Apexogénesis en premolar con necrosis pulparmediante endodoncia regenerativa con DensEvaginatus: Reporte de caso

Abstract

Dens Evaginatus (DE) is a developmental anomaly characterized by the presence of a supernumerary tubercle composed of enamel, dentin, and, in some cases, pulp tissue. Its fracture can lead to pulp exposure, favoring bacterial contamination and the development of inflammation, necrosis, and periapical lesions. In cases of teeth with immature apices, regenerative endodontics (RE) is a therapeutic alternative aimed at restoring pulp sensitivity and allowing root development.
This article presents the case of a 14-year-old patient with DE in a maxillary premolar, pulp necrosis, and chronic apical abscess. RE treatment was carried out in two phases, with chemical disinfection, intracanal medication with calcium hydroxide, induction of apical bleeding, and bioceramic sealing. After seven months, resolution of the lesion, apical closure, and root thickening were observed, findings confirmed radiographically and by cone beam tomography. RE presents itself as an effective alternative to traditional apexification, as it not only allows for the elimination of infection but also the regeneration of the dentin-pulp complex, promoting the structural and functional integrity of the affected tooth.