Treatments of dentition with four dens evaginatus and reverse overbite: a case report with a 6-year follow-up

Abstract Background Dens evaginatus is a dental anomaly characterized by a conical cusp or tubercle on the occlusal surface. It is generally believed to be caused by the protrusion of the dental papilla toward the enamel organ during odontogenesis, followed by the formation of enamel, dentin, and de...

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Main Authors: Mengyin Luan, Qiang Wang, Yixuan Fang, Xiaoying Wang
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Oral Health
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Online Access:https://doi.org/10.1186/s12903-025-05953-z
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author Mengyin Luan
Qiang Wang
Yixuan Fang
Xiaoying Wang
author_facet Mengyin Luan
Qiang Wang
Yixuan Fang
Xiaoying Wang
author_sort Mengyin Luan
collection DOAJ
description Abstract Background Dens evaginatus is a dental anomaly characterized by a conical cusp or tubercle on the occlusal surface. It is generally believed to be caused by the protrusion of the dental papilla toward the enamel organ during odontogenesis, followed by the formation of enamel, dentin, and dental pulp. Owing to the abrasion of the occlusal surface, the protrusive cusp will be quickly worn off, uncovering the dental pulp tissue and thereby giving rise to pulpal or periapical disorders in the affected tooth. Abnormal occlusion can also exert an impetus in facilitating the wear process of dens evaginatus. Case presentation This article presents a case of a patient possessing dens evaginatus on four first premolars, leading to diverse consequences such as abnormal abrasion, acute apical abscess and periapical cysts. The patient also exhibited reverse overbite on the left side dentition, which potentially accounted for the varying degrees of wear on the dens evaginatus. Regarding teeth with different disorders, we had attained favorable therapeutic outcomes through various approaches including progressive grinding, root canal treatment, and periapical surgery, and had conducted follow-up for 6 years. The results indicated that the treatment effects were stable and the teeth functioned properly. Conclusion This report demonstrates effective therapeutic approaches for the diverse clinical manifestations resulting from dens evaginatus, and suggests that if a tooth was found with dens evaginatus during intraoral examination, other corresponding teeth should also be examined carefully. Occlusion anomalies may exert a promotional effect on the wear of the deformed central cusp.
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spelling doaj-art-3811752dd43b4ea1a742e070e6e80f672025-08-20T02:27:06ZengBMCBMC Oral Health1472-68312025-04-012511610.1186/s12903-025-05953-zTreatments of dentition with four dens evaginatus and reverse overbite: a case report with a 6-year follow-upMengyin Luan0Qiang Wang1Yixuan Fang2Xiaoying Wang3Department of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong UniversityJinan Key Medical and Health Laboratory of Oral Diseases and Tissue Regeneration, Shandong Provincial Key Medical and Health Laboratory of Oral Diseases and Tissue Regeneration, Jinan Stomatological HospitalDepartment of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong UniversityDepartment of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong UniversityAbstract Background Dens evaginatus is a dental anomaly characterized by a conical cusp or tubercle on the occlusal surface. It is generally believed to be caused by the protrusion of the dental papilla toward the enamel organ during odontogenesis, followed by the formation of enamel, dentin, and dental pulp. Owing to the abrasion of the occlusal surface, the protrusive cusp will be quickly worn off, uncovering the dental pulp tissue and thereby giving rise to pulpal or periapical disorders in the affected tooth. Abnormal occlusion can also exert an impetus in facilitating the wear process of dens evaginatus. Case presentation This article presents a case of a patient possessing dens evaginatus on four first premolars, leading to diverse consequences such as abnormal abrasion, acute apical abscess and periapical cysts. The patient also exhibited reverse overbite on the left side dentition, which potentially accounted for the varying degrees of wear on the dens evaginatus. Regarding teeth with different disorders, we had attained favorable therapeutic outcomes through various approaches including progressive grinding, root canal treatment, and periapical surgery, and had conducted follow-up for 6 years. The results indicated that the treatment effects were stable and the teeth functioned properly. Conclusion This report demonstrates effective therapeutic approaches for the diverse clinical manifestations resulting from dens evaginatus, and suggests that if a tooth was found with dens evaginatus during intraoral examination, other corresponding teeth should also be examined carefully. Occlusion anomalies may exert a promotional effect on the wear of the deformed central cusp.https://doi.org/10.1186/s12903-025-05953-zDens evaginatusPremolarApical periodontitisReverse overbite
spellingShingle Mengyin Luan
Qiang Wang
Yixuan Fang
Xiaoying Wang
Treatments of dentition with four dens evaginatus and reverse overbite: a case report with a 6-year follow-up
BMC Oral Health
Dens evaginatus
Premolar
Apical periodontitis
Reverse overbite
title Treatments of dentition with four dens evaginatus and reverse overbite: a case report with a 6-year follow-up
title_full Treatments of dentition with four dens evaginatus and reverse overbite: a case report with a 6-year follow-up
title_fullStr Treatments of dentition with four dens evaginatus and reverse overbite: a case report with a 6-year follow-up
title_full_unstemmed Treatments of dentition with four dens evaginatus and reverse overbite: a case report with a 6-year follow-up
title_short Treatments of dentition with four dens evaginatus and reverse overbite: a case report with a 6-year follow-up
title_sort treatments of dentition with four dens evaginatus and reverse overbite a case report with a 6 year follow up
topic Dens evaginatus
Premolar
Apical periodontitis
Reverse overbite
url https://doi.org/10.1186/s12903-025-05953-z
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AT yixuanfang treatmentsofdentitionwithfourdensevaginatusandreverseoverbiteacasereportwitha6yearfollowup
AT xiaoyingwang treatmentsofdentitionwithfourdensevaginatusandreverseoverbiteacasereportwitha6yearfollowup