(A). Fusion
(B). Concrescence
(C). Germination
(D). Dens in dente
- Dens in dente (also called dens invaginatus) is formed as the enamel organ goes into the crown of a tooth before mineralization is completed. Radiographically, a tooth-like structure appears within the crown. Due to the irregularities of the crown structure, the tooth is more vulnerable to caries and infections, including periapical lesions. Dens invaginatus is most common with maxillary lateral incisors.
- Gemination is when one crown splits in two, creating two crowns.
- Fusion is the combination of two tooth buds with separate canals.
- Concrescence occurs when roots adhere together by cementum only.
Answer: (D). Dens in dente
As the radiograph shows, the “tooth” from within the tooth may not be obvious. It may just look like some radiopacity inside the tooth. For this reason, if there is an identification question in the dental hygiene board exams (NBDHCE, NDHCE, CSCE, WREB, CRDTS), many students fail to recognize dens in dente. And honestly, I cannot blame those students because it is really not obvious. But at least, if we went through the process of elimination in this question, we probably would have arrived at the conclusion that there is nothing else that can be this radiographic opacity seen in the image.
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