A Female patient aged 40 years comes for routine general examination. Full mouth radiographs are taken. Oval shaped radiolucent areas are seen in the root canals of maxillary central incisors Teeth are asymptomatic and show feeble response to vitality tests. What is your line of treatment?

**Core Concept**
The presence of oval-shaped radiolucent areas in the root canals of asymptomatic maxillary central incisors, along with a feeble response to vitality tests, suggests the possibility of apical periodontitis or a non-vital tooth due to pulp necrosis. This condition is often associated with the presence of a dens in dente, a calcified structure within the root canal.

**Why the Correct Answer is Right**
The feeble response to vitality tests and the presence of radiolucent areas in the root canals indicate a possible non-vital tooth. A dens in dente is a calcified structure that can be present in the root canal of maxillary central incisors and can be responsible for the non-vital condition. The oval-shaped radiolucent areas are likely a result of the resorption of the surrounding bone due to the presence of the dens in dente.

**Why Each Wrong Option is Incorrect**
* **Option A:** This option is not provided, so we will proceed to the next options.
* **Option B:** This option might suggest a different treatment approach, such as extraction or a non-invasive treatment, but it does not address the underlying cause of the non-vital tooth.
* **Option C:** This option might suggest a different type of treatment, such as a different type of endodontic treatment or a different material for the restoration, but it does not address the underlying cause of the non-vital tooth.
* **Option D:** This option is not provided, so we will proceed to the next step.

**Clinical Pearl / High-Yield Fact**
A dens in dente is a common finding in the root canals of maxillary central incisors and can be responsible for a non-vital tooth. It is essential to identify and remove the dens in dente during the endodontic treatment to ensure the success of the treatment.

**Correct Answer:** D. Endodontic treatment with removal of dens in dente.

✓ Correct Answer: B. Suggest root canal treatment