A rare developmental dental anomaly: Talon's Cusp
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.
Patient was healthy with no current medical concerns
No relevant dental history
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.
Upon digital radiographic examination using Radio visual graphy (RVG) revealed periapical irregular radiolucency indicating of periapical infection.
To resolve extra oral sinus associated with dental infection
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.
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 )
Developmental Disturbances of Oral and Paraoral Structures,Shafer's Textbook Of Oral Pathology;seventh edition; Shafer,Hine,Levy Page number 42