The relationship between a primary maxillary incisor with a talon cusp and the permanent successor: a study of 57 cases

BACKGROUND: Most reported cases of talon cusps in the primary dentition have been on the maxillary central incisors and the permanent successors have remained unaffected. Four of the five reported cases on a maxillary lateral incisor, however, have been associated with a supernumerary permanent successor. AIM: This paper describes the relationship between the presence of talon cusps on a primary maxillary incisor, and the morphology and number of the permanent successors in a population of Chinese children. DESIGN: The dental records of children diagnosed with a talon cusp on a primary incisor were retrieved for review. The diagnoses took place in a regional school dental clinic in Hong Kong between April 2002 and August 2005. RESULTS: Fifty-eight primary maxillary incisors with talon cusps were found. When the central incisors were involved, 32 of the 35 (91.4%) underlying permanent successors were not found to be associated with any odontogenic abnormalities. When the lateral incisors were involved, however, 18 of the 23 cases (78.3%) showed odontogenic abnormalities, 14 of which were associated with supernumerary teeth. CONCLUSIONS: The present study shows that, when there is a talon cusp on a primary maxillary lateral incisor, a high proportion of the underlying permanent successors can be expected to exhibit odontogenic abnormalities.     

An unusual case of double teeth with facial and lingual talon cusps

Double teeth and talon cusps are rare developmental dental anomalies affecting both primary and permanent dentitions. Talon cusps normally occur on the palatal surface of permanent maxillary incisors, although double teeth are more common in the primary anterior dentition. This paper describes a rare case of fusion of the mandibular permanent incisors with labial and lingual talon cusps. An understanding of these dental anomalies and their associated problems are important to provide prophylactic measures, thereby preventing or minimizing possible complications.     

A retrospective study on 69 cases of maxillary tooth transposition

The published literature on tooth transposition includes only a few studies that have involved more than 50 subjects. The aim of the present study was to investigate the prevalence of true maxillary tooth transposition and possible associated dental anomalies in a larger sample of children. The dental records and radiographs of children who had been diagnosed as having true maxillary tooth transposition at a School Dental Clinic in Hong Kong were studied retrospectively. Data were analyzed for sex and side distribution, as well as for associated dental anomalies. Trends of differences were analyzed statistically using the Fisher exact or chi-squared test. A total of 69 cases of true maxillary tooth transposition were identified and studied; its prevalence in Hong Kong Chinese children was 0.81%. More females than males were affected, and the difference between the sexes was statistically significant (P < 0.05). The prevalence of congenitally missing teeth, microdontia of the maxillary lateral incisors or dental impaction was higher in patients with maxillary tooth transposition than in the general population (P < 0.05, P < 0.0005, and P < 0.0001, respectively). The fact that patients with maxillary tooth transposition were more likely to have congenital absence or microdontia of the maxillary lateral incisors lent further support to the contention that a developmental field defect plays a role in the pathogenesis of maxillary tooth transposition.     

Talon cusp in the primary dentition: literature review and report of three rare cases

This paper reviews the nomenclature, prevalence, definition, etiology, association with other dental/anomalies, diagnosis and treatment planning of talon cusp in the primary anterior teeth. Most of the reported cases have involved the primary maxillary central incisors. However, talon cusps on the primary maxillary lateral incisors are associated with high percentages of anomalies in the permanent successors. This paper reported three such rare cases and dentists should be aware of such additional anomalies.     

Management of supplemental permanent maxillary lateral incisors in association with talon cusp on the primary predecessors: a report of 3 cases

Most of the cases of talon cusp in the primary dentition affected the maxillary central incisors, but have no effect on the permanent successors. Among the 5 cases of a talon cusp in primary maxillary lateral incisors reported in the dental literature, however, one was associated with a supernumerary tooth and 3 with supplemental permanent successors. The purpose of this report was to describe 3 cases of a talon cusp on the primary maxillary lateral incisors of Chinese children, all of which were associated with talon teeth or the permanent successors. A conservative approach was used to manage these supplemental permanent lateral incisors, and the advantages of such an approach are discussed.     

Prevalence and distribution of anomalies of permanent dentition in 9584 Japanese high school students

This study investigated the prevalence and distribution of anomalies of permanent dentition in the current Japanese population by examining an unbiased sample. We conducted a survey of dental anomalies by mass dental screening at eight high schools in 2012. Participants were all students with permanent dentition. Dental anomalies were classified as hypodontia, supernumerary teeth, peg-shaped teeth, fused teeth, and talon cusps. Students with one or more dental anomalies on oral examination were given a differential diagnosis by three specialists. The final sample comprised 9584 participants (5062 boys, 4522 girls). Hypodontia was present in 372 students (3.88 %) with no significant sex difference (191 boys, 181 girls). Frequent sites were the right or left mandibular second premolar, right or left maxillary second premolar, and right or left maxillary lateral incisor. Supernumerary teeth were observed in three boys (0.06 %) and one girl (0.02 %). Peg-shaped teeth were observed in 74 students (0.77 %; 27 boys, 47 girls), differing significantly between sexes; they were most prevalent among maxillary lateral incisors. Of affected students, 18 students (0.19 %) also had hypodontia (3 boys, 15 girls). Fused teeth were present in two boys (0.04 %) and three girls (0.07 %) (gemination in one boy and fusion in the remaining four students). Sites were limited to maxillary and mandibular central and lateral incisors. Talon cusps were observed in two boys (0.04 %) and four girls (0.09 %). The present survey of a large unbiased sample can be considered to reflect the prevalence and distribution of anomalies of permanent dentition in the current Japanese population.     

Molar incisor hypomineralization in Hong Kong Chinese children

Background.   Most prevalence studies on molar incisor hypomineralization (MIH) were carried out in European countries, and data from the East-Asian populations were lacking.
Aim.   This study aimed to investigate the prevalence of MIH in Hong Kong Chinese children.
Design.   Since 2006, charting of teeth with MIH was included into the routine dental examination in a school dental clinic. The dental records of grade 6 primary school children who attended annual check-up in this clinic in 2006 were subsequently reviewed retrospectively. The records were selected for this study if the charting indicated that the children were affected by MIH.
Results.   A total of 2635 records were reviewed and 73 cases of MIH were identified. The prevalence of MIH in this group of children was 2.8%. Their mean age was 12, and the male-to-female ratio was 1 : 1.2. The mean decayed, missing, or filled permanent teeth value of those affected was 1.5, which was higher than that of the general Hong Kong Chinese children aged 12 years old (0.8). A total of 192 teeth were affected. The most commonly affected teeth were permanent maxillary first molars, followed by mandibular first molars and maxillary central incisors. Dental fillings and fissure sealants were found in 52 (38%) and 65 (47%) permanent first molars with hypomineralization, respectively. Medical histories were unremarkable in 60 children, whereas early childhood diseases were reported in 13 cases.
Conclusions.   The prevalence of MIH in the permanent dentition of Hong Kong Chinese children was 2.8%. Children with MIH showed higher caries experience in the permanent dentition than the general population of similar age.     

Talon cusp in primary dentition

Six cases of talon cusp in the primary dentition are reported, bringing to ten the total cases described in the literature. The dental anomaly affected only maxillary primary central incisors, and no succedaneous teeth were affected. None of the ten cases were associated with any abnormal development syndrome. Clinical observations suggest that the incidence of talon cusps in the primary dentition may be not lower than that in the permanent dentition in Chinese children.     

非综合征性单侧完全性唇腭裂恒牙发育异常的研究

目的 经回顾性研究了解非综合征性单侧完全性唇腭裂患者恒牙发育异常的情况.方法 收集244例植骨期非综合征性单侧完全性唇腭裂患者的影像学资料,记录和统计分析恒牙发育异常.结果 在本研究中各种恒牙异常的发生率为:先天缺失163例(269颗)(163/244,66.8%),最常累及的牙位是上颌侧切牙;畸形牙82例(85颗)(82/244,33.6%),绝大多数为上颌侧切牙的小牙畸形;额外牙12例(12颗)(12/244,4.9%),多发生于裂区,表现为畸形小牙.牙位发育异常的性别比较发现,非裂侧上颌仅侧切牙缺失,男性高于女性(P<0.05).裂侧的先天缺牙、额外牙和畸形牙的发生率均高于非裂侧,差异有统计学意义(P<0.01),上下颌均有相同发现.结论 非综合征性单侧完全性唇腭裂患者各类牙齿发育异常的患病率均高于健康人群.裂侧的牙齿发育异常较非裂侧更为多见.

Abstract：

Objective To investigate the prevalence of dentM anomalies in Chinese children with complete unilateral cleft lip and palate(UCLP).Methods Dental histories and radiographs of 244 Chinese children with UCLP were collected.The diagnosis of dental anomalies waft based on panoramic radiographs before alveolar bone grafting.All patients were over 8 years old.Results In the UCLP group,66.8% of the patients was presented with hypodontia.The maxillary lateral incisors were the most common teeth affected,followed by maxillary second premolars,mandibular incisors and mandibulax second premolars.A total of 33.6%the patients Was presented with dental malformation,most were mierodontic laterel incisors.A total of 4.9% the patients was presented with hyperdontim The supernumerary teeth were more frequently found in the cleft region.The prevalence of missing maxillary lateral incisor in the noneleft side was statistically different between genders,which was higher in male(P<0.050).This group of Chinese children with UCLP demonstrated significantly higher prevalence of hypodontia,hyperdontia,and malformation on the cleft side than on the noncleft side(P<0.01).Conclusions Hypodontia is the most common type of dental anomalies.The prevalence of dental anomalies is higher in the UCLP patients than in the normal population.Dental anomalies occur more frequently on the cleft side than on the nonclefi side.     

Talon cusp affecting permanent maxillary lateral incisors in 2 family members.

The term talon cusp refers to a relatively rare dental anomaly in which an accessory cusplike structure projects from the cingulum area or cement-enamel junction. The condition can occur in either maxillary or mandibular anterior teeth in both the primary and permanent dentitions. This article reports 2 cases of talon cusp affecting consanguineous first cousins: a case of bilateral talon cusps on the permanent maxillary lateral incisors of a 16-year-old girl, and a case of talon cusp on the maxillary permanent lateral incisor of an 11-year-old boy. The talon cusps caused clinical problems that were related to caries or occlusal interferences. The presence of the dental anomaly in 2 members of the same family suggests that genetic inheritance may be a causative (related) factor. Examination of relatives could facilitate early diagnosis of the talon cusp and aid in preventing carious and occlusal problems.     

Pulpal tissue in bilateral talon cusps of primary central incisors: report of a case

Talon cusp is a tooth anomaly that affects both the primary and the permanent dentitions. However, the occurrence of this anomalous cusp is rather infrequent in the primary dentition. Only 7 cases of bilateral talon cusps affecting the primary teeth have been reported in the dental literature. This is a case report of bilateral talon cusps on primary maxillary central incisors whose histologic evaluation revealed the existence of pulpal tissue in the anomalous cusps.     

右下颌切牙融合伴畸形舌侧尖1例

融合牙容易发生在下颌乳前牙，而畸形舌侧尖好发在上颌恒前牙。本文报道的是临床上较少见的单侧下颌中切牙和侧切牙发生融合且融合牙伴畸形舌侧尖1例，同时对本病例这两种发育异常的发生原因进行分析，提出相应的防治措施以应对其并发症的发生。     

The dental problems and management of a patient suffering from congenital insensitivity to pain

This is a case report of a Caucasian female who presented with an unusual combination of dental anomalies: short roots on the maxillary central incisors and premolars, talon cusps, dens invaginati, low alveolar bone heights, tubercles of Carabelli on the maxillary first and second permanent molars, with pyramidal root morphology in three of the second permanent molars. None of the anomalies alone are particularly uncommon but they have not previously been reported together. The occurrence of the anomalies is probably incidental as the conditions are aetiologically unrelated.     

Prevalence of abnormalities in dental structure, position, and eruption pattern in a population of unilateral and bilateral cleft lip and palate patients.

OBJECTIVE: To evaluate the dental characteristics of patients subjected to a protocol that included early secondary gingivoalveoloplasty (ESGAP). DESIGN: Panoramic radiographs of 87 patients with unilateral cleft lip and palate (UCLP) and 29 with bilateral cleft lip and palate (BCLP) were evaluated. Missing and supernumerary teeth were also quantified on the cleft and noncleft side and in the maxilla and mandible. Crown and root malformations and tooth rotations were quantified. A subsample in permanent dentition was extrapolated to analyze canine eruption patterns. RESULTS: A total of 48.8% of the UCLP patients presented with missing permanent lateral incisors in the cleft area and 6.1% contralaterally. A total of 4.9% presented with missing second maxillary premolars on the cleft site and 1.2% contralaterally. A total of 7.3% presented with supernumerary lateral incisors, and 45% of the BCLP cleft sites presented with missing lateral incisors, while 25% of the cleft sites presented second maxillary premolars agenesis. Five percent of the cleft sites presented with supernumerary lateral incisors. Evaluation of the subsample in permanent dentition showed that 15.5% had a canine retention and 4.4% of the canines had to be surgically exposed. A significant association was observed between canine inclination and retention but not with absence of the lateral incisor. CONCLUSIONS: The frequency of dental anomalies in this sample was similar to other cleft populations. As surgical trauma has been suggested to damage forming teeth, the results of this study indicated that ESGAP has no detrimental influence on subsequent dental development.     

乌鲁木齐地区青少年恒牙形态及数目异常的分析

目的探讨乌鲁木齐地区青少年先天缺失牙、多生牙、过小牙的发生率及好发部位。方法本文观察和分析了620例患者的全颌曲面体层X线片．均无恒牙拔牙史或牙齿损伤史。结果先天缺失牙（包括第三磨牙）的发生率为45．48％,第三磨牙的缺失发生率为32．58％,缺失牙的好发部位依次为上颌第三磨牙、下颌第三磨牙、下颌侧切牙、下颌中切牙、上颌第二双尖牙等;多生牙发生率为2．58％,好发部位是上颌切牙区。过小牙的发生率为6．30％．其主要为上颌侧切牙。结论牙齿先天缺失在人群中的发生率明显高于多生牙．缺失牙主要发生在功能相对弱的牙位上：缺失牙与过小牙之间存在一定联系．     

Hypodontia and hyperdontia of permanent teeth in Hong Kong schoolchildren

This study was performed to determine the prevalence of hypodontia and hyperdontia of permanent teeth amongst Southern Chinese children in Hong Kong. The sample consisted of 1093 12-yr-old children on whom a panoramic radiograph was taken. The prevalence of congenitally missing teeth (third molars excluded) was 6.1% in boys, 7.7% in girls, and 6.9% for both sexes combined. On the average, each child was missing 1.5 teeth. The most commonly absent tooth was the mandibular incisor, affecting 58.7% of the children with hypodontia. Thirty children (2.7%) had supernumerary teeth, with a male:female ratio of 6.5:1; in four cases the tooth had erupted. Three children had fourth molars and one case of a supplemental premolar was recorded (all unerupted). Four cases of a maxillary supernumerary tooth and hypodontia in the mandible were seen.     

Bilateral palatal talon cusps on permanent maxillary lateral incisors: a case report

Talon cusp is a rare developmental extra cusp-like projection on the cingulum area of affected anterior teeth that may cause various functional and aesthetic problems. The present report describes a case of bilateral palatal talon cusps on permanent maxillary incisors and the treatment procedure to overcome the clinical problems associated with talon cusps.     

Multiple dental anomalies in the maxillary incisor region

A patient with multiple anomalies of the maxillary teeth, including shovel-shaped incisors, talon cusp, bilateral dens invaginatus and bilateral peg-shaped supernumerary incisors is reported. The patient also exhibited Carabelli's cusp on both maxillary first molars. No developmental syndrome was identified. This very unusual combination of anomalies has not been reported previously.     

Dens evaginatus in the Hong Kong Chinese population

Abstract A survey was conducted to determine the prevalence and treatment need of permanent teeth with an evaginated odontome in a random sample of 12-year-old Chinese schoolchildren living in Hong Kong. A total of 442 12-year-old Hong Kong Chinese schoolchildren were examined (215 males and 227 females); 15 children (3%) had teeth with evaginated odontomes present. Males were more commonly affected than females (9:6) and no left-to-right difference was detected. In 8 children there was bilateral involvement of collateral teeth. Over twice as many mandibular premolars were affected compared to those in the maxilla (27:11). Guidelines for future epidemiological surveys of this anomaly are discussed. The management of dens evaginatus is based upon empirical evidence and there has, to date, been no controlled clinical trial conducted to evaluate the effectiveness of any particular type of treatment for this anomaly. In the absence of objective evaluation, results are reported of a survey of the approaches of managing dens evaginatus used by general dental practitioners working in Hong Kong.