Bilateral gemination with talon cusp: report of case

Unilateral fusion of maxillary lateral incisor: diagnosis using cone beam computed tomography

Objective. The objective of this paper is to report a dental fusion case focusing on clinical and radiographic features for the diagnosis. Method. To report a case of right maxillary lateral incisor fusion and a supernumerary tooth, the anatomy of the root canal and dental united portion were assessed by cone beam computed tomography (CBCT). Results. The clinical examination showed dental juxtaposition with the absence of interdental papilla and esthetic impairment in the right maxillary lateral incisor region. The periapical radiography did not provide enough information for the differential diagnosis due to the inherent limitations of this technique. CBCT confirmed the presence of tooth fusion. Conclusion. CBCT examination supports the diagnosis and provides both the identification of changes in tooth development and the visualization of their extent and limits.

Management of 'double teeth' in children and adolescents

BACKGROUND

Abnormally, large teeth are often referred to as 'double teeth'. These can pose numerous challenges for the clinician. There is no published protocol on the management of double teeth.

AIM

To review the published literature and also patients managed at the Eastman Dental Hospital (EDH) and to develop a clinical protocol for the management of double teeth in children and adolescents.

DESIGN

Literature was searched (Medline and Embase) and data collated. Patient notes of cases managed at the EDH were reviewed.

RESULTS

Eighty-one teeth from 53 papers and 22 patients were included in the review. Success criteria were only reported in 32 papers and were variable. Twenty-three papers had no follow-up period. The main factor in determining the management of a double tooth was root and root canal system morphology. The treatment of choice in teeth with separate roots was hemisection and in those with a single root was crown modification or extraction.

CONCLUSION

It was not possible to determine the best management strategies because of the variable reporting in the literature. The authors have proposed a protocol for management and a data collection sheet for essential information needed when reporting on double teeth cases.

A rare occurrence of geminated-taloned maxillary lateral incisor

The talon cusp is a developmental anomaly characterized by the presence of an accessory cusp like structure projecting from the cingulum area of the anterior teeth. Gemination is an anomaly caused by a single tooth germ that attempted to divide during its development. These developmental anomalies may cause clinical problems including esthetic impairment, pain, caries and tooth crowding. Co-occurrence of two anomalies in a teeth is rare. This paper presents an unusual case of talon cusp on geminated permanent lateral incisor. How to cite this article: Neeraja R, Kayal VG. A Rare Occurrence of Geminated-Taloned Maxillary Lateral Incisor. Int J Clin Pediatr Dent 2012;5(2):136-138.

Occurrence of talon cusp on a geminated maxillary central incisor: a case report

This article reports an uncommon case of talon cusp on a geminated permanent maxillary central incisor, including details of the clinical and radiographic findings and treatment. A 28-year-old woman presented at the university dental clinic, and intraoral examination revealed a maxillary central incisor of abnormal size with a prominent accessory cusp on the lingual aspect. The case was diagnosed as talon cusp on a geminated tooth. Early diagnosis of this anomaly is important since it may cause clinical problems such as esthetic concerns, caries and tooth crowding. In the present case, these anomalies did not complicate the subsequent endodontic treatment.

The relationship between a primary maxillary incisor with a talon cusp and the permanent successor: a study of 57 cases

BACKGROUND

Most reported cases of talon cusps in the primary dentition have been on the maxillary central incisors and the permanent successors have remained unaffected. Four of the five reported cases on a maxillary lateral incisor, however, have been associated with a supernumerary permanent successor.

AIM

This paper describes the relationship between the presence of talon cusps on a primary maxillary incisor, and the morphology and number of the permanent successors in a population of Chinese children.

DESIGN

The dental records of children diagnosed with a talon cusp on a primary incisor were retrieved for review. The diagnoses took place in a regional school dental clinic in Hong Kong between April 2002 and August 2005.

RESULTS

Fifty-eight primary maxillary incisors with talon cusps were found. When the central incisors were involved, 32 of the 35 (91.4%) underlying permanent successors were not found to be associated with any odontogenic abnormalities. When the lateral incisors were involved, however, 18 of the 23 cases (78.3%) showed odontogenic abnormalities, 14 of which were associated with supernumerary teeth.

CONCLUSIONS

The present study shows that, when there is a talon cusp on a primary maxillary lateral incisor, a high proportion of the underlying permanent successors can be expected to exhibit odontogenic abnormalities.

Labial and palatal talon cusps on geminated tooth associated with dental root shape abnormality: a case report

Talon cusp on a geminated tooth is a very rare condition. To the best of our knowledge, the literature contains only one case report of a labial talon cusp on a geminated tooth. This is the first clinical report describing a case of bilateral talon cusps on geminated permanent maxillary central incisors associated with dental root shape abnormality and its successful management.

An unusual case of talon cusp on a geminated tooth

Talon cusp is a developmental anomaly seen on the lingual surface of anterior teeth. Gemination is an anomaly caused by a single tooth germ that attempted to divide during its development. These developmental anomalies may cause clinical problems including esthetic impairment, pain, caries and tooth crowding. This paper presents an unusual case of gemination accompanied by talon cusp in permanent dentition. The clinical and radiographic findings are described.

Mandibular facial talon cusp: case report

Background

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.

Case presentation

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.

Conclusion

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

Talon cusp in a primary lateral incisor from a medieval child

This paper describes talon cusp in an ancient skeleton and is a rare report of its occurrence in a primary lateral incisor. As well as talon cusp, the affected incisor also shows abnormal widening, probably representing a double tooth. There is also a supernumerary permanent incisor. The report shows that talon cusp existed in British populations more than 600 years before the first written description. A brief review of the literature on the occurrence of talon cusp in the primary dentition is presented.

Clinical problems associated with unusual cases of talon cusp

CASE REPORT

Talon cusp is an uncommon dental anomaly manifested as an accessory cusp-like structure on the crown of anterior teeth. This report describes two unusual cases of talon cusp. Case 1 showed bilateral anomalous cusps on the palatal aspects of maxillary supernumerary teeth, causing premature contact and tooth impaction. In case 2, a double-fused talon cusp was projected from the palatal surface of a large geminated central incisor. A talon cusp is not an innocuous defect, as it may provide a substantial diagnostic, treatment planning and procedural challenge. Early diagnosis and management are important to avoid complications.

Dens evaginatus of anterior teeth. Literature review and radiographic survey of 15,000 teeth

Case reports published between 1970 and 1995 that describe the characteristics of dens evaginatus of anterior teeth were reviewed. In addition, a radiographic survey of 15,000 anterior teeth was conducted to determine the occurrence of this developmental malformation. In this survey, dens evaginatus was found in about 1% of the anterior dentition and was more frequent in the maxilla, particularly in the lateral incisor. This anomaly was less frequent in the mandible.