864:
825:
737:
729:
651:
498:
343:
Lau's classification, divide teeth into groups according to their anatomical shape
205:
150:
1232:
162:
158:
106:
87:
1175:
829:
383:
268:
264:
75:
988:
1247:
1180:
1047:
878:
509:
169:
118:
95:
733:
1155:
1134:
1119:
1095:
1090:
946:
837:
751:
663:
457:
Seal exposed dentin with microhybrid acid-etched flowable light-cured resin
432:
288:
276:
146:
71:
908:
563:
338:
Tubercle arising from the occlusal surface obliterating the central groove
1129:
1074:
304:
219:
83:
971:
1109:
1069:
389:
260:
60:
320:
There are 4 different ways to classify/ categorize DE involved teeth.
1065:
461:
91:
40:
851:
Borie E, Eduardo; Oporto V, Gonzalo; Aracena R, Daniel (June 2010).
442:
227:
191:
173:
102:
66:
1045:
233:
983:
494:
142:
56:
715:
549:
508:
could be considered (e.g. for orthodontic purposes, failed
451:
Frequent dental check-up, pay extra attention to fissures
850:
489:
layer and composite could be used to restore the tooth.
716:
Manuja N, Chaudhary S, Nagpal R, Rallan M (June 2013).
924:
853:"Dens evaginatus in Hemophilic Patient: A Case Report"
961:
329:Tubercle on the inclined plane of the lingual cusp
335:Tubercle on the inclined plane of the buccal cusp
1245:
1031:
157:pain could be experienced secondarily due to
815:
894:
59:where the outer surface appears to form an
1038:
1024:
291:of a dental follicle of an immature apex.
868:
741:
641:
464:with MTA using a modified Cvek technique
332:Cone-like enlargement of the buccal cusp
398:Type 3 - Trace talon, prominent cingula
179:
55:developmental anomaly that is found in
1246:
920:
918:
897:ASDC Journal of Dentistry for Children
890:
888:
811:
809:
807:
805:
803:
801:
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1019:
779:
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761:
691:
689:
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675:
673:
591:
589:
587:
585:
583:
581:
579:
577:
575:
573:
545:
241:Shallow groove in the lateral incisor
132:
543:
541:
539:
537:
535:
533:
531:
529:
527:
525:
915:
885:
857:International Journal of Morphology
473:removed and tooth can be restored.
188:Aesthetic and/or occlusion problems
129:are at a higher risk of having DE.
13:
758:
670:
656:10.1111/j.1365-2591.1997.tb00679.x
570:
14:
1265:
957:
522:
372:Isolated pulp horn remnants (20%)
311:
115:incontinentia pigmenti achromians
939:10.1097/00004770-200108000-00010
644:International Endodontic Journal
870:10.4067/S0717-95022010000200006
428:Preventative measures include:
844:
448:Application of fissure sealant
317:has an abnormal root pattern.
1:
1254:Developmental tooth disorders
515:
420:
380:Hattab et al. classification
369:Constricted pulp horns (14%)
282:
7:
145:, pulpal complications and
10:
1270:
830:10.1016/j.joen.2005.10.009
111:Ellis-van Creveld syndrome
1220:
1202:Dentinogenesis imperfecta
1189:
1148:
1083:
1058:
965:
123:Rubinstein-Taybi syndrome
34:
26:
21:
1212:Regional odontodysplasia
1161:Regional odontodysplasia
253:
238:Prominent marginal ridge
1197:Amelogenesis imperfecta
734:10.1136/bcr-2013-009184
441:Application of topical
366:Narrow pulp horns (22%)
155:Temporomandibular joint
927:Journal of Endodontics
818:Journal of Endodontics
412:Palatal DE/ Lingual DE
497:to protect the pulp.
438:Scaling and polishing
363:Wide pulp horns (34%)
244:Shovel-shaped incisor
185:Additional tubercules
127:Sturge Weber syndrome
180:Associated anomalies
1166:Turner's hypoplasia
1140:Supernumerary roots
552:Pediatric Dentistry
149:. It occurs on the
139:periodontal disease
375:No pulp horn (10%)
273:stellate reticulum
133:Signs and symptoms
61:extra bump or cusp
1241:
1240:
1171:Enamel hypoplasia
1052:tooth abnormality
1013:
1012:
728:: bcr2013009184.
201:cusp of Carabelli
46:
45:
16:Medical condition
1261:
1228:Dental fluorosis
1207:Dentin dysplasia
1190:Other hereditary
1115:Dens invaginatus
1040:
1033:
1026:
1017:
1016:
963:
962:
951:
950:
922:
913:
912:
892:
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882:
872:
848:
842:
841:
813:
756:
755:
745:
722:BMJ Case Reports
713:
668:
667:
639:
568:
567:
547:
499:Fluoride varnish
403:Posterior teeth
109:. Patients with
103:mandibular teeth
19:
18:
1269:
1268:
1264:
1263:
1262:
1260:
1259:
1258:
1244:
1243:
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1237:
1233:Tooth impaction
1216:
1185:
1144:
1106:Dens evaginatus
1079:
1054:
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1008:
974:
960:
955:
954:
923:
916:
893:
886:
849:
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814:
759:
714:
671:
640:
571:
548:
523:
518:
504:In some cases,
445:on reduced cusp
423:
314:
285:
265:ectomesenchymal
256:
234:lateral incisor
213:Labial drifting
182:
172:and periapical
170:pulpal necrosis
159:occlusal trauma
135:
107:maxillary teeth
49:Dens evaginatus
22:Dens evaginatus
17:
12:
11:
5:
1267:
1257:
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1214:
1209:
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1199:
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1191:
1187:
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1178:
1176:Ectopic enamel
1173:
1168:
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1142:
1137:
1132:
1127:
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1117:
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1103:
1098:
1093:
1087:
1085:
1084:Shape and size
1081:
1080:
1078:
1077:
1072:
1062:
1060:
1056:
1055:
1046:Developmental
1043:
1042:
1035:
1028:
1020:
1011:
1010:
1007:
1006:
991:
975:
970:
969:
967:
966:Classification
959:
958:External links
956:
953:
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914:
884:
863:(2): 375–378.
843:
757:
669:
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384:Anterior teeth
378:
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341:
340:
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312:Classification
310:
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284:
281:
269:dental papilla
255:
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217:
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161:caused by the
134:
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98:populations).
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9:
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1210:
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1198:
1195:
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1188:
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1181:Ectopic tooth
1179:
1177:
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1164:
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1049:
1048:tooth disease
1041:
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1021:
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1005:
1001:
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546:
544:
542:
540:
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536:
534:
532:
530:
528:
526:
521:
513:
511:
510:apexification
507:
502:
500:
496:
490:
488:
487:Glass ionomer
483:
480:
477:
474:
470:
463:
459:
456:
453:
450:
447:
444:
440:
437:
434:
431:
430:
429:
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411:
408:
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404:
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397:
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387:
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368:
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318:
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293:
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290:
280:
278:
274:
270:
266:
262:
249:
248:Supernumerary
246:
243:
240:
237:
235:
231:
229:
226:
223:
221:
218:
216:Labial groove
215:
212:
209:
207:
204:
202:
198:
196:Bifid cingula
195:
193:
190:
187:
184:
183:
177:
175:
171:
166:
164:
160:
156:
152:
148:
144:
140:
130:
128:
124:
120:
119:Mohr syndrome
116:
112:
108:
104:
99:
97:
93:
89:
85:
81:
77:
73:
68:
64:
62:
58:
54:
50:
42:
39:
37:
33:
29:
25:
20:
1156:Dilaceration
1135:Taurodontism
1120:Enamel pearl
1105:
1091:Concrescence
993:
978:
933:(8): 540–2.
930:
926:
903:(5): 361–3.
900:
896:
860:
856:
846:
821:
817:
725:
721:
650:(2): 79–90.
647:
643:
558:(4): 314–7.
555:
551:
503:
491:
484:
481:
478:
475:
471:
467:
433:Oral hygiene
427:
424:
319:
315:
289:radiolucency
286:
277:enamel organ
257:
199:Exaggerated
167:
147:malocclusion
136:
100:
65:
48:
47:
1130:Microdontia
1125:Macrodontia
1075:Hyperdontia
435:instruction
406:Occlusal DE
305:Radiographs
232:Peg-shaped
74:(including
53:odontogenic
27:Other names
1110:Talon cusp
1101:Gemination
1070:Hypodontia
824:(1): 1–9.
516:References
506:extraction
421:Management
261:epithelium
206:Gemination
51:is a rare
1149:Formation
1066:Anodontia
879:0717-9502
462:pulpotomy
409:Buccal DE
388:Type 1 -
283:Diagnosis
271:into the
267:cells of
220:Mesiodens
210:Impaction
105:than the
67:Premolars
41:Dentistry
36:Specialty
1248:Category
1059:Quantity
947:11501594
838:16410059
752:23813995
664:10332241
460:Perform
443:fluoride
352:Terraced
228:Odontoma
224:Megadont
192:Agenesis
174:pathosis
163:tubercle
151:cingulum
92:Filipino
88:Japanese
909:6580300
743:3702862
564:7937267
349:Grooved
275:of the
76:Chinese
1096:Fusion
945:
907:
877:
836:
750:
740:
662:
562:
495:dentin
355:Ridged
346:Smooth
143:caries
96:Indian
72:Asians
1221:Other
1004:520.2
989:K00.2
390:Talon
254:Cause
80:Malay
57:teeth
999:9-CM
943:PMID
905:PMID
875:ISSN
834:PMID
748:PMID
726:2013
660:PMID
560:PMID
263:and
125:and
94:and
84:Thai
995:ICD
980:ICD
935:doi
865:doi
826:doi
738:PMC
730:doi
652:doi
279:.
1250::
1002::
987::
984:10
941:.
931:27
929:.
917:^
901:50
899:.
887:^
873:.
861:28
859:.
855:.
832:.
822:32
820:.
760:^
746:.
736:.
724:.
720:.
672:^
658:.
648:30
646:.
572:^
556:16
554:.
524:^
512:)
176:.
165:.
141:,
121:,
117:,
113:,
90:,
86:,
82:,
78:,
63:.
1108:/
1068:/
1050:/
1039:e
1032:t
1025:v
997:-
982:-
972:D
949:.
937::
911:.
881:.
867::
840:.
828::
754:.
732::
666:.
654::
566:.
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