1. Dens evaginatus

2. General information
• Dense evaginatus is a developmental
condition that appears clinically as an
accessory cusp or globules of enamel on
occlusal surface, between buccal and lingual
cusp of premolar

3. Pathogenesis
• Caused by proliferation and evagination of
inner enamel epithelium and subsequent
odontogenic mesenchyme into dental organ,
during early tooth development

4. Clinical features
• It occurs in premolar and molar teeth and
usually occurs unilaterally or bilaterally
• Develops in people of Mongoloid ancestry
• Consist of all three dental tissues that is
enamel dentine and cementum
• Tubercle of enamel on occlusal surface of the
affected tooth
• polyp like protuberance in Central groove, on
lingual Ridge of buccal cusp is seen

5. Radiographic appearance
• Dentine and enamel – dentine core is covered
with opaque enamel
• pulp – fine pulp horns may be apparent
• occlusal surface have tuberculated
appearance

6. Diagnosis
• Tubercle on occlusal surface of enamel is the
key to diagnosis
• tuberculated appearance of occlusal surface

7. Management
• Grinding of tubercle
• composite reinforcement