Endodontic management of a talon cusp and dens invaginatus in a mandibular lateral incisor: A case report

Nagarathna J¹ image, S.K. Srinath2 image, Bineeth M.K3 image, Harikrishnan V4 image, Revathi Murugan5 image

Highlights

Endodontic treatment of teeth with dens invaginatus is complex due to unusual root canal anatomy.

This case presents endodontic management of a mandibular lateral incisor with both talon’s cusp and dens invaginatus.

Early identification and prophylactic treatment of these morphological variations is Early diagnosis and preventive care of dental anomalies can prevent pulpal complications.

Abstract

Anomalies in tooth development represent deviations from normal morphogenesis and may arise due to disturbances in epithelial–mesenchymal interactions during odontogenesis. These disturbances can manifest as variations in the number, shape, size, or morphology of teeth. Talon cusp and dens invaginatus are rare developmental anomalies that present unique diagnostic and therapeutic challenges, particularly when coexisting in a single tooth. This case report describes the endodontic management of a 12-year-old male who presented with a dentoalveolar abscess in the lower anterior region, although the affected mandibular lateral incisor (tooth 42) appeared clinically intact and non-carious. Intraoral examination revealed a prominent talon cusp with a lingual pit on tooth 42, which also exhibited grade I mobility and tenderness on percussion. Radiographic and cone-beam computed tomography (CBCT) analyses revealed a Type II dens invaginatus with mesiobuccal deviation of the primary canal and a centrally located accessory invaginated canal. Access cavity preparation under rubber dam isolation revealed two distinct canal orifices. Endodontic treatment included negotiation and shaping of both canals, followed by intracanal medication with calcium hydroxide and obturation using the lateral condensation technique. The unique internal morphology necessitated tailored endodontic protocols supported by CBCT guidance. This report underscores the importance of recognizing rare morphological anomalies in pediatric patients and adopting a comprehensive diagnostic approach to ensure effective and conservative management of complex endodontic cases.

Keywords: Cone-Beam Computed Tomography; Dens Invaginatus; Incisor; Talon Cusp

Author Affiliations

  1. Assoc. Prof., Department of Pediatric and Preventive Dentistry, Government Dental College and Research Institute, India (Correspondence:nagarathnagiri_1975@yahoo.co.in)
  2. Prof., Department of Pediatric and Preventive Dentistry, Government Dental College and Research Institute, India
  3. Postgraduate student, Department of Pediatric and Preventive Dentistry, Government Dental College and Research Institute, India
  4. Postgraduate student, Department of Pediatric and Preventive Dentistry, Government Dental College and Research Institute, India
  5. Postgraduate student, Department of Pediatric  and Preventive Dentistry, Government Dental College and Research Institute, India
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Article Info

Contemp Pediatr Dent 2025:6(2):172-179

Received: 13 March 2025

Accepted: 25 July 2025

Online First: 05 August 2025

DOI: 10.51463/cpd.2025.15

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					Nagarathna J, S.K. Srinath, Bineeth M.K., Harikrishnan V, Revathi Murugan.   Endodontic management of a talon cusp and dens invaginatus in a mandibular lateral incisor: A case report. Contemp Pediatr Dent 2025:6(2):172-179

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