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References

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Double Trouble: Rare Presentations of Molar Dens Evaginatus

From Volume 48, Issue 5, May 2021 | Pages 399-406

Authors

Matthew Chung

BDS; MFDS RCPS (Glasgow); PgCert MedEd

Dental Core Trainee, Royal School of Dentistry, Belfast

Articles by Matthew Chung

Email Matthew Chung

Catherine Coyle

BDS (Hons), MFDS RCPS (Glasgow), MPaedDent, FDS RCS (Paed Dent)

Consultant in Paediatric Dentistry, Royal School of Dentistry, Belfast

Articles by Catherine Coyle

Abstract

Prevalence of dens evaginatus (DE) is very rare in molars, with only nine previous cases described, and all involving patients of Asian heritage. This article presents two unique cases of molar DE in European patients of 10 and 5 years of age, and a review of the current literature. The aim of the article is to review the aetiology, diagnosis, clinical significance and management of teeth affected with DE.

CPD/Clinical Relevance: Dens evaginatus describe teeth with supplemental cusps that may contain pulpal tissue. These are susceptible to wear, fracture and caries. This may lead to pain and pulpal necrosis. Early diagnosis and management are key to prevent symptoms and optimize tooth prognosis

Article

Dens evaginatus (DE) is a rare developmental anomaly describing teeth with supplemental cusps or protuberances consisting of enamel surrounding a core of dentine, and typically with pulpal tissue.1 Consequently, they are susceptible to pulpal exposure and introduction of pathology into the root canal system when worn or fractured. 2 This underpins the importance for early detection and dental intervention.

The prevalence of DE ranges from 0.5% to 4.3%,3 with genetic predisposition favouring 2% of the Asian population,4 in particular those of Mongolian origin with 1.29–3.6% among Chinese and as high as 15% observed in Alaskan Eskimo natives.3,5 Limited cases in African-Americans and Caucasians have also been described.6,7,8

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