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Anomalies of Tooth Structure

Course Number: 651

Accessory Cusps

The talon cusp, a supernumerary or accessory cusp, affects maxillary or mandibular incisor teeth.10 This extra cusp occurs on the cingulum of maxillary lateral incisor teeth, most commonly, followed respectively by maxillary central incisors, mandibular incisors, and maxillary canine teeth.7 More common in the permanent dentition, the cusp extends from the lingual aspect of the tooth with a formation that resembles an eagle’s talon.10 Facial talon cusps have been reported but are rare.10 The cusp is well-formed and extends at least half the distance from the cementoenamel junction to the incisal edge, often containing a pulpal extension.7,10 A deep developmental groove may exist between the talon cusp and the underlying tooth structure.7,10 Radiographically, the cusp anatomy will appear superimposed over the other tooth structure components.7,10 The pulpal extension, if present, may not be demonstrated radiographically.10

Talon cusps tend to occur more frequently in Native American, Asian, Inuit and Arab populations with prevalence ranging from 1-8%.7,10 This cuspal anomaly can occur in either gender and may present unilaterally or bilaterally.7,9 The talon cusp is often associated with other dental anomalies such as supernumerary teeth, impacted teeth and dens invaginatus.9,10