{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T03:13:05Z","timestamp":1777000385089,"version":"3.51.4"},"reference-count":41,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T00:00:00Z","timestamp":1752624000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Dens invaginatus is a developmental dental anomaly characterized by the infolding of the enamel organ into the dental papilla during early odontogenesis. This process leads to a broad spectrum of anatomical variations, ranging from minor enamel-lined pits confined to the crown to deep invaginations extending through the root, occasionally communicating with periodontal or periapical tissues. The internal complexity of affected teeth presents diagnostic and therapeutic challenges, particularly in severe forms that mimic root canal systems or are associated with pulpal or periapical pathology. Maxillary lateral incisors are most frequently affected, likely due to their unique developmental timeline and morphological susceptibility. Although various classification systems have been proposed, Oehlers\u2019 classification remains the most clinically relevant due to its simplicity and correlation with treatment complexity. Recent advances in diagnostic imaging, especially cone beam computed tomography (CBCT), have revolutionized the identification and classification of these anomalies. CBCT-based adaptations of Oehlers\u2019 classification allow for the precise assessment of invagination extent and pulpal involvement, facilitating improved treatment planning. Contemporary therapeutic strategies now include calcium-silicate-based cement sealing materials, endodontic microsurgery for inaccessible anatomy, and regenerative endodontic procedures for immature teeth with necrotic pulps. Emerging developments in artificial intelligence, genetic research, and tissue engineering promise to further refine diagnostic capabilities and treatment options. Early detection remains critical to prevent complications such as pulpal necrosis or apical disease. A multidisciplinary, image-guided, and patient-centered approach is essential for optimizing clinical outcomes in cases of dens invaginatus.<\/jats:p>","DOI":"10.3390\/medicina61071281","type":"journal-article","created":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T10:46:05Z","timestamp":1752662765000},"page":"1281","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Dens Invaginatus: A Comprehensive Review of Classification and Clinical Approaches"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1670-8674","authenticated-orcid":false,"given":"Abayomi O.","family":"Baruwa","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman 346, United Arab Emirates"}]},{"given":"Craig","family":"Anderson","sequence":"additional","affiliation":[{"name":"Private Practice, Biloxi, MS 39532, USA"}]},{"given":"Adam","family":"Monroe","sequence":"additional","affiliation":[{"name":"Private Practice, Vista, CA 92083, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1353-4231","authenticated-orcid":false,"given":"Fl\u00e1via","family":"Cracel Nogueira","sequence":"additional","affiliation":[{"name":"Private Practice, 4700-262 Braga, Portugal"}]},{"given":"Lu\u00eds","family":"Corte-Real","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Cooperativa de Ensino Superior Polit\u00e9cnico e Universit\u00e1rio (CESPU), 4585-116 Gandra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6932-2038","authenticated-orcid":false,"given":"Jorge N. R.","family":"Martins","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina Dent\u00e1ria, Universidade de Lisboa, 1600-277 Lisboa, Portugal"},{"name":"LIBPhys-FCT UID\/FIS\/04559\/2013, 1600-277 Lisboa, Portugal"},{"name":"Grupo de Investiga\u00e7\u00e3o em Bioquimica e Biologia Oral (GIBBO), Unidade de Investiga\u00e7\u00e3o em Ci\u00eancias Orais e Biom\u00e9dicas (UICOB), 1600-277 Lisboa, Portugal"},{"name":"Centro de Estudos de Medicina Dent\u00e1ria Baseada na Evid\u00eancia (CEMDBE), 1600-277 Lisboa, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1111\/aej.12635","article-title":"Rare variant of dens invaginatus with accessory root and labial talon cusp in maxillary lateral incisor\u2014Case report","volume":"49","author":"Ali","year":"2023","journal-title":"Aust. Endod. 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