• children
• dental anomaly
• primary dentition
• supernumerary teeth
• taurodontism

• Project No: IFP-2020-55 Deputy Deanship for Research and Innovation, Ministry of Education, Saudi Arabia

• dental
• incisors
• morphogenesis
• morphology
• teeth

• Male
• Female
• Animals
• Humans
• Macaca mulatta/genetics
• Tooth, Supernumerary
• Incisor
• Prevalence
• Papio

• National Science Foundation, National Institutes of Health
• NIH 5P40OD012217 National Institutes of Health NIH contracts
• NSF 1926601 NSF grants
• NSF 1926481 NSF grants
• NSF 1926402 NSF grants
• NSF 1926528 NSF grants

• Dens evaginatus
• diagnosis
• managements
• premolars
• treatments

• Humans
• Pulpitis/therapy
• Bicuspid/abnormalities
• Root Canal Therapy/methods
• Dental Pulp Necrosis/therapy
• Inflammation

• dens evaginatus
• dentistry
• endodontics
• mandibular premolar

• Retruded contact position
• Talon cusp
• Three-cusped structure/ternion
• Topical fluoride

Introduction: Dental anomaly of shape leads to various clinical dental pathologies requiring the intervention of a dental specialist. Early diagnosis and intervention in earlier stages can restore a near-normal dentition and esthetics. So, the present study was undertaken to determine the prevailing dental anomalies of shape and its various subtypes in various age groups and gender variations.

Materials and methods: Retrospective dental casts and radiographs were evaluated in 3,000 cases consisting of an equal proportion of males and females. Only cases with an age range from 10 to 40 years were included in the study. Dental anomalies of shape were evaluated for the presence of Gemination, fusion, talon cusp, dens evaginates, the cusp of carabelli, dens invaginatus, taurodontism, and dilacerations and recorded.

Result: A total of 538 (17.9%) cases were found to have dental anomalies of shape which included 288 (19.2%) males and 250 (16.6%) females. Dilaceration was found to be the most common (9.2%) dental anomaly of shape followed successively by taurodontism (3.7%), talon cusp (2.23%), and the cusp of carabelli (1.4%). Most of the shape anomalies showed male predilection. A higher prevalence of most dental anomalies of shape was found in the younger age group of 10 to ≤25 years as it is not linked with age but still has got importance to know while the treatment is carried out in this age group.

Conclusion: It is quite imperative to have complete knowledge of trends and patterns of shape anomalies in India. It will guide dental practitioners to formulate a treatment plan on the basis of existing prevailing anomalies.

• Anomalies
• dental defects
• developmental
• hypoplasia
• supernumerary teeth

• Anodontia/epidemiology
• Child
• Cross-Sectional Studies
• Female
• Humans
• Infant, Newborn
• Male
• Nigeria/epidemiology
• Prevalence
• Tooth Abnormalities/epidemiology

• Classification
• Developmental anomaly
• Prevalence
• Systematic review
• Talon cusp

Talon cusp is a rare dental anomaly that appears as a cusp-like projection on anterior teeth. Although numerous articles considering this anomaly have been published, this report has displayed a unique presentation of talon cusp. This case series is the first report in literature on which talon cusp has been presented in multiple siblings which highlights the genetic/familial component of the etiology. The report has also displayed unfamiliar morphological appearance (heart shape) of the talon cusp. Furthermore, talon cusp has shown an association with taurodontism in this report. Taurodontism has never been mentioned in the previous literature among the odontogenic variations that may associate talon cusp. A 25-year-old male has presented with talon cusps on the palatal surface of anterior teeth. Family history revealed four of his siblings had the same anomaly on anterior teeth. Talon cusps in the five cases cause clinical problems like occlusal interference, displacement and proclination of the anterior tooth, caries in the grooves delineating talon cusp, or pulp necrosis. Free dental treatment has been offered in the university clinic. However, they live in remote rural areas making it difficult to follow up with treatment.

Dens evaginatus (DE) is an odontogenic developmental anomaly that can be defined as a supernumerary tubercle structure that extends from the occlusal surface of the affected tooth. Tubercular fracture or attrition of the tubercle, invaded by pulp tissue, may cause various pulpal diseases, such as pulpitis, pulp necrosis, and periapical periodontitis. This study aimed to determine the prevalence of premolars with DE in Taiwanese and Spanish study populations and to report associated dental complications.

This study was based on the clinical examination of volunteers of Spanish and Taiwanese origin, recruited among the undergraduate dentistry students at CEU-Cardenal Herrera University, Valencia, Spain. Informed consents were obtained from students identified with DE. Additional examinations were performed, including vitality test, percussion, palpation, and radiographs, to diagnosis the status of the pulp and periapical tissue.

The prevalence of DE among Taiwanese students was 4.08%, compared to 0% in the Spanish Caucasian group. In the Taiwanese group, the occurrence of DE in premolars was more common in the mandibular (78.9%) compared to the maxillar region (21.1%). In 84% of the cases, DE-affected teeth were found bilaterally. The mandibular second premolar was the most commonly involved tooth (57.8%). When investigating the complications related to DE among six affected Taiwanese students, it was found that two teeth (10.5%) had received pulp treatment, one of them prior to complete root formation.

DE appears to be more prevalent in people of Mongoloid origin and rare in those of Caucasian origin. The wear or fracture of DE may affect pulpal tissue, leading to incomplete root growth.

• Complication
• dens evaginatus
• premolar
• prevalence
• tubercle fracture

• Computed tomography
• Partial pulpotomy
• Talon cusp

Dental anomalies affecting the teeth are relatively common. Simultaneous occurrence of multiple dental abnormalities in a single tooth is uncommon and relatively rare. One such abnormality routinely encountered in dental clinics is the talon cusp. It is also referred to as dens evaginatus, characterized by the presence of an accessory cusp-like structure projecting from the cingulum of anterior teeth. It has an increased predilection for maxillary teeth and permanent dentition. Although numerous cases of talon cusp have been reported in the literature, occurrence of multiple talon cusps in maxillary central incisors has not been found in the literature. This case report highlights the presence of talon cusps in maxillary anterior teeth with multiple impacted supernumerary teeth.

• Dens evaginatus
• maxilla
• multiple
• supernumerary tooth
• talon cusp

Fusions of teeth and talon cusp are two rare developmental dental anomalies, affecting both primary and permanent dentitions. Both the anomalies are mostly reported as isolated finding and are rarely associated with other dental anomalies. Talon cusp is more common in maxillary anterior teeth in permanent dentition and fusion is commonly reported in mandibular teeth in primary dentition. The concomitant occurrence of talon cusp and fusion is rare and its occurrence in fused mandibular permanent teeth is also rare. This case report presents two unusual cases of concomitant occurrence of talon cusp with fusion in permanent mandibular incisors. The clinical problems associated with these dental anomalies and importance of their management are discussed in these case reports.

• Fusion
• Mandibular permanent teeth
• Talon cusp.

The teeth are formed during intrauterine life (i.e., gestation) during the odontogenesis stage. During this period, the teeth move until they enter the oral cavity. This course covers various stages of dental development, namely, initiation, proliferation, histodifferentiation, morphodifferentiation, and apposition. The talon cusp is an anomaly that occurs during morphodifferentiation, and this anomaly may have numerous adverse clinical effects on oral health. The objective of this study was to report a case of “Talon Cusp Type I” and to discuss diagnostic methods, treatment options for this anomaly, and the importance of knowledge of this morphological change among dental professionals so that it is not confused with other morphological changes; such knowledge is required to avoid unnecessary surgical procedures, to perform treatments that prevent caries and malocclusions as well as enhancing aesthetics, and to improve the oral health and quality of life of the patient.

This paper reviewed the literature on newer three-dimensional imaging techniques and their applications in diagnosis and treatment planning of various dental anomalies. Developmental anomalies can occur during any of the developmental stages and are manifested clinically after the tooth is fully formed. These dental anomalies may involve a single tooth, a group of teeth, or the entire dentition. Two-dimensional diagnostic imaging, including periapical, occlusal, panoramic, or cephalometric radiographs are essential in localization and management of morphological and eruptive disorders. However, due to their inherent limitations such as insufficient precision because of unusual projection errors and lack of information about spatial relationships, these methods are considered unreliable. Thus, the use of newer image acquisition techniques that allow comprehensive three dimensional imaging and visualization of dental abnormalities is highly recommended for making a confirmatory diagnosis. The significance of accurate endodontic, surgical and orthodontic treatment planning in dental abnormalities cannot be overstated as it pertains to critical anatomic landmarks such as proximity to adjacent teeth or the mandibular canal. The precise information on spatial relationships provided by multiplanar imaging helps the dental surgeon to establish more accurate diagnosis, management strategies and also increases the patient safety. This review highlights the use of high-end diagnostic imaging modalities in diagnosis of the various morphologic and eruptive dental abnormalities.

• Three-dimensional imaging
• Spiral computed tomography
• Magnetic resonance imaging
• Eruptive malformations
• Morphological disturbances
• Conebeam computed tomography

• Facial talon
• mandibular
• talon cusp

Talon cusp is a dental anomaly that occurs as an accessory cusp like structure, from the cingulum of maxillary and mandibular anterior teeth. Lingual location is usually considered pathognomic. This case report discuss about the unusual appearance of talon cusp on the facial surface of the maxillary left permanent central incisor and a mild talon cusp on the facial surface of the maxillary right permanent central incisor.

• Facial cusp
• maxillary permanent central incisors
• talon cusp

The talon cusp is a relatively rare dental developmental anomaly characterized by cusp-like projections, usually observed on the lingual surface of the affected tooth. Normal enamel covers the cusp and fuses with the lingual aspect of the tooth. The cusp may or may not contain an extension of the pulp. The condition can occur in both the primary and permanent dentitions. However, the occurrence of anomalous cusp is rather infrequent in the primary dentition. Little data is available about the treatment of talon cusps in the primary dentition as compared with the permanent dentition. A case of talon cusp in the primary maxillary left central incisor is reported. This dental anomaly was not associated with any other somatic or dental abnormality. The tooth was carious. Pulpal extension into the cusp was detected radiographically. Pulpectomy of the tooth was carried out and restored with composite restoration.

How to cite this article: Bahadure RN, Thosar N, Jain ES. Management of Talons Cusp associated with Primary Central Incisor: A Rare Case Report. Int J Clin Pediatr Dent 2012;5(2): 142-144.

• Primary maxillary left central incisor
• Pulpectomy
• Talons cusp

• Anomaly
• Gemination
• Talon's cusp
• Tooth abnormality

• Adolescent
• Humans
• Incisor/abnormalities
• Male
• Tooth Abnormalities/complications
• Tooth Crown/abnormalities
• Tooth Eruption, Ectopic/complications

The aim of this investigation was to study children with supernumerary teeth who visited the Department of Pedodontics and Preventive Dentistry, Government Dental College and Hospital, Rohtak, Haryana, India. Only children with supernumerary teeth were included in the study while patients having supernumerary teeth with associated syndromes were excluded. Supernumeraries were detected by clinical and radiographic examination. The results indicated that males were affected more than females with a sex ratio of 2.9 : 1. Single supernumerary tooth was seen in 79% of the patients, 20% had double, and 1% had three or more supernumeraries. Premaxillary supernumeraries accounted for 93.8% of the cases. Conical shaped supernumerary teeth were the most common type (59.7%). Majority of supernumeraries remained unerupted (65%). Fusion of supernumerary tooth with a regular tooth was observed in 4% of the patients. Talon cusp, an associated dental anomaly, was seen in 5% of the cases. Simultaneous hypodontia occurred in 2.3% of patients with supernumeraries.

Aim: To investigate the prevalence of the talon cusps in a sample of Indian dental patients and their distribution among different types of teeth. To determine the presence of other dental anomalies associated with the talon cusps. Method: 2740 out patients (1523 males and 1217 females) attending Oral Medicine department from November 2010 to January 2011 were screened for the presence of talon cusps and were subjected to Intra Oral Peri-apical (IOPA) radiograph to rule out any associated anomalies or peri-apical changes. Results: Talon cusps were detected in 16 out of 2740 patients (person prevalence 0.58%). Thirty one teeth were found to have talon cusp. Maxillary lateral incisors were the most commonly affected teeth (54.8%, 17 teeth), followed by maxillary central incisors and canines (16.12%, 5 teeth).Talon cusp was found in two mandibular central incisors (6.45%) and one each in mandibular second and third molar (3.22% each). Seventeen teeth in 7 patients (54.83%) were found to be associated with anomalies like dens invagination (6 teeth, 19.35%), impacted 13, 23 (6 teeth, 19.35%), partial anodontia (3 teeth, 9.67%), geographic and fissured tongue (2 teeth, 6.45%). Peri-apical granuloma was found in one tooth with talon cusp associated with dens invaginatus. None of the patients were found to be associated with any syndromes. Conclusion: Attention should be paid to the presence of the talon cusp and the associated anomalies. Early diagnosis of the talon cusp can help the clinician in preventing the further complications.

Key words:Orthopantomography, atheroma, stroke.

• Connation
• Talon's cusp
• double teeth
• fusion

The aim of the study is to investigate the prevalence of talon cusps in a sample of Jordanians dental patients and their distribution among different types of teeth.

The data were collected from radiographic examination of 3,024 periapical films showing 9,377 teeth from a random sample of 1,660 patients. A tooth was considered having talon cusp if there was a V-shape radiopaque structure superimposed the tooth structure.

Talon cusps were detected in 52 teeth (tooth prevalence = 0.55%). Maxillary canines were the most commonly affected teeth (46% of cases), followed by maxillary lateral incisor teeth (39% of cases) and maxillary central incisors teeth (15% of cases). Teeth with talon cusps were found in 40 subjects (person prevalence = 2.4%). Bilateral talon cusps were seen in 12 patients.

Attention should be paid to the presence of talon cusp and the treatment problems associated with it.

• Adolescent
• Anodontia/epidemiology
• Anodontia/ethnology
• Asian People
• Child
• Comorbidity
• Dentition, Permanent
• Female
• Hong Kong/epidemiology
• Humans
• Incisor/abnormalities
• Male
• Maxilla
• Sex Distribution
• Tooth Abnormalities/epidemiology
• Tooth Abnormalities/ethnology
• Tooth Crown/abnormalities
• Tooth, Supernumerary/epidemiology
• Tooth, Supernumerary/ethnology

• Anodontia/complications
• Child
• China/ethnology
• Dens in Dente/complications
• Female
• Hong Kong
• Humans
• Incisor/abnormalities
• Male
• Maxilla
• Retrospective Studies
• Tooth, Deciduous/abnormalities
• Tooth, Supernumerary/complications

• Child
• Dental Enamel/abnormalities
• Dental Pulp Cavity/abnormalities
• Fused Teeth/therapy
• Humans
• Incisor/abnormalities
• Magnetic Resonance Imaging
• Male
• Maxilla
• Occlusal Adjustment
• Orthodontics, Corrective
• Tooth Crown/abnormalities

• Child
• Cleft Palate/complications
• Consanguinity
• Dental Enamel/abnormalities
• Female
• Humans
• Incisor/abnormalities
• Maxilla
• Tooth Abnormalities/complications
• Tooth Crown/abnormalities
• Tooth, Deciduous/abnormalities

Talon cusp is a supernumerary structure projecting from the dento-enamel junction to a variable distance towards the incisal edge of an anterior tooth. Studies have shown that it consists of enamel, dentine and a variable amount of pulp tissue. Hyperactivity of the enamel organ during morphodifferentiation has been attributed to its formation. Most previous reports have been made concerning the occurrence of this structure on primary and permanent teeth and mostly on the palatal aspect. Only few have been reported on the facial aspect of the teeth. When it occurs, the effects are mainly aesthetic and functional and so early detection and treatment is essential in its management to avoid complications.

An unusual case of talon cusp on the facial aspect of a mandibular central incisor is reported. Its presence resulted in attrition of the opposing tooth. Reduction of the cusp and topical application of fluoride gel was initiated.

The management and treatment outcome of talon cusp depends on the size, presenting complications and patient cooperation.

• Abnormalities, Multiple/pathology
• Dentition
• Follow-Up Studies
• Humans
• Mouth Abnormalities/etiology
• Mouth Abnormalities/pathology
• Rubinstein-Taybi Syndrome/complications
• Rubinstein-Taybi Syndrome/pathology

• England
• Fused Teeth/history
• History, Medieval
• Humans
• Incisor/abnormalities
• Maxilla
• Paleodontology
• Tooth Abnormalities/history
• Tooth Crown/abnormalities
• Tooth, Deciduous/abnormalities
• Tooth, Supernumerary/history

• Adult
• Dens in Dente/pathology
• Humans
• Incisor/abnormalities
• Male
• Maxilla