Endodontic management of Dens Invaginatus using Dynamic Navigation System in pediatric patient: A Case Report

Authors

Ayesha S. Fathima, Saveetha institute of medical and technicals sciencesFollow
Sahana Selvaganesh, Saveetha Institute of Medical and Technical SciencesFollow
Ganesh Jeevanandan, Saveetha Institute of Medical and Technical SciencesFollow
Pradeep Solete, Saveetha Institute of Medical and Technical Sciences, Saveetha University,Follow
Prabahdevi C. Maganur, Jazan University, JazanFollow
Ather Syed Ahmed, Jazan university, Jazan, Saudi ArabiaFollow
Satish Vishwanathaiah Prof, Jazan university , JazanFollow

DOI

https://doi.org/10.70174/iajd.v16i1.1402

Abstract

Introduction:

Dens invaginatus, also known as dens in dente, is a dental anomaly resulting from infolding the enamel organ into the dental papilla. Dynamic Navigation Systems (DNS) like Navident offer real-time guidance during endodontic procedures, proving especially useful in complex cases, such as calcified canals or pulp obliteration.

Case Report: This case report presents a 13-year-old female with dens invaginatus in tooth 23, treated under DNS. The system facilitated precise canal localisation and minimized the risk of iatrogenic errors, resulting in a successful outcome with minimal postoperative discomfort. While DNS offers enhanced accuracy and precision, it requires strong hand-eye coordination and improved haptic feedback in the operator, posing challenges for clinicians. The calibration process begins with the trace registration of the patient's jaw with certain points selected on the CBCT of the patient loaded in the computer. The calibrator and a stylus tip tracer are used for the trace registration process. Dynamic navigation works with the triangulation theory and the trace registration of the patient's jaw was carried out by matching the data in the CBCT.

Despite these limitations, DNS has shown promise in improving treatment outcomes, particularly in complex endodontic cases. The system allowed precise localization of the root and precise apicoectomy with a minimal invasive cavity, avoiding iatrogenic errors. The whole procedure was performed in less than 45 minutes. Overall, the outcome of the treatment was considered a success with limited postoperative discomfort because of the minimally invasive technology. The healing was good at the controls after 6 months and 1 year. One year follow up also showed no complications, the periapical lesion has completely resolved. There was minimal to zero deviation from the original plan for the location of the canal, which resulted in the successful negotiation of the same.

Recommended Citation

Fathima, Ayesha S.; Selvaganesh, Sahana; Jeevanandan, Ganesh; Solete, Pradeep; Maganur, Prabahdevi C.; Ahmed, Ather Syed; and Vishwanathaiah, Satish Prof (2025) "Endodontic management of Dens Invaginatus using Dynamic Navigation System in pediatric patient: A Case Report," International Arab Journal of Dentistry: Vol. 16: Iss. 1, Article 16.
DOI: https://doi.org/10.70174/iajd.v16i1.1402
Available at: https://digitalcommons.aaru.edu.jo/iajd/vol16/iss1/16