Hindawi Publishing Corporation Case Reports in Dentistry Volume 2012, Article ID 871937, 3 pages doi:10.1155/2012/871937 Case Report Radicular Dens Invaginatus: Report of a Rare Case V. T. Beena, 1 R. Sivakumar, 1 R. Heera, 2 R. Rajeev, 1 Kanaram Choudhary, 1 and Swagatika Panda 3 1 Department of Oral Pathology & Microbiology, Government Dental College, Trivandrum, Kerala, Thiruvananthapuram 695011, India 2 Department of Oral Pathology & Microbiology, Government Dental College, Kottayam, Kerala, India 3 Institute of Dental Sciences, Bhubaneshwar, India Correspondence should be addressed to V. T. Beena, drvtbeena@gmail.com Received 21 March 2012; Accepted 28 June 2012 Academic Editors: N. Brezniak, C. H. Kau, and N. Shah Copyright © 2012 V. T. Beena et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Dens invaginatus is a developmental anomaly resulting from invagination of a portion of crown forming within the enamel organ during odontogenesis. The invagination ranges from a slight pitting (coronal type) to an anomaly occupying most of the crown and root (radicular type). Although a clinical examination may reveal a deep fissure or pit on the surface of an anterior tooth, radiographic examination is the most realistic way to diagnose the invagination. The objective of this case presentation is to report a rare case of radicular dens in dente, which is a rare dental anomaly. 1. Introduction Dens invaginatus is a developmental anomaly resulting from invagination of a portion of crown (enamel organ) during odontogenesis [1]. The invagination ranges from a slight pitting (coronal type) to an anomaly occupying most of the crown and root (radicular type) [2]. While the coronal type of invagination is lined with enamel, the radicular type of invagination is lined with cementum [3, 4]. A clinical examination reveals a deep fissure or pit on the lingual surface of an anterior teeth and an occlusal pit on the posterior teeth. Radiographic examination is the most realistic way to diagnose such anomalies as dense invaginatus [1, 2]. The most popular system used to classify Dens invagi- natus given by Oehlers [5]. Invaginations are classified as follows: (i) Type 1: invagination ends as a blind sac within the crown. (ii) Type 2: The invagination extends apically beyond the cemento-enamel junction. (iii) Type 3: The invagination extends beyond the cemento-enamel junction, and a second “apical fora- men” is evident [1, 2, 6]. The objective of this case presentation is to report a rare case of radicular dens in dente. Radicular dens invaginatus is a rare dental anomaly [1, 6]. 2. Case Report A 20-year old female presented with a chief complaint of spontaneous, severe and a nocturnal pain in her mandibular right posterior teeth. There was no significant medical history. Extraoral examination revealed no abnormalities. Intraoral examination revealed slight cuspal anomaly in the mandibular right second premolar. This tooth had 3 cups, a small buccal cusp, a small mesiolingual, and a large dis- tolingual cusp but retaining the Y-shaped groove (Figure 1). The tooth was sensitive to vertical and horizontal percussion. There was also horizontal mobility and depressibility. The adjacent gingiva was normal. Extraction of right lower first molar was done before 2 months due to periapical involvement from caries.