Endodontic Treatment and Esthetic Management of a Geminated Central Incisor Bearing a Talon Cusp

Abstract

Gemination with talon cusps is an uncommon morphologic dental anomaly, characterized by the formation of clinically wide tooth that can cause significant aesthetic and clinical problems including esthetic impairment, pain, caries susceptibility, and tooth crowding. These morphological dental anomalies have specific treatment needs due to the abnormal morphology and need virtuous radiologic diagnosis. Multidisciplinary approach can supply success of the treatment plan that can provide esthetic and occlusal requirements. In this case report, the multidisciplinary approach for the treatment of geminated tooth with talon cusp is presented with the clinical and radiographic findings.

Management of non-syndromic dens evaginatus affecting permanent maxillary central incisors: a systematic review

“…CBCT allows for visualising any pulpal extension into the dens evaginatus. However, we found only two articles, published in 2014, describing the performance of CBCT 39 42. About 30% of included articles were published before 2000, which could explain the low use of CBCT.…”

“…Dens evaginatus was bilateral in 5 cases (15%), so 39 incisors were affected by dens evaginatus. Among the 34 cases, 12 featured dens evaginatus associated with double tooth 16 20–23 26 29 31 34 39 40. According to the Hattab et al classification, the anomaly was type 1 for 32 incisors (82%), type 2 for 2 (5%) and type 3 for 2 (5%); we had insufficient information to characterise the type for 3 incisors.…”

Management of non-syndromic double tooth affecting permanent maxillary central incisors: a systematic review

“…Since 2D periapical radiographs cannot be totally conclusive for the diagnosis, CBCT should be systematically performed in all cases because it provides 3D dental imaging to help determine the best treatment 78 79. However, we found only four case reports (6%), published in 2003, 2010, 2012 and 2014, in which the authors performed CBCT 13 47 67 71. About 45% of included articles were published before 2000, which could explain in part the low use of CBCT.…”

“…The age range varied across studies from 7 to 60 years. For 12 of the 72 cases, the double tooth was associated with dens evaginatus 17 25 26 29 46 51 58 67 69. Double tooth was bilateral in 29 cases (40%), so we describe 101 permanent maxillary central incisors.…”

Talon Cusp Type I: Restorative Management

“…Furthermore, the diagnosis is important to prevent dental problems, such as caries development in the groove, aesthetic impairment, occlusal interference resulting from tooth displacement, speech problems, and soft tissue lesions (especially on the tongue). If caries lesions are present, the lesions are removed and restored; in cases of premature contact and occlusal interference, the talons should be reduced gradually [ 10 , 12 , 13 ].…”