Separated root tip formation associated with a fractured tubercle of dens evaginatus: A case report

Figure 1 Preoperative clinical and radiographic evaluation. A: Overview of mandibular dentition shows a gingival sinus (white arrow) on the buccal side of tooth # 45. The right column is a local enlarged image of the orange dotted area with the white circle showing the fractured tubercle of dens evaginatus on the occlusal surface of tooth # 45; B: Panoramic radiograph at the initial visit showing that the root of tooth # 45 was fractured and separated. The separated root apex was almost completely formed, and the main root remained immature with thin root walls associated with a large radiolucency (black arrow).

Figure 2 Clinical evaluation at the 2 wk follow-up and periapical radiograph after revascularization. A: Clinical evaluation at the 2 wk follow-up showing that the fistula was completely resolved (subsided); B: Periapical radiograph after revascularization showing iRoot Bp Plus was placed below the cementoenamel junction.

Figure 3 Periapical radiograph during the follow-up period. A: Periapical radiograph at the 3 mo follow-up demonstrated complete resolution of the radiolucency and a drifting root tip (white arrow); B: Periapical radiograph at the 1 yr follow-up showed that the separated root tip (black arrow) was more distally drifted than before. The root length and dentin thickness of the main root did not increase.