This study was performed to measure distribution of different types of Carabelli cusps among population and relationship of each cusp type with dental caries. Method: this study included the examination of 200 patients for both right and left sides, to find the distribution of Carabelli cusp and their caries susptability. Patients with severe destructed or extracted upper first molar from any side were excluded. Results: percentage of presence or appearance of prominent Carabelli cusp was approximately 23%. Groove obtained in 33% of total examined teeth. Prominent cusps showed higher rate of caries infection, while smooth surface had lower caries susptability. Conclusion: according to the anatomical differences of mesiopalatal surface of upper first molar, Carabelli cusp prevalence was high and caries susptability was increased in positive cusp expression
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