Talon cusp

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Talon cusp
Talon cusp on a tooth
Synonyms Dens evaginatus of anterior teeth
Pronounce N/A
Specialty N/A
Symptoms Extra cusp on the lingual or palatal surface of a tooth
Complications Malocclusion, tooth wear, pulpal necrosis
Onset Developmental
Duration Permanent
Types N/A
Causes Genetic factors
Risks
Diagnosis Clinical examination, radiographic imaging
Differential diagnosis Dens invaginatus, supernumerary teeth
Prevention
Treatment Selective grinding, restorative dentistry, endodontic therapy
Medication
Prognosis Generally good with treatment
Frequency Rare
Deaths


A dental anomaly characterized by an extra cusp on an anterior tooth


A talon cusp is a rare dental anomaly characterized by the presence of an extra cusp on the surface of an anterior tooth, typically a maxillary incisor. This additional cusp resembles an eagle's talon, hence the name. Talon cusps can vary in size and shape, and they may contain enamel, dentin, and sometimes a pulp horn.

Epidemiology

Talon cusps are relatively uncommon, with a prevalence ranging from 0.04% to 10% in different populations. They are more frequently observed in the permanent dentition than in the primary dentition. There is no significant gender predilection, although some studies suggest a slight male predominance.

Etiology

The exact cause of talon cusp formation is not well understood. It is believed to result from an alteration in the morphodifferentiation stage of tooth development. Genetic factors may play a role, as talon cusps have been observed in association with certain syndromes, such as Sturge-Weber syndrome and Rubinstein-Taybi syndrome.

Clinical presentation

Talon cusps are most commonly found on the lingual surface of the maxillary lateral incisors, but they can also occur on the central incisors and, less frequently, on mandibular incisors. The cusp may be unilateral or bilateral. Clinically, a talon cusp can cause esthetic concerns, occlusal interference, and difficulties in maintaining oral hygiene.

Diagnosis

Diagnosis of a talon cusp is primarily clinical, based on visual examination and palpation. Radiographic imaging, such as periapical radiographs, can help assess the extent of the cusp and its relationship to the pulp chamber. The cusp appears as a V-shaped radiopaque structure superimposed over the crown of the affected tooth.

Management

The management of a talon cusp depends on its size, location, and associated symptoms. In asymptomatic cases, no treatment may be necessary. However, if the cusp interferes with occlusion or causes esthetic concerns, gradual reduction of the cusp may be performed. This should be done cautiously to avoid pulp exposure. In some cases, endodontic treatment may be required if the pulp is involved.

Prognosis

The prognosis for teeth with talon cusps is generally good, especially if the condition is managed appropriately. Regular dental check-ups are recommended to monitor the affected teeth and address any potential complications.

See also

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Contributors: Prab R. Tumpati, MD