{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T05:12:35Z","timestamp":1778735555905,"version":"3.51.4"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Dens invaginatus<\/jats:italic>\n                    (DI) is a developmental anomaly characterized by the invagination of enamel and dentin into the pulp space, predisposing affected teeth to pulpal and periapical pathologies. The complex and irregular canal anatomy often complicates endodontic management. This case report describes the nonsurgical endodontic retreatment of a maxillary lateral incisor (22) with Oehler's Type II DI in a 32\u2010year\u2010old female patient presenting with chronic apical periodontitis. Cone beam computed tomography revealed a highly complex root canal anatomy, consisting of a large, irregular main canal, numerous fine accessory canals, and multiple foramina associated with an extensive latero\u2010radicular lesion. Treatment was performed under magnification and rubber dam isolation. The preexisting obturation material and part of the distal wall of the invagination were selectively removed to gain access to the root canal system. Owing to the inaccessibility of the true canal for mechanical instrumentation, disinfection was achieved exclusively through sonically activated irrigation. To manage the anatomical complexity, a novel dual\u2010viscosity calcium silicate\u2010based obturation technique was used, consisting of a low\u2010viscosity tricalcium silicate sealer (BioRoot RCS), followed by incremental compaction of a high\u2010viscosity tricalcium silicate cement (Biodentine). This approach aimed to allow the high\u2010viscosity cement to obturate the large, irregular main canal while simultaneously driving the sealer into canal irregularities and accessory canals through the hydraulic pressure generated during its condensation. Clinical and radiographic follow\u2010up at 18\u2009months demonstrated evidence of periapical healing, supporting the success of the approach.\n                  <\/jats:p>","DOI":"10.1002\/ccr3.72715","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T04:45:56Z","timestamp":1778733956000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nonsurgical Endodontic Management of Oehler's Type\n                    <scp>II<\/scp>\n                    <i>Dens Invaginatus<\/i>\n                    Using a Combined High\u2010 and Low\u2010Viscosity Calcium Silicate\u2010Based Obturation Approach: A Case Report"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8757-1317","authenticated-orcid":false,"given":"Chlo\u00e9","family":"Laporte","sequence":"first","affiliation":[{"name":"Facult\u00e9 de Chirurgie Dentaire Universit\u00e9 de Strasbourg  Strasbourg France"},{"name":"H\u00f4pitaux Universitaires de Strasbourg  Strasbourg France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7376-371X","authenticated-orcid":false,"given":"Davide","family":"Mancino","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de Chirurgie Dentaire Universit\u00e9 de Strasbourg  Strasbourg France"},{"name":"H\u00f4pitaux Universitaires de Strasbourg  Strasbourg France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9213-8338","authenticated-orcid":false,"given":"Maryline","family":"Minoux","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de Chirurgie Dentaire Universit\u00e9 de Strasbourg  Strasbourg France"},{"name":"H\u00f4pitaux Universitaires de Strasbourg  Strasbourg France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"issue":"12","key":"e_1_2_15_2_1","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1111\/j.1365-2591.2008.01468.x","article-title":"Dens Invaginatus. Part 1: Classification, Prevalence and Aetiology","volume":"41","author":"Alani A.","year":"2008","journal-title":"International Endodontic Journal"},{"issue":"2","key":"e_1_2_15_3_1","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1111\/j.1365-2591.1997.tb00679.x","article-title":"Dens Invaginatus: Aetiology, Classification, Prevalence, Diagnosis, and Treatment Considerations","volume":"30","author":"Hulsmann M.","year":"1997","journal-title":"International Endodontic Journal"},{"issue":"11","key":"e_1_2_15_4_1","doi-asserted-by":"crossref","first-page":"e959","DOI":"10.4317\/jced.59849","article-title":"Prevalence of Dens Invaginatus Assessed by CBCT: Systematic Review and Meta\u2010Analysis","volume":"14","author":"Gonzalez\u2010Mancilla S.","year":"2022","journal-title":"Journal of Clinical and Experimental Dentistry"},{"issue":"1","key":"e_1_2_15_5_1","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1111\/aej.12763","article-title":"Conservative Management of Dens in Dente","volume":"49","author":"Castelo\u2010Baz P.","year":"2023","journal-title":"Australian Endodontic Journal"},{"issue":"12","key":"e_1_2_15_6_1","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1111\/j.1365-2591.2008.01469.x","article-title":"Dens Invaginatus. Part 2: Clinical, Radiographic Features and Management Options","volume":"41","author":"Bishop K.","year":"2008","journal-title":"International Endodontic Journal"},{"issue":"3","key":"e_1_2_15_7_1","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1111\/adj.12513","article-title":"An Update on the Diagnosis and Treatment of Dens Invaginatus","volume":"62","author":"Zhu J.","year":"2017","journal-title":"Australian Dental Journal"},{"issue":"2","key":"e_1_2_15_8_1","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.joen.2021.11.014","article-title":"Dens Invaginatus: Clinical Implications and Antimicrobial Endodontic Treatment Considerations","volume":"48","author":"Siqueira J. F.","year":"2022","journal-title":"Journal of Endodontics"},{"issue":"7","key":"e_1_2_15_9_1","doi-asserted-by":"crossref","DOI":"10.3390\/medicina61071281","article-title":"Dens Invaginatus: A Comprehensive Review of Classification and Clinical Approaches","volume":"61","author":"Baruwa A. O.","year":"2025","journal-title":"Medicina (Kaunas, Lithuania)"},{"issue":"4","key":"e_1_2_15_10_1","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1111\/iej.12867","article-title":"A New System for Classifying Tooth, Root and Canal Anomalies","volume":"51","author":"Ahmed H. M. A.","year":"2018","journal-title":"International Endodontic Journal"},{"issue":"11","key":"e_1_2_15_11_1","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1016\/0030-4220(57)90077-4","article-title":"Dens Invaginatus (Dilated Composite Odontome). I. Variations of the Invagination Process and Associated Anterior Crown Forms","volume":"10","author":"Oehlers F. A.","year":"1957","journal-title":"Oral Surgery, Oral Medicine, and Oral Pathology"},{"issue":"2","key":"e_1_2_15_12_1","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1046\/j.1365-263x.2001.00234.x","article-title":"Dens Invaginatus: A Retrospective Study of Prophylactic Invagination Treatment","volume":"11","author":"Ridell K.","year":"2001","journal-title":"International Journal of Paediatric Dentistry"},{"issue":"1","key":"e_1_2_15_13_1","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1186\/s12903-024-04377-5","article-title":"Application of Personalized Templates in Minimally Invasive Management of Coronal Dens Invaginatus: A Report of Two Cases","volume":"24","author":"Li M.","year":"2024","journal-title":"BMC Oral Health"},{"issue":"9","key":"e_1_2_15_14_1","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1016\/j.joen.2015.07.013","article-title":"AAE and AAOMR Joint Position Statement: Use of Cone Beam Computed Tomography in Endodontics 2015 Update","volume":"41","year":"2015","journal-title":"Journal of Endodontics"},{"issue":"2","key":"e_1_2_15_15_1","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1111\/aej.12651","article-title":"Endodontic Management of a Double\u2010Type IIIB Dens Invaginatus in a Vital Maxillary Central Incisor Aided by CBCT: A Case Report","volume":"49","author":"Kalogeropoulos K.","year":"2023","journal-title":"Australian Endodontic Journal"},{"issue":"4","key":"e_1_2_15_16_1","first-page":"521","article-title":"Nonsurgical Management of an Immature Maxillary Central Incisor With Type III Dens Invaginatus Using MTA Plug: A Case Report","volume":"12","author":"Norouzi N.","year":"2017","journal-title":"Iranian Endodontic Journal"},{"issue":"2","key":"e_1_2_15_17_1","doi-asserted-by":"crossref","first-page":"67","DOI":"10.2209\/tdcpublication.2022-0032","article-title":"Root Canal Treatment of Oehlers Type III Dens Invaginatus in Maxillary Lateral Incisor and Remote Sinus Tract Using Dental Surgical Microscope and Cone\u2010Beam Computed Tomography","volume":"64","author":"Fujii R.","year":"2023","journal-title":"Bulletin of Tokyo Dental College"},{"issue":"1","key":"e_1_2_15_18_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/iej.12270","article-title":"Cone Beam Computed Tomography in Endodontics\u2010A Review","volume":"48","author":"Patel S.","year":"2015","journal-title":"International Endodontic Journal"},{"issue":"1","key":"e_1_2_15_19_1","article-title":"Nonsurgical Endodontic Treatment of Type IIIa Dens Invaginatus in an Immature Maxillary Central Incisor: A Case Report","volume":"20","author":"Rezaei F.","year":"2025","journal-title":"Iranian Endodontic Journal"},{"issue":"3","key":"e_1_2_15_20_1","first-page":"232","article-title":"Nonsurgical Endodontic Treatment of Type II Dens Invaginatus in A Maxillary Lateral Incisor: A Case Report","volume":"19","author":"Isaltino M. D. C.","year":"2024","journal-title":"Iranian Endodontic Journal"},{"issue":"1","key":"e_1_2_15_21_1","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1186\/s12903-025-06419-y","article-title":"Comparative Analysis of Dentinal Tubule Penetration: Effects of Irrigation Activation Methods and Root Canal Sealers: In\u2010Vitro Study","volume":"25","author":"Kilic Y.","year":"2025","journal-title":"BMC Oral Health"},{"issue":"4","key":"e_1_2_15_22_1","doi-asserted-by":"crossref","first-page":"345","DOI":"10.4103\/JCDE.JCDE_24_24","article-title":"Premixed Calcium Silicate\u2010Based Root Canal Sealers Have Better Biological Properties Than AH Plus: A Systematic Review and Meta\u2010Analysis of in Vivo Animal Studies and in Vitro Laboratory Studies","volume":"27","author":"Malta C. P.","year":"2024","journal-title":"Journal of Conservative Dentistry and Endodontics"},{"issue":"2","key":"e_1_2_15_23_1","doi-asserted-by":"crossref","first-page":"150","DOI":"10.4103\/JCDE.JCDE_754_24","article-title":"Evaluating the Penetration Efficacy of Calcium Silicate\u2010Based Bioceramic Sealers Into Dentinal Tubules With Cold Lateral Compaction Technique Using Confocal Laser Scanning Microscopy: An in Vitro Study","volume":"28","author":"Mann N. S.","year":"2025","journal-title":"Journal of Conservative Dentistry and Endodontics"},{"issue":"2","key":"e_1_2_15_24_1","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.joen.2015.11.020","article-title":"Apically Extruded Sealers: Fate and Influence on Treatment Outcome","volume":"42","author":"Ricucci D.","year":"2016","journal-title":"Journal of Endodontics"},{"issue":"4","key":"e_1_2_15_25_1","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1007\/s10266-019-00425-7","article-title":"Comparison of the Antibacterial Activity of Calcium Silicate\u2010 and Epoxy Resin\u2010Based Endodontic Sealers Against \n                     Enterococcus faecalis\n                   Biofilms: A Confocal Laser\u2010Scanning Microscopy Analysis","volume":"107","author":"Alsubait S.","year":"2019","journal-title":"Odontology"},{"issue":"5","key":"e_1_2_15_26_1","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1016\/j.joen.2013.09.043","article-title":"Shrinkage of Backfill Gutta\u2010Percha Upon Cooling","volume":"40","author":"Lottanti S.","year":"2014","journal-title":"Journal of Endodontics"},{"issue":"4","key":"e_1_2_15_27_1","doi-asserted-by":"crossref","DOI":"10.3390\/ma14040728","article-title":"Physico\u2010Chemical Investigation of Endodontic Sealers Exposed to Simulated Intracanal Heat Application: Hydraulic Calcium Silicate\u2010Based Sealers","volume":"14","author":"Donnermeyer D.","year":"2021","journal-title":"Materials"},{"issue":"5","key":"e_1_2_15_28_1","doi-asserted-by":"crossref","first-page":"2717","DOI":"10.1007\/s00784-020-03586-w","article-title":"Effect of Heat Application on the Physical Properties and Chemical Structure of Calcium Silicate\u2010Based Sealers","volume":"25","author":"Aksel H.","year":"2021","journal-title":"Clinical Oral Investigations"},{"issue":"6","key":"e_1_2_15_29_1","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1016\/j.joen.2018.02.019","article-title":"Clinical Outcome of Non\u2010Surgical Root Canal Treatment Using a Single\u2010Cone Technique With Endosequence Bioceramic Sealer: A Retrospective Analysis","volume":"44","author":"Chybowski E. A.","year":"2018","journal-title":"Journal of Endodontics"},{"key":"e_1_2_15_30_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jdent.2025.105804","article-title":"Outcomes and Prognostic Factors of Endodontically Treated Teeth With Unintentional Root Canal Sealer Extrusion: A Retrospective Cohort Study","volume":"158","author":"Bamrungwong J.","year":"2025","journal-title":"Journal of Dentistry"},{"issue":"1","key":"e_1_2_15_31_1","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/s13005-022-00332-3","article-title":"Clinical Outcome of Bioceramic Sealer iRoot SP Extrusion in Root Canal Treatment: A Retrospective Analysis","volume":"18","author":"Li J.","year":"2022","journal-title":"Head & Face Medicine"},{"issue":"4","key":"e_1_2_15_32_1","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.dental.2015.01.004","article-title":"Calcium Silicate Bioactive Cements: Biological Perspectives and Clinical Applications","volume":"31","author":"Prati C.","year":"2015","journal-title":"Dental Materials"},{"issue":"3","key":"e_1_2_15_33_1","doi-asserted-by":"crossref","DOI":"10.3390\/jcm15030973","article-title":"Cytotoxicity of Root Canal Sealers and Potential Clinical Implications: A Comprehensive Systematic Review of in Vitro Studies","volume":"15","author":"Piscopo M.","year":"2026","journal-title":"Journal of Clinical Medicine"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72715","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.72715","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72715","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T04:46:04Z","timestamp":1778733964000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.72715"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":32,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/ccr3.72715"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.72715","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2026-01-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e72715"}}