Which dental anomaly is most likely to lead to an apical lesion due to its developmental structure?

Dens invaginatus (dens in dente) is a developmental anomaly resulting from invagination of the enamel organ into the dental papilla before calcification. This creates an inner enamel-lined tract that communicates with the oral cavity, allowing bacteria to enter the pulp through poorly mineralized areas. The deep invagination traps bacteria, and the thin, defective enamel/dentin lining provides inadequate pulpal protection, leading to early pulp necrosis and periapical pathology - often in young patients before root completion. This is why dens invaginatus has the highest risk of apical lesion formation among developmental anomalies. Dens evaginatus (an occlusal tubercle) can also lead to pulp exposure when it fractures.