Invaginations

Invaginations are shallow or deep developmental cavities in tooth crowns, covered partly or totally by enamel walls. Their frequency has been reported to be between 0.1 and 10%. They are most frequent in upper lateral incisors, but can be found in any tooth. Invaginations are divided into four main types (see drawing). Invaginations often increase the risk of pulp infection, and they should be well sealed with a permanent filling whenever found, in order to reduce the risk of infection in the pulp or in the periodontal tissues. Deeper invaginations (type 2) should be cleaned mechanically and by irrigation, and they should be filled to their whole depth if possible. Type 3 and 4 invaginations are problematic to treat if the infection penetrates to the tissues.