DENS EVAGINATUS

Dens envaginatus is a condition found in teeth where the outer surface appears to form an extra bump or cusp. Premolars are more likely to be affected than any other tooth. This may be seen more frequently in Asians. The pulp of the tooth may extend into the dens evaginatus. There is a risk of the dens evaginatus chipping off in normal function. Hence this condition requires monitoring as the tooth can loose its blood and nerve supply as a result and may need root canal treatmentDens evaginatus (DE) is an uncommon dental anomaly, having been well documented since 1925.

It occurs primarily in people of Asian descent and is exhibited by protrusion of a tubercle from occlusal surfaces of posterior teeth, and lingual surfaces of anterior teeth.

Tubercles have an enamel layer covering a dentin core containing a thin extension of pulp. These cusp-like protrusions are susceptible to pulp exposure from wear or fracture because of malocclusion, leading to pulpal complications soon after eruption.

review of the literature reveals an abundance of terms for this anomalous dental structure, the most frequently encountered being: odontome, odontoma (odontome) of the axial core type, evaginatus odontoma (evaginated odontome), occlusal enamel pearl, occlusal tubercle, tuberculum anomalous, accessory cusp, supernumerary cusp, interstitial cusp, tuberculated cusp, tuberculated premolar, Leong’s premolar, and talon cusp (specifically for anterior teeth)

Talon cusp originated as a descriptive term for DE when observed on the lingual surface of anterior teeth because of a resemblance to an eagle’s talon. Currently, DE is the preferred terminology utilized to describe this developmental abnormality, first recommended by Oehlers in 1967

DE is thought to develop from an abnormal proliferation and folding of a portion of the inner enamel epithelium and subjacent ectomesenchymal cells of the dental papilla into the stellate reticulum of the enamel organ during the bell stage of tooth formation