Prevalence of Talon cusp in Indian population

Dens Evaginatus and Dens Invaginatus in Dilacerated Maxillary Lateral Incisor Diagnosed Using Cone Beam Computed Tomography - A Case Report and Review of Literature

INTRODUCTION

Dens invaginatus (DI) and Dens evaginatus (DE), the developmental anomalies affecting the morphology of the tooth structure are extremely rare to occur. DI occurs because of invagination of a crown into dental papillae. DE is a tubercular emergence from occlusal surfaces of posterior teeth and lingual surfaces of anterior teeth. The two anomalies on separate teeth are frequently mentioned, but their co-occurrence in a single tooth is a rare entity.

PATIENT CONCERNS

A 20-year-old male patient presented with the rare combination of DE and DI on a dilacerated maxillary right lateral incisor diagnosed using cone beam CT. Treatment: The patient was managed conservatively and is undergoing fixed orthodontic treatment for malocclusion. Despite its uniqueness, very few localized cases have been documented.

TAKEAWAY LESSONS

These anomalies act as an etiological factor for several dental problems for neighboring & opposing tooth. Early diagnosis of such anomalies should be done so that prophylactic management can be initiated.

Facial Cellulitis Due to Type I Talon Cusp in a Pediatric Patient: A Case Report

Talon cusp is a rare odontogenic developmental anomaly with male predilection and multifactorial etiology. It projects as an accessory cusp-like structure from the cingulum area or the cement enamel junction (CEJ) affecting both primary and permanent dentition. It is imperative to clinically examine the developing dentition for occlusal harmony, especially in children with this anomaly. This report highlights facial cellulitis as a complication arising from a type I taloned maxillary lateral incisor and its endodontic management in a female pediatric patient. It emphasizes the clinical significance, early diagnosis, and prompt prophylactic management of the talon cusp so as to prevent the development of acute sequelae in children.

Ternion Cusp: An Unusual Variant of Talon's Cusp: A Case Report

Background

Teeth are hard mineralized anatomical components of the dentofacial skeleton that are developed during the gestation period by odontogenesis. This dental development comprises five stages viz. initiation, proliferation, histodifferentiation, morphodifferentiation, and apposition. Excitation to the dental organ during morphodifferentiation is responsible for the formation of a talon cusp, which manifests as a cusp-like structure of hard tissue projecting from the cingulum to a varying measurable length toward the incisal edge of maxillary and mandibular anterior teeth. Various literature has reported that it comprises enamel, dentine, and an inconsistent amount of pulp tissue. Old literature suggests its occurrence in primary and permanent teeth and mostly on the palatal aspect of teeth as one cusp; therefore, known as a talon cusp (eagle's talon).

Case description

An exceptional case of three cusped structures projecting from the palatal side of a maxillary central incisor is thus reported. The rare occurrence of an atypical talon cusp with three well-defined mamelon-like cusps on the palatal surface of the permanent maxillary central incisor is coined as ternion cusp, meaning "three" by authors. Its occurrence is repercussed as attrition of the teeth in the opposite arch. Selective or retruded contact position (RCP) was done, followed by topical fluoride application was rendered.

Conclusion

Managing and treating these exceptional cusps depends upon their size, present complications, and patient compliance.

How to cite this article

Sharma V, Mohapatra A, Bagchi A. Ternion Cusp: An Unusual Variant of Talon's Cusp: A Case Report. Int J Clin Pediatr Dent 2022;15(6):784-788.

Evaluating the Prevalence and Distribution of Dental Anomalies in the Permanent Dentition of Patients Seeking Dental Care

BACKGROUND

 Disturbances seen during tooth formation result in developmental dental anomalies presenting in the oral cavity. These anomalies manifest as discrepancies in the number, color, size, and shape of the teeth. These dental anomalies can either be acquired, congenital, or developmental. Their early detection and management are necessary as they affect aesthetics and occlusion. The study had the aim of gauging the prevalence of developmental anomalies in the permanent dentition of Indian subjects.

METHODS

A total of 1192 participants recruited from the institute for study purposes, comprising males and females, were examined clinically and radiographically, and their dental casts were also evaluated. These subjects were assessed for anomalies in position, structure, number, and/or shape. Anomalies in the position include transmigration, transportation, and/or ectopic position; anomalies in the structure, including dentinogenesis imperfecta or amelogenesis imperfecta; anomalies in number, including hyperdontia or hypodontia; and anomalies in shape, including peg laterals, taurodontism, fusion, dens evaginatus, talon cusp, and/or microdontia.

RESULTS

A statistically significant difference was seen in unilateral microdontia and dentinogenesis imperfecta between males and females, with attained p-values of 0.003 and 0.06, respectively. The results of the present study showed that 9.89% (n = 118) study subjects, whereas 1% (n = 12) study subjects had two dental anomalies in their permanent dentitions, with no subject presenting more than two dental anomalies, showing that various dental anomalies have a low prevalence in the Indian population.

CONCLUSION

The present study has led to the conclusion that the prevalence of dental anomalies is low in Indian subjects. However, these anomalies should be detected and treated early to prevent them from causing further complications.

Double facial talons on maxillary incisor-A rare case report and new proposed classification system

Background

Double facial talon's cusp is a rare developmental anomaly affecting the deciduous or/and permanent dentition. The major complications associated with facial talons of maxillary incisors include poor esthetic appearance with increased susceptibility to caries and, sometimes, even soft tissue irritation, thereby needing early detection and precise management.

Case Report

We report a case of a 10 year-old female patient with a large double talon's cusp on the permanent left maxillary central incisor who presented with issues of soft tissue irritation and esthetic concern. One of the highlighting feature of this documented case was the difference in the extent of both talon's cusps on the facial surface of 21 teeth. As per Mayes' classification system, the talon towards the midline belonged to stage 2 and the talon away from the midline belonged to stage 3.

Highlights

Based on the previous literature search on classification systems, we intended to propose a new classification system for double facial talons depending on their size (equal/unequal) and presence of developmental grooves (separate or fused). The aim of this new classification system is to enlighten a new area of research that can be conducted on the treatment aspect by studying the difference in the structure of enamel rods, dentin, especially in case of double talons of unequal size (as the direction of enamel rods/dentinal tubules of the talons with that of the direction of enamel rods/dentinal tubules of the underlying tooth will vary) and their compatibility with choice of dental materials, to be used for proper adaptation and develop new treatment protocols of tooth preparation and restoration for such cases.

Prevalence of talon cusp: Systematic literature review, meta-analysis and new scoring system

OBJECTIVES

Talon cusp is a developmental anomaly consisting of a vertical ridge or cusp projecting labially or lingually from an anterior permanent or primary tooth. A range of prevalence between 0.06 % and 40.8 % has been reported in the literature. Although many epidemiological studies have been conducted, no synthesis of these data has been performed to date. The aim of this paper was to determine the prevalence of talon cusp and to investigate the link between sex and talon cusp.

SOURCE

A systematic search was undertaken using the PubMed/Medline, Embase and Cochrane Library electronic databases for publications from 1981 to 2020 investigating the prevalence of talon cusp and the link between talon cusp and sex.

STUDY SELECTION

Three reviewers selected the studies independently, extracted the data in accordance with the PRISMA statement, and assessed the risk of bias via the GRADE & Cochrane approaches.

RESULTS

From 39 potentially eligible studies, 9 were selected for full text analysis and 8 were included in the meta-analysis, representing 35,224 participants. The meta-analyses were performed with a random model, calculating a weighted-mean prevalence (at least one talon cusp per individual) of 1.67 %. Sex and talon cusp were not statistically significantly associated in our study (OR = 1.10; 95 % CI [0.82-1.47]; p > 0.05).

DISCUSSION

We report the first prevalence of talon cusp provided by meta-analysis in a non-syndromic sample. A non-statistically significant association between sex and talon cusp is relevant in terms of genetic etiology. In order to improve the homogeneity and accuracy of the results of further studies, we propose a new universal scoring system for talon cusp.

CLINICAL SIGNIFICANCE

Talon cusp is a developmental anomaly with various clinical implications. Therapeutics may vary from simple monitoring to extraction of the supporting tooth. This condition occurs in approximately 1.67 % of the population.

Prevalence of Shape-related Developmental Dental Anomalies in India: A Retrospective Study

Aim and objective

The aim and objective of this study was to review the literature to analyze the prevalence of developmental dental anomalies regarding shape in India.

Background

Although there have been several studies investigating the prevalence of individual dental anomalies related to shape, only a few studies considered all subtypes and their distribution among genders, especially in India.

Results

An electronic search was made in the PUBMED database to review prevalence-based data on developmental dental anomalies related to shape in India up to December 2018. A diverse range of results regarding prevalence of developmental dental anomalies related to shape were seen in these studies due to vast regional, cultural, and ethnic diversities and various environmental factors affecting the tooth development.

Conclusion

There is a necessity to conduct more study on shape-related dental anomalies because there are very limited studies regarding prevalence of concrescence, dilacerations, and accessory root and various associated factors.

Clinical significance

Early diagnosis and timely management of these anomalies can prevent complications. The knowledge on identification and prevalence of dental anomalies helps the dental practitioners improve the treatment plan. The prevalence studies can be of utmost importance in the formulation of oral healthcare programs by using their data to analyze the intensity of dental anomalies.

How to cite this article

Goswami M, Bhardwaj S, Grewal N. Prevalence of Shape-related Developmental Dental Anomalies in India: A Retrospective Study. Int J Clin Pediatr Dent 2020;13(4):407–411.