Dens evaginatus is a rare odontogenic developmental anomaly that is found in teeth where the outer surface appears to form an extra bump or cusp.
[4] This may be seen more frequently in Asians[3] (including Chinese, Malay, Thai, Japanese, Filipino and Indian populations).
[3][2] It is important to diagnose DE early and provide appropriate treatment to help prevent periodontal disease, caries, pulpal complications[3] and malocclusion.
The extra cusp can cause occlusal interference, displace of the affected tooth and/or opposing teeth, irritates the tongue when speaking and eating and decay the developmental grooves.
[2] Temporomandibular joint pain could be experienced secondarily due to occlusal trauma caused by the tubercle.
Preventative measures[3] include: For teeth with normal pulp and mature apex, reduce the opposing occluding tooth.
[4] For teeth with inflamed pulp and mature apex, conventional root canal treatment could be carried out and restored accordingly.
[4] For teeth with inflamed pulp and immature apex, shallow MTA pulpotomy could be performed and then restore with glass ionomer and composite.