Mandibular facial talon cusp: Case report

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.The management and treatment outcome of talon cusp depends on the size, presenting complications and patient cooperation.This unusual dental anomaly showing an accessory cusp-like structure projecting from the cingulum to the cutting edge was first described by Mitchell in 1892 [1]. It was thereafter named a Talon cusp by Mellor and Ripa [2] due to its resemblance to an eagle's talon. Since then, this odontogenic anomaly has been given several descriptions, such as, prominent accessory cusp-like structure [3], exaggerated cingula [4] additional cusp [5], cusp-like hyperplasia [6], accessory cusp [7] and supernumerary cusp [8]. It has been defined as a supernumerary accessory talon-shaped cusp projecting from the lingual or facial surface of the crown of a tooth and extending for at least half the distance from the cemento-enamel junction to the incisal edge [7]. There is a wide variation in the size and shape of this anomaly. Due to this variation, and in order to have a diagnostic criteria, it has been classified into 3 types by Hattab et al [9]:Type1: Talon – refers to a morphologically well-delineated additional cusp that prominently projects from the palatal (or facial) surface of a primary or permanent anterior tooth and extends at least half the distance from the cemento-enamel junction to the incisal edge.Type 2: Semi talon – refers to an additional cusp of a millimeter or more extending less than half the distance from the cemento-enamel junction to the incisal edge. It may blend with the palatal surface or stand away from the rest of the crown.Type 3: Trace talon – an enlarged or prominent cingula and their variations, i.e. conical, bifid or tubercle-like.Radiographically, it may appear typically as a v-shaped radiopaque structure,