BackgroundTalon cusp usually refers to the abnormal cusp‐like protrusion on labial/facial or lingual/palatal surface of anterior teeth, and the labial one is rarely seen. Labial talon cusps might be associated with caries susceptibility, occlusal interference, and esthetic problems. Here we showed the treatment process of a facial talon cusp and followed it for 1.5 years.Case ReportWe report a case with a labial small triangular projection on the right maxillary permanent central incisor of an 8‐year‐old girl, which was diagnosed as Stage 1 talon cusp according to Mayes classification and consequently treated by grinding and flowable resin restoration, achieving satisfactory appearance and maintaining vitality of the pulp. One and a half years′ follow‐up showed the tooth developed well.ConclusionsThe present paper demonstrates the clinical management of a facial talon cusp emphasizing minimally invasive and preventive principles. Furthermore, we summarize and propose the therapeutic strategy of labial talon cusp to offer increasing understanding according to a total of 20 cases reporting 26 labial talon cusps searched from the PubMed/Web of Science.

Dens invaginatus (DI) is a developmental dental anomaly that complicates diagnosis and treatment due to its varied morphology and potential pulpal and periapical involvement. This case report presents the successful endodontic management of a Type II DI in a 14-year-old female patient, affecting the maxillary left central incisor, which also exhibited a talon cusp. The patient was asymptomatic, and the lesion was discovered during orthodontic evaluation. Cone-beam computed tomography (CBCT) revealed an enamel-lined invagination extending into the root canal system without communication with the periodontal ligament, confirming a Type II DI. Clinical tests indicated pulp necrosis. A conservative treatment plan was adopted, targeting only the main canal and leaving the invaginated portion untreated. Modern diagnostic tools, including CBCT imaging and a dental operating microscope, facilitated accurate diagnosis and precise execution of the treatment. Follow-up at 3 months and two years showed complete healing of the periapical lesion, and the patient remained asymptomatic. This case highlights the efficacy of a minimally invasive, selective treatment strategy supported by advanced imaging and magnification in managing DI.

Mucopolysaccharidoses (MPS) represent a heterogeneous group of rare, inherited lysosomal storage disorders characterized by the accumulation of glycosaminoglycans in various tissues, including the orofacial region. This study aims to investigate the orofacial features and radiographic manifestations in a cohort of pediatric patients diagnosed with MPS. Thirty-five patients (18 males, 17 females) diagnosed with different subtypes of MPS underwent comprehensive oral and radiographic examinations. The presence and frequency of clinical and radiographic findings were documented. Radiographic analysis was feasible in 26 patients, with 9 excluded due to severe intellectual disability. The decayed, missing, and filled teeth (DMFT/dft); decayed, missing, and filled surfaces (DMFS/dfs) indices were recorded according to WHO criteria. The dental plaque scores were determined according to Silness & Löe plaque index. Data was analysed using SPSS 25.0, with descriptive statistics summarizing variables and Fisher's Exact test applied for subgroup comparisons by MPS subtype; significance was set at p < 0.05. The most frequent orofacial findings included tongue thrusting (80%, n = 28/35), limited mouth opening (71%, n = 25/35), macroglossia (71%, n = 25/35), and anterior open bite (54%, n = 19/35). Radiographic analysis revealed a thin mandibular cortex in 38% (n = 10/26) of cases, impacted teeth in 27% (n = 7/26), and a short mandibular ramus in 23% (n = 6/26). This is the first reported case of a talon cusp, a rare dental anomaly occurring in a patient with MPS-IV, highlighting a previously unrecognized association in the literature. The distribution of MPS types was: MPS-I (n = 3), MPS-II (n = 6), MPS-III (n = 8), MPS-IV (n = 10), MPS-VI (n = 7), and MPS-VII (n = 1). Orofacial manifestations are frequently observed in patients with MPS and may serve as early indicators of the disorder, particularly within dental settings. Recognition of these features is essential, as they underscore the need for multidisciplinary care and routine dental evaluations to mitigate potential complications and enhance overall quality of life. Orofacial abnormalities are common in children with MPS and may provide early clues to the diagnosis. This study emphasizes the importance of dental evaluations in identifying these signs, including the first reported case of a talon cusp in a patient with MPS. Early recognition by dental professionals can support timely diagnosis, guide appropriate referrals, and improve patient outcomes through coordinated, multidisciplinary care.

Dental anomalies may arise from developmental, congenital, or acquired factors. These irregularities can complicate the achievement of ideal occlusion and aesthetic outcomes, often necessitating a multidisciplinary approach to treatment. This study was conducted to assess the prevalence and distribution of morphological anomalies in permanent maxillary lateral incisors among Libyan patients. The study also investigates the correlation between gender and the occurrence of these dental anomalies. The study population consisted of 400 Libyan individuals with no history of dental treatment. Each participant was examined for anomalies associated with permanent maxillary lateral incisors, including malformations and agenesis. All observed abnormalities were carefully recorded. Clinical dental examinations were conducted on 163 males (40.8%) and 237 females (59.2%). The overall prevalence of dental anomalies was 3.75%. The most frequently observed anomaly was congenital absence of the upper lateral incisor (1.5%), followed by peg-shaped incisors (1.25%). The least common anomalies were talon cusps and micro-sized lateral incisors (0.5%). Females exhibited a higher rate of anomalies compared to males. Bilateral congenital absence of upper lateral incisors was observed. Peg-shaped incisors occurred both bilaterally and unilaterally in both genders. The findings highlight the variability in the prevalence of dental anomalies across different populations. Early diagnosis is essential for comprehensive treatment planning and improved prognosis.

PurposeDevelopmental disturbances of teeth in children with neurodevelopmental disorders like autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) can significantly impact their oral health. Children with these disorders show behavior and cognitive impairment. Both the disorders are associated with environmental, genetic, and systemic factors that can impact odontogenesis. Although dental anomalies have been reported in children with neurodevelopmental disorders, the frequency and distribution of these disturbances remain insufficiently studied in children with ASD and ADHD, especially in comparison to their neurotypical peers. The study aims to determine and compare the frequency and distribution of developmental dental disturbances in children with ASD and ADHD and neurotypical children.Materials and methodsA total of 673 children in Chennai, aged 3-13, were included in this cross-sectional study. Demographic data and oral examinations were recorded after obtaining informed consent. Statistical analysis included Chi-squared test. A p -value of ≤0.05 was considered statistically significant.ResultsChildren with ASD and ADHD had a significantly higher prevalence of developmental disturbances of teeth (51.6%) compared to controls (22.6%). Anomalies such as hypodontia, peg-shaped laterals, talon's cusp, and enamel hypoplasia had higher prevalence in the case group than in the control group.ConclusionDevelopmental dental abnormalities are more prevalent in children with ASD and ADHD than in neurotypical peers. These findings emphasize the need for early dental screening and interdisciplinary management to address systemic, genetic, and environmental factors influencing odontogenesis.How to cite this articleShan S, Swaminathan K, Vivek K, et al. Developmental Disturbances of Teeth in Children with Autism Spectrum Disorder and Attention-deficit Hyperactivity Disorder: A Cross-sectional Study. Int J Clin Pediatr Dent 2025;18(S-1):S80-S85.

Context: Dental anomalies are developmental irregularities in the number, size, shape, position, or structure of teeth. Their prevalence varies across populations and can significantly affect orthodontic treatment planning. While such anomalies are well-documented in many regions, limited data exist on their radiographic prevalence in Nigerian orthodontic populations. Objective: To determine the prevalence and distribution of dental anomalies in an orthodontic population in Lagos, Nigeria, using orthopantomogram (OPG) radiographs, and to assess associations with gender and arch location. Materials and Methods: This retrospective cross-sectional study analyzed 662 orthodontic patient records from a private dental clinic in Lagos over a 12-month period. Only patients with complete diagnostic records, including OPGs, were included. Two calibrated examiners assessed anomalies radiographically. Anomalies were categorized into types based on number, size, shape/structure, and position. Descriptive statistics, chi-square tests, and Fisher’s exact tests were utilized to analyze associations. Results: Dental anomalies were present in 49.4% of patients. The most prevalent anomaly was impaction (40.2%), followed by dilaceration (5.3%), talon cusp (2.9%), and hypodontia (2.1%). Arch distribution revealed that the lower arch was most commonly affected (34.6%), and anomalies in both arches were present in 8.3% of cases. Impactions and microdontia showed statistically significant arch associations (p &lt; 0.001). No statistically significant gender differences were observed. Conclusion: Nearly half of the orthodontic patients in this Lagos-based sample exhibited at least one dental anomaly, with impactions being predominant. These findings underscore the need for early radiographic screening and anomaly-based treatment planning in Nigerian orthodontic practice.

Anomalies in tooth development represent deviations from normal morphogenesis and may arise due to disturbances in epithelial–mesenchymal interactions during odontogenesis. These disturbances can manifest as variations in the number, shape, size, or morphology of teeth. Talon cusp and dens invaginatus are rare developmental anomalies that present unique diagnostic and therapeutic challenges, particularly when coexisting in a single tooth. This case report describes the endodontic management of a 12-year-old male who presented with a dentoalveolar abscess in the lower anterior region, although the affected mandibular lateral incisor (tooth 42) appeared clinically intact and non-carious. Intraoral examination revealed a prominent talon cusp with a lingual pit on tooth 42, which also exhibited grade I mobility and tenderness on percussion. Radiographic and cone-beam computed tomography (CBCT) analyses revealed a Type II dens invaginatus with mesiobuccal deviation of the primary canal and a centrally located accessory invaginated canal. Access cavity preparation under rubber dam isolation revealed two distinct canal orifices. Endodontic treatment included negotiation and shaping of both canals, followed by intracanal medication with calcium hydroxide and obturation using the lateral condensation technique. The unique internal morphology necessitated tailored endodontic protocols supported by CBCT guidance. This report underscores the importance of recognizing rare morphological anomalies in pediatric patients and adopting a comprehensive diagnostic approach to ensure effective and conservative management of complex endodontic cases

An unusual dental deformity known as a talon cusp can be described by an extra cusp similar projection in anterior tooth, reaching the incisal border at least halfway from the cemento-enamel junction (CEJ). Typically found on palatal or lingual surfaces, they can occasionally appear on the facial surface. This anomaly may occur alone or with other dental irregularities, affecting aesthetics, caries management, and function. Regular monitoring is essential for preventing complications. We present a rarely seen instance of a labial talon cusp on the maxillary central incisor in 13 y/o boy concerned about the unusual shape of the front tooth.

Aim: The purpose of this study was to determine how common developmental dental abnormalities were in children in Rajasthan, India's Jaipur area. Materials and Methods: Five thousand youngsters between the ages of six and fourteen were the subjects of a cross-sectional study. Statistical analysis: SPSS software (version 25.0) was utilized. Results:The prevalence of microdontia was 42 cases, the most common (0.84%), followed by talon cusp 13 (0.26%) and double teeth 9 (0.18%) was observed.Conclusions: The results highlight the value of early identification and treatment in pediatric dentistry.

Dental anomalies present a significant challenge to clinicians due to their impact on both dental function and esthetics. The correction of these anomalies plays a critical role in improving the quality of life of our patients, highlighting the importance of this restorative work. The purpose of this systematic review is to assess the techniques used to restore various dental anomalies, and their subsequent esthetic impact on the overall dentition. Inclusion criteria consisted of restorative rehabilitations of the permanent dentition in non-syndromic patients with dental anomalies of morphology, structure, size, and number in the maxillary incisors. Exclusion criteria included surgical rehabilitation techniques, endodontic treatments, and anomalies of the primary dentition. The medical literature was systematically searched (Pubmed, PMC, Embase, Cochrane Central Register of Controlled Clinical trials, Scopus and Google Scholar) to identify all relevant articles reporting data regarding the chosen anomalies. ROBINS-I was used to assess the risk of bias tool, and the results were tabulate due to data heterogeneity. Of the 1821 analyzed articles, 46 articles met the inclusion criteria, and were chosen to go through the final review procedure. Of the selected articles, 3 investigated amelogenesis imperfecta and dentinogenesis imperfecta, 1 analyzed conoid teeth, 1 considered hypodontia (other than MLIA), 3 concerned microdontia (excluding peg laterals and conoid teeth), 10 evaluated peg-shaped laterals, 2 investigated talon cusps and geminated teeth, 15 were regarding maxillary lateral incisor agenesis, and 11 papers were related to the perception of anomalies. Pre-visualization using Digital Smile Design, a treatment plan encompassing minimally invasive restorations, and using a multidisciplinary approach among practitioners helps the anomalous patient achieve the best possible esthetic result.

Disruption in odontogenesis can influence the normal development of both deciduous and permanent dentition resulting in anomalies in morphology, number, and position of teeth. Although dental anomalies are frequently reported in clinical practice, their occurrence in past populations from archeological contexts is rarely acknowledged. To describe two cases of dental anomalies on two non-adult individuals from Italian archeological sites. Individual sex diagnosis was performed by analyzing amelogenin peptides from the dental enamel through liquid chromatography mass spectrometry (LC-MS/MS). Age-at-death estimation was based on stages of dental formation and eruption. Dental twinning and talon cusp were morphologically evaluated and classified following standardized scoring systems proposed by clinical literature. The first individual, a 3-4-year-old female from the Imperial Roman necropolis of Isola Sacra, presents the fusion of the upper right deciduous central incisor with a supplementary tooth; the second individual, a 3-3.5-year-old male from a Late Antiquity catacomb, shows a case of bilateral gemination on the upper permanent central incisors with a co-occurrence of dental gemination and talon cusp on the right one. The cases reported here (the two anomalies in the individuals presented) are useful into understanding these dental conditions within past/archaeological populations.

Selective reduction of bilateral nonsyndromic talon cusps in an 11-year-old class II patient enabled successful mandibular repositioning with a twin block appliance. This approach achieved desired orthodontic outcomes without causing pain or sensitivity following reduction, highlighting a novel strategy for managing talon cusps in orthodontic treatment.

Talon Cusp Management of a Maxillary Central incisor

Endodontic management of bilateral talon cusps: A case report

BackgroundSome chromatinopathies may present with common clinical findings (intellectual disability, brain and limb malformation, facial dysmorphism). Furthermore, one of their cardinal shared features is growth dysregulation.We aimed to assess and deepen this resemblance in three specific conditions, namely Wiedemann-Steiner (WDSTS), Kleefstra (KLEFS1) and Coffin-Siris syndrome (CSS1), with a particular focus on possible metabolic roots.Methods Eleven patients were enrolled, three with WDSTS, five with KLEFS1 and three with CSS1, referring to Fondazione IRCCS Ca’ Granda Ospedale Maggiore, Milan, Italy. We performed both a physical examination with detailed anthropometric measurements and an evaluation of the patients’ REE (rest energy expenditure) by indirect calorimetry, comparing the results with age- and sex-matched healthy controls.ResultsWe observed new clinical features and overlap between these conditions suggesting that different disturbances of epigenetic machinery genes can converge on a common effect, leading to overlapping clinical phenotypes. The REE was not distinguishable between the three conditions and healthy controls.ConclusionsEpigenetic machinery plays an essential role both in growth regulation and in neurodevelopment; we recommend evaluating skeletal [craniovertebral junction abnormalities (CVJ) polydactyly], otolaryngological [obstructive sleep apnea syndrome (OSAs), recurrent otitis media], dental [tooth agenesis, talon cusps], and central nervous system (CNS) [olfactory bulbs and cerebellum anomalies] features. These features could be included in monitoring guidelines. Further studies are needed to deepen the knowledge about energy metabolism.

Whether gemination or fusion, double teeth are rare worldwide, including Africa based on few published data. New cases from the continent are tallied, and anomalies potentially associated with double teeth are identified. These findings should interest a range of dental researchers. The presence of double teeth was recorded in 97 modern and premodern North and sub-Saharan African samples (5631 inds.). They and coexistent anomalies are described relative to published examples. Prevalence was estimated as possible, using a Poisson model for 95% confidence intervals (CI). Three maxillary double teeth were identified: a primary left lateral incisor in a Nubian child (1938-1756 BC), permanent left central incisor in an adult Egyptian (3650-3500 BC), and permanent right central incisor in a modern (19th century) adult from Guinea. Each co-occurs, respectively, with a talon cusp, peg lateral incisor and, in the latter individual, second premolar crown variation with rotation, and third molar dens evaginatus. Double tooth prevalence is 0.048% (CI 0.001%-0.270%), with regional variation, in premodern, and 0.000% in modern North Africans. It is 0.000% for premodern and 0.048% for modern sub-Saharan Africans (0.008%-1.714%). The double incisors are comparable to other global examples, indicative of common developmental processes during odontogenesis. Prevalence is lower than published modern rates, to suggest some exceptionality in Africans as reported earlier for other dental variants. Finally, though circumstantial, double teeth and accompanying anomalies may share an etiology. Continuing research overall, and in Africa specifically, will promote an improved understanding of double teeth formation and expression.

Dens invaginatus is one of the developmental abnormities of the tooth which occurs with an invagination of the enamel organ into the dental papilla during tooth development. This abnormity presents a wide spectrum of morphological variations. According to Oehlers classification, in dens invaginatus type II the invagination invades above the cemento-enamel junction, connecting to the pulp; however, there is no connection with the periodontal ligament. This abnormity presents significant challenge when root canal treatment is necessary. The most frequently affected teeth are permanent maxillary lateral incisors, followed by permanent maxillary central incisors. There are limited case reports of mandibulary central incisors; however, there is no publication of mandibular lateral incisors with dens invaginatus type II. This case report aimed to present cone-beam computed tomography aided diagnosis and treatment for type II dens invaginatus in a mandibular lateral incisor with a talon cusp and a large periapical lesion.

Objectives: This research was aimed to determine the distribution of dental anomaly cases on panoramic radiographs at Universitas Airlangga Dental Hospital (RSGMP). Materials and Methods: This research used a descriptive observational design with a total sampling technique from panoramic radiographic data at the Radiology Clinic of RSGMP Universitas Airlangga during 2018–2020, which had cases of dental anomalies. Results: The result showed 116 cases of dental anomalies, with more incidence in female (64%) than in male (36%). The most common dental anomaly category was the number of teeth anomalies (47.41%), followed by tooth size anomalies (29.31%), tooth shape anomalies (23.28%), and there were no cases of anomalies in tooth structure and position. The most common types of dental anomalies were microdontia (27.59%), missing teeth/agenesis (25%), supernumerary teeth (22.41%), dilaceration (16.38%), talon cusp (3.45%), taurodontism (2.59%), macrodontia (1.72%), gemination (0.86%). Conclusion: The most common cases of dental anomalies were based on their categories, namely anomalies in the number of teeth, followed by tooth size, and tooth shape.

Background: Pediatric dental anomalies refer to irregularities or abnormalities in the development, structure, or positioning of the teeth in the oral cavity of children. These anomalies can encompass a wide range of conditions that affect the number, size, shape, and structure of teeth. In Karachi, there is limited evidence regarding the prevalence of dental anomalies in children. Objective: This study investigated the prevalence of dental anomalies in the pediatric population of the Abbasi Shaheed Hospital, Karachi, Pakistan. Material and Methods: A cross-sectional study was conducted among 278 children aged between 3 and 12 years. The socio-demographic and thorough medical history were recorded on a predesigned performa. The diagnosis of all dental anomalies was based on clinical interpretation using sterilized mouth mirrors, probes, or tongue depressors. Difficult cases were addressed by senior faculty members. Data analysis was conducted using SPSS version 19. Descriptive statistics were used to present the frequency and Mean ± SD. Result: The prevalence of dental anomalies was 7.4%. in the study area. Male-to-female ratio was 2.2:1. Boys exhibited a higher prevalence of 10.05% compared to girls (4.3%). Peg Lateral Incisors and Fusion/Gemination were the most common anomalies among both genders. Dilaceration, Dentinogenesis Imperfecta, Amelogenesis Imperfecta, Talon Cusp, Anodontia, and supernumerary Tooth (disto-molar) were not identified in either boys or girls. The highest number of dental anomalies was recorded at ages 11 and 12 years. Conclusion: The prevalence of dental anomalies was high in the study area, underscoring the significance of early diagnosis and careful management to prevent complications.

Rubinstein Taybi syndrome is a rare neurodevelopmental disorder characterized by broad thumbs and first toe, microcephaly, developmental delay, beaked nose, talon cusps, and various systemic abnormalities like cardiac defects, hearing loss, respiratory infections, and ocular abnormalities which are common with this syndrome. The various ocular abnormalities reported in the literature are corneal opacities, lacrimal gland abnormalities, strabismus, coloboma, retinal dysfunction, and congenital glaucoma. We hereby report the case of a 7-year-old boy who presented in the glaucoma clinic of a tertiary eye care center with large eyeballs and a typical dysmorphic face characterized by high-arched brows with a low-hanging columella, grimacing smile, talon cusps, diffuse corneal haze, and enlarged corneal diameters (12.5 mm) and who was subsequently diagnosed with congenital glaucoma after evaluation under anesthesia (EUA). EUA revealed raised intraocular pressure (IOP) of 22 mmHg, and optic never head cupping in the right eye (RE) was 0.8:1 the other eye had a total leucomatous corneal opacity. The child was started on topical antiglaucoma medication in RE, and subsequent evaluation revealed well-controlled IOP on these medications.