Maxillary Central Incisors Research Articles

Removal of fiber posts using conventional versus guided endodontics: a comparative study of dentin loss and complications.

To compare the efficacy of fiber post removal using conventional (CONV) versus guided endodontics (GE) in terms of dentin loss, residual resin material, procedural errors, and working time in vitro. Ninety human central incisors were root-filled and scanned by micro-computed tomography (CT), then restored with fiber posts and composite. Twenty-four sets of teeth with up to four human maxillary central incisors were fabricated and divided into three groups: conventional post removal by a general dentist (CG) or endodontology specialist (CS) and guided endodontics (GE) by a general dentist, yielding 30 teeth per operator and group. After treatment, the prepared access cavities were volumetrically assessed by micro-CT. Statistical significance was evaluated by one-way analysis of variance followed by post hoc comparisons with Tukey's HSD test and Pearson's chi-squared test for independence. Both CONV and GE resulted in dentin loss and residual resin material. CS resulted in more dentin loss and less residual resin material than CG and GE (p < .05). All groups had some deviations from the original root canal but no perforations. The shortest working time was observed in the GE group. Compared to the conventional freehand technique, GE resulted in significantly less radicular dentin loss, a few deviations but no perforations. Guided endodontics can improve the speed and safety of fiber post removal without root perforation.

Crown forms and gingival phenotypes: Insights from a diverse Asian population

ObjectiveThis study aimed to classify the crowns of maxillary central incisors into distinct categories and to examine the associations between these crown forms and morphometric characteristics in an ethnically diverse Asian population. This is significant for the treatment planning and management of cases, especially for the anterior teeth, from the restorative and aesthetic points of view. Method and MaterialsClinical measurements and photographic data were collected from 160 participants, comprising students, staff, and patients of the Faculty of Dentistry, Universiti Kebangsaan Malaysia. The crown length, crown width, contact surface, papilla height, papilla fill, keratinized mucosa width, and gingival tissue thickness were measured. Cluster analyses were performed to identify the different crown form categories and corresponding characteristics. ResultsThe mean crown width measured 7.093 ± 0.637 mm, while the mean crown length was 10.209 ± 0.966 mm. Three crown-form clusters were identified: triangular (50 %), square/tapered (23.1 %), and square (26.9 %) shapes. The triangular cluster had a significantly higher mean papilla height (4.64 mm ± 0.818) and the highest incidence of incomplete papilla fill (17.5 %). The chi-squared test showed a significant difference in crown forms between the different ethnicities, χ2 (2, 160) = 0.033. ConclusionWithin this diverse Asian population, the crown form demonstrates three clusters: triangular, square/tapered, and square, characterized by a notably small average crown width and crown length. Most participants predominantly exhibited triangular crown forms with reduced crown width, crown length, and crown width/ crown length ratio. Furthermore, noticeable variations in crown forms and their morphometric attributes were observed among the three ethnic groups: Malays, Chinese, and Indians.

A Comparative Study to Check the Accuracy of Tooth Shade Selection With Standardized Digital Photographs and a Spectrophotometer.

The success of any dental prosthesis depends on aesthetics and function. A proper shade selection is a prime requisite for providing aesthetics to dental patients. This study aims to compare the photographic method of shade selection with that of a digital spectrophotometer. The study included 50 participants. The primary inclusion criterion was the presence of the maxillary left central incisor without a history of restorative or endodontic procedures. The shade of the left maxillary central incisor was determined using the VITA Easyshade V spectrophotometer (VITA Zahnfabrik, BadSäckingen, Germany) and the digital photography method for all the selected participants. The CIELAB colour space utilizes three values (L*, a*, and b*) to objectively measure colour. While the digital photography approach used Adobe Photoshop software (Adobe Systems Incorporated, San Jose, CA) to report solely the L*, a*, and b* values, the spectrophotometer reported the L*, a*, and b* values along with the actual shade. After obtaining the values of L*, a*, and b*, ΔE, which is their difference, was calculated using a standard formula. Statistical analysis was carried out by using Student's t-test and proportion z-test. When the comparison of the L*a*b* values was done, Student's t-test showed similar (P>0.05) L(t=0.16, P=0.872), a (t=0.52, P=0.607), and b (t=0.23, P=0.820) values between the two groups; that is, they did not differ significantly or showed perfect matching. There was agreement (ΔE≤2) in 42 (84.0%) cases and disagreement (ΔE>2) in eight (16.0%) cases. The proportion z-test showed an agreement of 84.0%, which was statistically highly significant (z=20.44, P<0.001). The true shade of the teeth can be depicted using standardized digital images.

Comparative evaluation of incidence of dentinal defects after root canal preparation using three different endodontic retreatment systems - An in vitro study.

Safe and efficient removal of all root filling materials from the root canal system without compromising radicular dentin structure is essential for optimal nonsurgical retreatment. The aim of this study was to evaluate and compare the incidence of dentinal defects caused during root canal filling removal using conventional, rotary, and reciprocating retreatment file systems. A detailed protocol explaining purpose and procedures of the study was submitted to the Institutional Ethics Committee and ethical clearance obtained. Sixty human maxillary permanent central incisors were collected and decoronated to 12-mm standardized length. The canals prepared up to a master apical file size F3 with Protaper hand files, obturated using AH plus sealer, examined under the stereomicroscope (×40 magnification): Group I: Control (n = 15), Group II: Conventional (n = 15), Group III: Protaper Universal Retreatment Files (n = 15), and Group IV: Reciproc Blue (n = 15). After instrumentation, teeth were sectioned at 3, 6, and 9 mm from the apex to evaluate the presence of dentinal defects under the stereomicroscope. Statistics were performed using the SPSS, version, 25 (SPSS Inc., Chicago, IL, USA). Initially, normality test was done using the Shapiro-Wilk test and data were not normally distributed followed by Kruskal-Wallis test. P < 0.05 is considered statistically significant. Maximum percentage increase in dentinal defects was observed in Protaper Universal Retreatment Files followed by Conventional method and Reciproc Blue. Significantly Reciproc Blue reduced the incidence of dentinal defects after root canal preparation.

Fracture strength of fiber post with polyetheretherketone post: An In vitro comparative study

Abstract Aim: To assess and compare the fracture strength of polyetheretherketone (PEEK) post materials with fiber posts on endodontically treated maxillary central incisors. Materials and Methods: In this in vitro comparative study, two dental post materials were evaluated: fiber-reinforced post and PEEK post. Simple random sampling was done and 30 specimens were fabricated using extracted, decoronated, and endodontically treated maxillary central incisors (n = 15 for each group). Post-space preparation was done 5 mm short of the apex and restored with prefabricated fiber post (n = 15) and customized PEEK post (n = 15). Samples were mounted in a cold cure acrylic cylindrical block, at 45° angulation for testing the fracture strength using a universal testing machine. The data were analyzed and compared statistically, using an independent t test. Results: Mean fracture strength of the PEEK post was 65.79 kg and the fiber post was 59.32 kg with no statistically significant difference in the fracture strength between the two groups. Conclusion: Within the limitations of the study, it can be concluded that the PEEK post has similar mechanical properties to the fiber post and could be considered as an alternative to the fiber post having the advantages of being custom-made requiring conservative canal preparation with minimal dentin removal.

Correlation between Cleft Width and Adjacent Teeth Inclination in Patients with Unilateral Cleft Lip and Palate Using CBCT: A Retrospective Study.

To evaluate buccolingual and mesiodistal inclination of cleft-adjacent maxillary permanent central incisors (U1) and canines (U3) in patients with unilateral cleft lip and palate (UCLP) in the late mixed dentition and to investigate the correlation between the alveolar cleft width and cleft-adjacent teeth inclination using cone beam computed tomography (CBCT). Observational cross-sectional retrospective study. Department of Orthodontics, Hama University Dental School. 32 patients with UCLP (22 boys, 10 girls; mean age = 10.53 ± 1.51 years). Buccolingual and mesiodistal inclination of maxillary central incisors and canines were measured on both sides. Then, the cleft and non-cleft sides were compared using the Wilcoxon signed-rank test. Pearson's correlation was used to explore the association between the alveolar cleft width and cleft-adjacent U1 and U3 buccolingual and mesiodistal inclination. The cleft-adjacent central incisors were significantly inclined lingually and distally compared with their non-cleft antimeres (P = .003, P < .001, respectively). The cleft-adjacent canines were significantly inclined buccally and mesially compared with their non-cleft antimeres (P < .001, for both). A positive correlation was found between the buccolingual inclination of cleft-adjacent U1 and the alveolar cleft width (r = 0.49, P = .004). Patients with UCLP demonstrated a significant lingual and distal inclination of cleft-adjacent U1 and a significant buccal and mesial inclination of cleft-adjacent U3. The buccolingual inclination of cleft-adjacent U1 tends to increase with increasing the alveolar cleft width; however, the correlation was weak.

Dental prosthetic rehabilitation of a patient with parafunctional habit: A case study

Introduction: Parafunctional habits such as clenching, grinding, gnashing of the teeth leave multiple consequences on the natural dentition if left untreated. Purpose: The purpose of this study is to represent a patient treated prosthetically with parafunctional habit of clenching his teeth. Material and methods: For the purpose of this study a 42 year old patient was analyzed, treated and rehabilitated with metal ceramic anterior dental bridge. He was treated with a dental splint before beginning of the treatment. His left central maxillary incisor, left maxillary lateral incisor, and left canine were treated endodontically, and then restaurated with posts and cores. After that a dental frontal aesthetic bridge was manufactured. Because the patient has a habit to clench his teeth, he needs to be monitored so that he does not damage the anterior bridge, which is the reason why a dental splint was designed for protecting the patient. Results and Discussion: Patients with parafunctional habits represent a highly challenging group for treatment. Authors worldwide have tried to find optimal solutions on how to help patients with different parafunctional habits and how to prevent them in the future. In this case study the patient was successfully treated and rehabilitated. Conclusion: The consequences that parafunctional habits can leave on the dentition can be observed, and dental prosthetic treatment can create functional – aesthetic solution that needs to be preserved.

Staged Extractions and Implant Placement for Maxillary Central Incisors: A Case Report

A patient sought treatment at a prosthodontics practice to replace mobile maxillary centrals and exposed defective veneer margins on the maxillary laterals. Staged extractions and immediate implant placement were offered as the treatment option to preserve the hard and soft tissue around the implants and maximize the esthetic outcome. Staged extraction of adjacent teeth and immediate implant placement was performed to the maxillary central incisors. After osseointegration, custom impression copings were made to capture the gingival contours. The implants were restored with implant retained ceramic crowns and the maxillary laterals were restored with ceramic veneers. Although treatment time is lengthened staged extraction of adjacent anterior teeth and immediate implant placement can provide a predictable and successful treatment option to manage soft tissues and achieve a highly esthetic outcome. Keywords: Implants; Esthetics; Immediate Implants; Immediate Provisionals; Staged Extractions; Prosthetic Dentistry

Explaining the colour of natural healthy gingiva

To examine the differences between natural gingival colour in men and women. To determine the degree of predictability of changes in the gingival colour coordinates recorded for healthy gingiva, according to age, long-term medication, frequency of toothbrushing, and smoking habits. The CIELAB colour coordinates were recorded using a spectrophotometer for 360 Caucasian adult participants (aged 18–92 years), in three zones of the healthy attached gingiva of the maxillary central incisor. Regression models were created for each zone and each sex, taking the L*, a* and b* coordinates as dependent variables and age, frequency of toothbrushing, smoking habits (0—non-smoker; 1—smoker) and whether participants were taking long-term medication (0—no; 1—yes) as independent variables. The statistical analysis was conducted with SPSS version 26.0, using multiple regression models. Statistically significant differences between men and women were found only for colour coordinate b*, in all three zones. The only colour coordinate on which the predictor variables had a significant effect was the L* coordinate. In men, age and long-term medication had the greatest effect as predictors (maximum R2 = 0.149). In women, frequency of toothbrushing was the strongest predictor in the predictive models (maximum R2 = 0.099). The colour of gingiva in men contained a larger amount of blue, given that significantly lower values for colour coordinate b* were recorded in men than women, although this difference lacked clinical implications. For both sexes, the regression models produced had a modest predictive capacity. The L* coordinate was the dependent variable that showed the greatest predictability.

Reliability of Artificial Intelligence-based Cone Beam Computed Tomography Integration with Digital Dental Images.

This study aimed to introduce cone-beam computed tomography (CBCT) digitization and integration of digital dental images (DDI) based on artificial intelligence (AI)-based registration (ABR) and to evaluate the reliability and reproducibility using this method compared with those of surface-based registration (SBR). This retrospective study consisted of CBCT images and DDI of 17 patients who had undergone computer-aided bimaxillary orthognathic surgery. The digitization of CBCT images and their integration with DDI were repeated using an AI-based program. CBCT images and DDI were integrated using a point-to-point registration. In contrast, with the SBR method, the three landmarks were identified manually on the CBCT and DDI, which were integrated with the iterative closest points method. After two repeated integrations of each method, the three-dimensional coordinate values of the first maxillary molars and central incisors and their differences were obtained. Intraclass coefficient (ICC) testing was performed to evaluate intra-observer reliability with each method's coordinates and compare their reliability between the ABR and SBR. The intra-observer reliability showed significant and almost perfect ICC in each method. There was no significance in the mean difference between the first and second registrations in each ABR and SBR and between both methods; however, their ranges were narrower with ABR than with the SBR method. This study shows that AI-based digitization and integration are reliable and reproducible.

Artificial intelligence-based automated preprocessing and classification of impacted maxillary canines in panoramic radiographs.

Automating the digital workflow for diagnosing impacted canines using panoramic radiographs (PRs) is challenging. This study explored feature extraction, automated cropping, and classification of impacted and nonimpacted canines as a first step. A convolutional neural network with SqueezeNet architecture was first trained to classify two groups of PRs (91with and 91without impacted canines) on the MATLAB programming platform. Based on results, the need to crop the PRs was realized. Next, artificial intelligence (AI) detectors were trained to identify specific landmarks (maxillary central incisors, lateral incisors, canines, bicuspids, nasal area, and the mandibular ramus) on the PRs. Landmarks were then explored to guide cropping of the PRs. Finally, improvements in classification of automatically cropped PRs were studied. Without cropping, the area under the curve (AUC) of the receiver operating characteristic (ROC) curve for classifying impacted and nonimpacted canine was 84%. Landmark training showed that detectors could correctly identify upper central incisors and the ramus in ∼98% of PRs. The combined use of the mandibular ramus and maxillary central incisors as guides for cropping yielded the best results (∼10% incorrect cropping). When automatically cropped PRs were used, the AUC-ROC improved to 96%. AI algorithms can be automated to preprocess PRs and improve the identification of impacted canines.

The Effect of Different Ferrule Configurations and Preparation Designs on the Fatigue Performance of Endodontically Treated Maxillary Central Incisors: A 3D Finite Element Analysis

The presence of an adequate circumferential ferrule is of great importance for the prosthetic rehabilitation of endodontically treated teeth. However, there may not be an adequate circumferential ferrule effect. This study aimed to evaluate the fatigue performance of endocrown and post–core restorations applied to different configurations without an adequate ferrule effect using the finite element method and endeavors to offer a comprehensive perspective on the challenging rehabilitation of maxillary incisors with excessive coronal substance loss, addressing a notable gap in research and providing valuable insights for clinicians. The goal is to address this gap in research and contribute valuable insights that could be beneficial for practitioners. The maxillary central incisor was selected, and lithium disilicate (LS) and a polymer-infiltrated ceramic network (PICN) were used in post–core groups with no ferrule effect (PC0); a 2 mm ferrule effect on the buccal wall (PC1); a 2 mm ferrule effect on the buccal-mesial wall (PC2); a 2 mm ferrule effect on the buccal–mesial–palatal wall (PC3); and a 2 mm circumferential ferrule effect (PC4) In the endocrown groups, an external retention group with a circumferential ferrule (ECER) and an inner retention form group (ECIR) were prepared. Fatigue performance was examined by applying a 150 N oblique load. The evaluation of the fatigue performance of the restorative materials shows that LS always had more successful fatigue performance results, while the post–core groups were generally more successful in terms of dentin survival. In situations where there is insufficient circumferential ferrule, the application of endocrowns is likely to result in a less successful prognosis for survival.

Immediate dentoalveolar restoration (IDR) of central maxillary incisor using sinus lateral wall block graft to regenerate loss of facial and palatal bone: Literature review and 1 year follow-up.

Replacement of missing or hopeless teeth in the esthetic zone is one of dentistry's most critical challenges. In the past, multiple surgical procedures have been needed to reconstruct compromised extraction sites. The surgeries have been associated with long healing times and increased morbidity, all the while patients are using either fixed or removable interim restorations. The procedures identified in this paper minimize surgical operating times, healing times, and delays in obtaining definitive restorations by combining multiple surgical procedures in one visit. The procedures are technique sensitive. This particular patient has been followed for 1 year post-operatively with clinical photographs and CBCT scans. Excellent clinical results were obtained. Benefits and limitations of the procedures have also been identified.

In vitro biomechanics of divot use, and their placement, in orthodontic aligner therapy.

To evaluate biomechanics of an aligner utilizing divots and the effect of their vertical placement on the right maxillary central incisor. An invitro Orthodontic SIMulator (OSIM) was used to test forces and moments generated by aligners incorporating divots. The OSIM arch was scanned to generate a. STL version that was modified to create four models by placing divots on different positions of the right central maxillary incisor: GI - divots on gingival-third of lingual surface and incisal-third of labial surface; GM - divots on gingival-third of lingual surface and middle-third of labial surface; MI - divots on middle-third of lingual surface and incisal-third of labial surface; MM - divots on middle-third of lingual surface and middle-third of labial surface. Aligners (n = 30/model) were fabricated using a 0.75 mm thick polyethylene terephthalate material and Biostar® machine following the manufacturer's recommendations. A one-way MANOVA followed by one-way ANOVA (α = 0.05) was utilized to test effect of models on buccolingual force (Fy) and mesiodistal moment (Mx) at 0.20 mm of lingual displacement of the right maxillary central incisor. Mean Mx for GI (-5.68 ± 7.38 Nmm), GM (3.75 ± 5.54 Nmm), MI (-4.27 ± 1.48 Nmm) and MM (1.96 ± 0.99 Nmm) models showed statistical differences between GI and GM, GI and MM, GM and MI and MI and MM. GI exerted the largest Fy (1.87 ± 0.75 N) followed by GM (1.10 ± 0.47 N), MI (0.70 ± 0.23 N) and MM (0.28 ± 0.08 N) with significant differences between GI and GM, GI and MI, GI and MM and GM and MM models. Vertical divot placement on a right central incisor had a significant effect on aligner biomechanics. Buccolingual forces exerted by models GI, GM and MI were within the range suggested by literature for bodily tooth movement without major root tipping for GM and MI models.

The Impact of the Gender on the Pulp Vitality Testing for the Various Types of the Conducting Media: An Original Research

ABSTRACT Introduction: To identify gender-based differences in pulpal sensory thresholds in human teeth utilizing various conducting media. Materials and Methods: The study involved 50 participants of both genders equally distributed. The maxillary central incisors were the teeth selected for the intervention. The three conducting media that were put to the test were Colgate Sensitive Pro-Relief Enamel Repair Toothpaste (CS), Himalaya herbals sensitivity toothpaste (HS), and Lignox 2% gel (LG). Subject’s sensory threshold readings as well as the Visual analogue scale (VAS) scores were noted at the tiniest sensation they experienced. Following an ANOVA, a post hoc analysis was performed to confirm the significance between the three media. Results: Lox 2% Jelly significantly reduced sensory threshold values compared to the other conducting media (P &lt; 0.001). Comparing the sensory threshold values of the sexes showed that men have greater values. Male and female readings differed significantly in the Lox 2% Jelly group (P = 0.021), whereas Colgate Sensitive Pro-Relief Enamel Repair Toothpaste, Himalaya herbals sensitivity toothpaste (P &lt; 0.001) groups showed highly significant variances. All the three conducting media had a highly significant variance for the VAS scores. (P &lt; 0.001). Conclusion: The conducting material used and gender affect the pulpal sensory thresholds to electric impulses produced by EPT.

Surgical Management of Radicular Cyst with the Application of a Natural Platelet Concentrate and Ostoden: A Case Report

ABSTRACT The most frequent cystic lesions that affect the jaw are radicular cysts. The current case report describes the surgical management of a radicular cyst in the periapical region of maxillary central and lateral incisors, and highlights the efficacy of natural platelet concentrate [platelet-rich fibrin (PRF)] along with Ostoden bone graft material used for postoperative healing. A 46-year-old male patient presented to the department with swelling in the palatal aspect of the maxillary anterior region. On radiographic examination, a radiolucent periapical lesion was evident in relation to the left maxillary central and lateral incisor. In the maxillary anterior region, root canal therapy was performed, followed by periapical surgery, and PRF with Ostoden bone graft was placed in the surgical site to initiate the healing at a faster rate. The patient was recalled at follow-ups after 7 days, 3, 6, and 9 months. No symptoms such as pain, inflammation, or discomfort were observed during the review period.

Analysis of Post-Operative Pain Following Single Sitting Root Canal Treatment

ABSTRACT Background: The objective of root canal therapy is the complete cleansing and sealing of the entire root canal system, encompassing all of its elements. This current study was undertaken to evaluate the occurrence of postoperative pain in the patients during single-session RCT. Materials and Methods: A total of 70 maxillary central incisor teeth from 55 patients, representing both genders, were chosen for a one-session root canal procedure. Postoperative discomfort was measured using the Visual Analog Scale (VAS) at the following time intervals: 6 hours, 12 hours, 24 hours, and 48 hours following the treatment. Results: Among the 55 patients, there were 35 males and 20 females. The average VAS scores at various time points were as follows: 6 hours (7.4), 12 hours (5.2), 24 hours (3.4), and 48 hours (2.5). These differences were found to be statistically significant (P &lt; 0.05). Conclusion: The authors observed a significant reduction in postoperative pain following a one-session RCT.

Bracketless fixed orthodontic treatment with mandibular incisor extraction

As an alternative to the conventional fixed appliance that uses orthodontic brackets, a simple tube without a bonding base can be bonded by covering it with flowable composite resin. However, bracketless fixed treatment has been limited to non-extraction cases because rigid archwires cannot be used. In this report, a 23-year-old female patient presented with the chief complaint of the reopening of the maxillary lateral incisor extraction space and the development of mandibular anterior crowding during retention. She was orthodontically treated with the extraction of the maxillary right and left lateral incisors and mandibular left central incisor nine years ago. Spacing at the maxillary extraction site and mandibular crowding developed due to the lingual fixed retainer bond failure. She was diagnosed as skeletal Class I with 1/4-cusp dental Class II. The extraction of the mandibular right central incisor was planned to relieve the mandibular anterior crowding and increase the required overjet for retracting the maxillary central incisors to close the spacing. Simple tubes were bonded to the teeth instead of brackets. Stainless steel retraction overlay archwires were used to close the extraction space and apply Class II elastics. Overlays worked as a rigid archwire, preventing the bowing effect. After treatment, favorable occlusion was achieved. This case report demonstrates that bracketless fixed orthodontic treatment with simple tubes can be applied to mandibular incisor extraction cases with the aid of a rigid overlay archwire.

A Minimally Invasive Esthetic Approach for Teeth with Molar Incisor Hypomineralization: a Clinical Case Report

Molar incisor hypomineralization (MIH) is a qualitative defect of enamel, clinically characterized by white or yellow/brownish demarcated opacities that affect permanent molars, often associated with permanent incisors. The etiology is multifactorial, including systemic and genetic/epigenetic factors. Defects of anterior teeth can negatively impact children since they might present lower self-esteem and socialization problems. Purpose: To describe a minimally invasive treatment for anterior teeth affected by molar incisor hypomineralization, performed with direct composite resin restoration and a universal adhesive system. Case Report: An 8-year-old patient sought dental care with complaints about her dental appearance, reporting suffering from school bullying. She presented a white-yellowish opacity on the maxillary right central incisor. After a clinical examination, she was diagnosed with molar incisor hypomineralization. To improve dental esthetics, a direct composite resin restoration was proposed. The enamel surface was prepared and etched with 35% phosphoric acid etchant solution for 15 seconds before applying the universal adhesive system. Two different shades of the composite were used for layering the material to disguise the defect without extensive removal of the dental structure. The result was satisfactory as it was possible to mask the opacity, reestablish enamel thickness, and improve the patient's quality of life. Conclusion: Conservative restorations comprising a universal adhesive system seem to bring desirable esthetic results for anterior teeth with molar incisor hypomineralization.

An atypical presentation of talon cusp: Double talon cusps

Talon cusp is an uncommon developmental anomaly resulting in an extra cusp or cuspal projection on an anterior tooth consisting of normal enamel, dentin, and varying degrees of pulp tissue. Talon cusp shows varied presentations of which the palatal talon cusp has been the most common of all. The management requires an extensive understanding of this clinical entity and the complications associated with its occurrence. In this case series, we are reporting double talon cusps which is a rarity itself, involving the palatal aspect of maxillary central incisors.