During clinical examination, abnormally shaped tooth can be observed. Teeth with this condition can have a conical shape or deep pit on the lingual side or have an exaggerated talon cusp. Although examination may reveal a fissure on the surface of anterior tooth, radiographic examination is the way. On a periapical radiograph, the invagination lesion will appear as a radiolucent pocket. It is usually seen beneath the cingulum or incisal edge. Larger lesions can appear as fissures. A radio-opaque could be shown. Pulp may be involved and the root canal could have complex anatomy. Two periapical radiographs are often required to make sure that it is not a masked lesion. Cone beam computed tomography (CBCT) is useful in diagnosing DI. It provides clinicians a detailed 3D image and could aid treatment planning. Feasibility of root canal treatment or apical surgery or other procedures could be assessed. Oehler's classification *Class I - Partial invagination. It is limited to the crown of tooth. The lesion does not extend pass the cementoenamel junction (CEJ) or the pulp. *Class II - Partial invagination. It extends beyond the crown and CEJ. Pulp may be involved but remain within the root anatomy. There is no communication of the lesion with periodontal ligament (PDL). *Class IIIa - Complete invagination. It extends through root and communicates with PDL. It usually does not involve the pulp but can cause anatomical malformation. *Class IIIb - Complete invagination. It extends through the root and communicates with PDL through apical foramen. Pulpal anatomy may not be directly involved but can cause disruption to the dental anatomy. Histology *No irregularities in the dentin below invagination *Strains of vital tissue or fine canals that communicates with the pulp could be found *Enamel lining irregularly structured *External and internal enamel have different structures
Dens invaginatus
Dens evaginatus
Vesical tenesmus
Caput medusae
Corpora arenacea
Torus palatinus
Genu recurvatum
Pinguecula