Home | About Us | Editorial Board | Current Issue | Archives | Search | Instructions | Subscription | Feedback | e-Alerts | Login 
Journal of Indian Society of Pedodontics and Preventive Dentistry Official publication of Indian Society of Pedodontics and Preventive Dentistry
 Users Online: 815  
 
  Print this page Email this page   Small font sizeDefault font sizeIncrease font size


 
  Table of Contents    
CASE REPORT
Year : 2011  |  Volume : 29  |  Issue : 3  |  Page : 248-250
 

Talon cusp in a primary incisor: A rare entity


Department of Pediatric and Preventive Dentistry, Oral Health Sciences Center, PGIMER, Chandigarh, India

Date of Web Publication10-Oct-2011

Correspondence Address:
A Kapur
Department of Pediatric and Preventive Dentistry, Oral Health Sciences Centre, PGIMER, Sector 12, Chandigarh
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-4388.85835

Rights and Permissions

 

   Abstract 

This case report describes the presence of a talon cusp in a right primary incisor in a 6-year-old girl. It is a rare entity with only three cases having been reported from the Indian population. The talon cusp showed presence of wear facets along with altered morphology of the involved tooth. No treatment was done apart from sealing the cusp-tooth interface with fissure sealant.


Keywords: Primary incisor, talon cusp


How to cite this article:
Kapur A, Goyal A, Bhatia S. Talon cusp in a primary incisor: A rare entity. J Indian Soc Pedod Prev Dent 2011;29:248-50

How to cite this URL:
Kapur A, Goyal A, Bhatia S. Talon cusp in a primary incisor: A rare entity. J Indian Soc Pedod Prev Dent [serial online] 2011 [cited 2019 Jul 16];29:248-50. Available from: http://www.jisppd.com/text.asp?2011/29/3/248/85835



   Introduction Top


Talon cusp as a developmental anomaly is easily diagnosed due to its prominent and characteristic appearance. It is projected as an accessory cusp from the cingulum area of an anterior tooth resembling an eagle's talon, which is the shape of an eagle's claw when hooked on to a prey. It may vary in its projection from a well-defined additional cusp prominently projecting from the palatal surface of an anterior tooth and extending at least half the distance from the cemento-enamel junction to the incisal edge- a Type 1 or true talon, to just an enlarged and prominent cingulum- a type III talon; type II being an additional cusp of 1 mm that extends less than half the distance from the cemento-enamel junction to the incisal edge, which either blends with the palatal surface or stands away from the crown, known as a semi-talon. [1],[2] The most accepted hypothesis regarding its etiology is the aberrant hyperactivity of the anterior part of the dental lamina. [1] The role of genetic and environmental influences is yet unclear. This anomaly has more commonly been reported in the permanent dentition with prevalence ranging from 0.06−7.7%. The total number of reported cases in the primary dentition worldwide is 39, with one or more teeth affected; 21 of these individuals are males. [1] There are, however, only three cases reported from the Indian population. [3],[4],[5] This article adds one more case to the existing pool of cases in primary dentition.


   Case Report Top


A 6-year-old Indian girl belonging to the low socio-economic group reported to the Out Patient Department of Unit of Pediatric Dentistry with the chief complaint of decayed teeth. Extra-oral findings were not significant. Intra-oral findings revealed an early mixed dentition stage with multiple carious teeth and erupting permanent manibular incisors. A prominent talon cusp (type I) was visible on the palatal surface of the right maxillary primary incisor [Figure 1]. No other anterior tooth had this projection. Occlusion was end-on and there was no interference on closure, in spite of wear facets on the tip of the talon's cusp [Figure 2], as the mandibular primary central incisors had exfoliated and the permanent incisors were still erupting. Family history was doubtful as the patient's mother was not aware of the present condition as well. The involved incisor on closer examination was found to be morphologically different form its antimere with a concavity present on the labial surface corresponding to the projection on the palatal side, giving it a 'pulled back' appearance [Figure 3]; along with a sagged or U-shaped incisal edge [Figure 4]. It was similar in dimensions to the contra lateral tooth and was positioned labially. An intra-oral peri-apical radiograph revealed the pulp horn extending to nearly half the length of the talon's cusp [Figure 5]. No treatment was rendered apart from sealing the sides of the talon with a fissure sealant and routine restorative care [Figure 6].
Figure 1: A prominent talon on the palatal aspect of 51

Click here to view
Figure 2: Wear facets on the tip of talon's cusp

Click here to view
Figure 3: Concavity on the labial surface of 51

Click here to view
Figure 4: U-shaped incisal edge

Click here to view
Figure 5: Intra-oral periapical view showing pulp extension into half length of the talon cusp

Click here to view
Figure 6: Post– restorations

Click here to view



   Discussion Top


Talon cusp was first reported by William Mitchell in the year 1892 in a permanent incisor, which showed an accessory cusp-like structure, projecting lingually from the cingulum. [1],[8] The term 'talon' was coined by Mellor and Ripa in 1970 because of its characteristic resemblance to an eagle's talon. The first reported case in primary dentition is by Sawyer et al. (1976) found in the archeological remains of prehistoric times. [1] Since then, nearly 39 more case reports have been published, one of them being present in the archeological remains of a 5-year-old child in UK, dating back to the period AD 950-1350, [1] The first clinical case in the primary dentition was reported by Henderson in 1977 in a 4-year-old Filipino girl. [6],[7] All these cases depicted talon's cusp on the palatal surfaces of primary maxillary incisors except one case report, which showed its presence in the primary mandibular lateral incisors. [4] Batra P et al. (2006) for the first time, reported talon cusp on the facial aspect of primary lateral incisors in two non-syndromic cleft lip and palate cases. [8] Siraci et al. (2006) reported the presence of both facial and palatal talon on a supernumerary tooth in a 3.5-year-old boy with cleft lip and palate. [9]

This abnormality has been more frequently reported in the Asian population. [1] Based on their clinical experience, Chen and Chen stated that there does not appear to be a difference in the prevalence of talon cusp in the primary and permanent teeth in the Chinese population. [7] This point is worth noting as its prevalence in primary dentition in the Indian population may also be more than reported. In the present case too, it had not been observed by the parent and had got noticed during a routine clinical examination.

The presence of a talon's cusp can cause problems such as occlusal interferences; predisposition to dental caries and unpleasant esthetics as was seen in the present case. The occlusal disturbance could be diagnosed from the wear facets on the cusp tip of the talon. A few more complications such as tongue irritation, accidental cusp fracture, advanced attrition leading to pulp exposure, misinterpretations of radiographs, displacement of opposing teeth, damage to periodontium due to excessive occlusal force and temporomandibular joint pain have also been reported. [2],[7]

Preventive treatment towards dental caries should be done in every case by sealing the interface of the talon and the palatal surface of the involved tooth with a fissure sealant as was done in the present case. Occlusal disturbances and unpleasant esthetics necessitates cusp reduction, which should be done at periodical intervals with an aim to facilitate formation of reparative dentin. The presence of a pulp horn in all cases of talon cusp is doubtful; but care should be taken to avoid inadvertent pulp exposure while reduction, in case the pulp extension is visible radio graphically.

 
   References Top

1.Mays S. Talon cusp in a primary lateral incisor from a medieval child. Int J Paediatr Dent 2005;15:67-72.  Back to cited text no. 1
[PUBMED]  [FULLTEXT]  
2.Hattab FN, Yassin OM. Bilateral talon cusps on primary central incisors: a case report. Int J Paediatr Dent 1996;6:191-5.  Back to cited text no. 2
[PUBMED]    
3.Subba Reddy VV, Mehta DS. Talon cusp in a primary lateral incisor: Report of a case. J Indian Soc Pedod Prev Dent 1989;1:20-2.  Back to cited text no. 3
    
4.Hegde S, Kumae BR. Mandibular talon cusp: Report of two rare cases. Int J Pediatr Dent 1999;9:303-6.  Back to cited text no. 4
    
5.Sarkar S, Misra J. Talon cusp in primary dentition: a case report. J Indian Soc Pedod Prev Dent 2000;18:151-2.  Back to cited text no. 5
[PUBMED]    
6.Morin CK. Talon cusp affecting the primary maxillary central incisors: Report of case. ASDC J Dent Child 1987;54:283-6.  Back to cited text no. 6
[PUBMED]    
7.Chen RJ, Chen HS. Talon cusp in primary dentition. Oral Surg Oral Med Oral Pathol 1986;62:67-72.  Back to cited text no. 7
[PUBMED]    
8.Batra P, Enocson L, Hagberg C. Facial talon cusp in primary maxillary lateral incisor: A report of two unusual cases. Acta Odontol Scand 2006;64:74-8.  Back to cited text no. 8
[PUBMED]  [FULLTEXT]  
9.Siraci E, Cem Gungor H, Taner B, Cehreli ZC. Buccal and palatal talon cusps with pulp extensions on a supernumerary primary tooth. Dentomaxillofac Radiol 2006;35:469-72.  Back to cited text no. 9
[PUBMED]    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]



 

Top
Print this article  Email this article
 

    

 
  Search
 
  
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Article in PDF (13,799 KB)
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  


    Abstract
   Introduction
   Case Report
   Discussion
    References
    Article Figures

 Article Access Statistics
    Viewed4629    
    Printed86    
    Emailed3    
    PDF Downloaded346    
    Comments [Add]    

Recommend this journal


Contact us | Sitemap | Advertise | What's New | Copyright and Disclaimer 
  2005 - Journal of Indian Society of Pedodontics and Preventive Dentistry | Published by Wolters Kluwer - Medknow 
Online since 1st May '05