A rare developmental dental anomaly: Talon's Cusp
A rare developmental dental anomaly: Talon's Cusp
Background:

A 26-year-old female patient reported to the dental clinic with the chief complaint of an extraoral sinus with frequent pus discharge since 10 days and swelling in the submental region along with acute throbbing pain and fever.

Medical history:

Patient was healthy with no current medical concerns

Dental history:

No relevant dental history

Clinical examination:

Intraorally there was brown discoloration of Mandibular Right Central Incisor(41) along with anomalous structure resembling an eagle's talon projecting from cingulum.

The Cusp was blending smoothly with the tooth with a deep developmental groove.

Oral hygiene status: Fair

No other soft or hard tissue anomaly was found.

Investigation:

Upon digital radiographic examination using Radio visual graphy (RVG) revealed periapical irregular radiolucency indicating of periapical infection.

Treatment goals:

To resolve extra oral sinus associated with dental infection

Treatment plan:

The Patient was explained all the treatment modalities along with pros and cons and ultimately Patient chose the extraction of the tooth.

Phase I - Preoperative medication

For fever and pain: combination of Paracetamol 500 mg and Diclofenac Sodium 50 mg TDS for 5 days was prescribed

For infection: Combination of Amoxicillin 500 mg with Clavulanic Acid 125 mg BD for 5 days was prescribed

The Patient recalled after 3 days.

Phase II - Patient evaluation and extraction

There was no pus discharge from sinus and the swelling subsided with no complaint of fever in last 24 hours.

The Mandibular Right Central Incisor(41) tooth was extracted along with socket curettage

Postoperative instructions were given.
The Patient was recalled after 5 days.

Phase III - patient evaluation and maintenance

The socket healing was satisfactory.
Extra oral sinus was resolved.

The Patient is recalled after 4 weeks for healing evaluation and prosthetic consideration.

Summary:

Talon cusp is a developmental disturbance in the shape of teeth resembling an eagle's talon. This is uncommon among the general population. However it has been reported prevalent in person with Rubinstein Taybi syndrome(developmental retardation,broad thumbs,great toes,characteristic facial features )

Reference:

Developmental Disturbances of Oral and Paraoral Structures,Shafer's Textbook Of Oral Pathology;seventh edition; Shafer,Hine,Levy Page number 42
V●●●●●a G●●●●o and 23 others like this
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Dr. F●●●●l S●●●●h
Dr. F●●●●l S●●●●h Dentistry
I appreciate the way the treament phases were carried out and the way they are documented..!! good job..!!
Aug 26, 2016Like
V●●●●●a G●●●●o
V●●●●●a G●●●●o Dentistry
Nice case!
Aug 26, 2016Like
H●●●y K●●●●●n
H●●●y K●●●●●n Dentistry
Great information from a student's perspective
Aug 27, 2016Like