Cone-Beam Computed Tomography versus Rendered Panoramic Images in Determination of Dens Invaginatus Characteristics: Retrospective Cohort Study

Background: "Dens in Dente" is another name for Dens invaginatus. It's an uncommon developmental aberration that comes in a range of shapes and sizes. Invagination begins in the crown and may go to the root. The goal of this study was to use CBCT and panoramic pictures created from CBCT scans to evaluate the existence, kind, and features of DI in full-mouth surveys in Saudi patients presenting to Qassim dental college, and to compare the findings of the imaging modalities.

Methods: This retrospective cohort study was performed by using 302 previously obtained CBCT records of patients from the database of the oral and maxillofacial radiology department of Qassim University, Saudi Arabia from yer 2016 to 2021. The research was ethically approved by the ethical approval committee of Qassim university (Code #: F-2019-3005).

Results: In the present study, the age of the patients ranged from 9 to 80 years (mean age was 44 years). Out of 302 scans, 153 patients were female, and 149 were found to be male. According to the Cohen kappa test, the inter-examiner agreement was high between the 2 assessments of the observers: k = 0.795, P < .000 for CBCT and k = 0.915, P < .000 for panoramic images rendered from CBCT images. On the basis of the CBCT images, DI was observed in 98 of the 302 patients (frequency, 32.5%). Type I DI was the most commonly observed type of invaginatus (93.9%), followed by type II (6.1%). However, type III was not being observed.

Conclusion: We can deduce that there is no special relationship between gender and the presence of dens invagnatus. When it comes to diagnosing and classifying dens invaginatus, CBCT images outperform rendered panoramic images. Because it provides an accurate representation of the external and internal dental anatomy, as well as appropriate visualization of associated characteristics with such cases that would be absolutely necessary in their treatment phases, CBCT can be recommended as an effective diagnostic device for identifying DI.