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Prevalence and Characteristics of Talon Cusps in Turkish Population

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Prevalence and Characteristics of Talon Cusps in Turkish Population [Downloaded free from http://www.drjjournal.net on Tuesday, March 08, 2016, IP: 176.102.244.1] Dental Research Journal Original Article Prevalence and characteristics of talon cusps in Turkish population Yeliz Guven1, Yelda Kasimoglu1, Elif Bahar Tuna1, Koray Gencay1, Oya Aktoren1 1Department of Pedodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey ABSTRACT Background: Talon cusp is a rare dental anomaly characterized by a cusp‑like projection, often including the palatal surface of the affected tooth. The aim of the present study was to investigate the prevalence and characteristics of talon cusps in a group of Turkish children. Materials and Methods: The study population consisted of 14,400 subjects who attended the clinics of the Department of Pediatric Dentistry at the Istanbul University, Istanbul, Turkey . Subjects ranged in age from 1 to 14 years with a mean age of 10.5 ± 2.55 years. Talon cusps were mainly categorized by visual examination according to the classification of Hattabet al. The distribution and frequency of talon cusps were calculated with respect to dentition type, tooth type, talon type, the affected surface, associated dental anomalies, and clinical complications. Statistical analysis included descriptive statistics, frequencies, and crosstabs with Chi‑square analysis. Results: Talon cusps were detected in 49 subjects (26 males and 23 females) of 14,400 (0.34%). A total of 108 teeth showed talon cusps. Distribution of talon cusps according to gender showed no statistically significant differences. The incidence of talon cusps was found to be greater in maxillary lateral incisors (53.7%) than central incisors (29.62%). Regarding the type of talon cusp, Received: April 2015 47.22% of teeth showed a Type III talon cusp, whereas 30.55% of teeth demonstrated a Type II talon Accepted: September 2015 and 22.22% of teeth demonstrated a Type I talon cusp. Nine patients (18.36%) with talon cups also Address for correspondence: exhibited other developmental dental anomalies. Clinical complications associated with talon cusps Dr. Yelda Kasimoglu, were detected as caries formation and occlusal interference. Department of Pedodontics, Conclusion: This is the most comprehensive study of the prevalence of talon cusps in Turkish population Faculty of Dentistry, Istanbul University, Capa 34093, using the largest sample size to date. Also, taurodontism associated with a talon cusp has been reported st Istanbul, Turkey. here for the 1 time. Clinical complications associated with talon cusps need more investigations. E‑mail: yeldakasimoglu@ gmail.com Key Words: Accessory, developmental anomaly, talon, tooth INTRODUCTION cusp-like structure varies in size from an enlarged cingulum to a full-formed talon cusp extending Talon cusp is an uncommon developmental dental toward the incisal edges of the teeth. Hattab et al. anomaly characterized by an accessory cusp-like classified these anomalous cusps into three types: structure mostly projecting from the cingulum area True talon (Type I), semi talon (Type II), and trace or cementoenamel junction of anterior teeth.[1] It has talon (Type III) according to the degree of cusp rarely been described either on the labial surface or [2] on both surfaces of a single tooth. This anomalous This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which Access this article online allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. Website: www.drj.ir For reprints contact: [email protected] www.drjjournal.net www.ncbi.nlm.nih.gov/pmc/journals/1480 How to cite this article: Guven Y, Kasimoglu Y, Tuna EB, Gencay K, Aktoren O. Prevalence and characteristics of talon cusps in Turkish population. Dent Res J 2016;13:145-50. © 2016 Dental Research Journal | Published by Wolters Kluwer - Medknow 145 [Downloaded free from http://www.drjjournal.net on Tuesday, March 08, 2016, IP: 176.102.244.1] Guven, et al.: Prevalence of talon cusps in children formation and extension.[1] A recent classification Talon cusps were mainly categorized independently based on the affected surface was proposed by by visual examination by two calibrated examiners Mallineni et al. and divided into three types such as (YG and YK) twice according to the classification facial, lingual, and facial and lingual.[3] of Hattab et al. The teeth were classified as Type I, Type II, and Type III according to Hattab’s Talon cusps are more prevalent in permanent dentition scale [Figure 1] as shown in Table 1. An interexaminer than in primary dentition. Maxillary lateral incisors reliability analysis using the kappa statistic was are the most frequently affected teeth followed by performed to determine consistency among examiners. the maxillary central incisors and the canines. The The kappa coefficient was found to be 0.96, indicating incidence of talon cusp on mandibular teeth has been almost perfect inter-examiner reliability. found to be very rare.[4] The distribution and frequency of talon cusps Histologically, a talon cusp is composed of normal were calculated with respect to dentition type enamel and dentin structure and usually contains a (primary/permanent and maxilla/mandible), tooth pulpal extension.[5,6] The appearance of a talon cusp type, talon type, the affected surface (palatal/facial/ in radiographs looks like a V-shaped radiopaque both), associated dental anomalies, and clinical structure due to the superimposition of the cusp complications. over the affected tooth crown.[7,8] The radiographic demonstration of pulpal extension inside the talon cusp is difficult due to this superimposed appearance.[9] Mader and Kellogg proposed that large talon cusps (Type I), especially when projected from the lingual surface of the tooth, are more likely to contain pulpal extension.[10] There have been limited studies revealing the a frequency of occurrence of this anomaly. Most of the studies documented in the literature are single case reports.[3] Although studied in other groups, the frequency of talon cusps in Turkish people is not well documented in the literature. Therefore, the aim of the present study was to investigate the frequency, distribution, and characteristics of talon b c cusps in a large group of Turkish children attending to the clinics of the Pediatric Dentistry Department at Istanbul University. MATERIALS AND METHODS d The present study evaluated a total of 14,400 Figure 1: Clinical examples of Type I (a), Type II (b and c), subjects (7704 females, 6696 males) ranging in and Type III (d) talon cusps based on the classification of age between 1 and 14 years who were referred to Hattab et al.[1] Istanbul University, Faculty of Dentistry, Department of Pediatric Dentistry between September 2009 and Table 1: Classification for talon cusps into three April 2014. Patients diagnosed with any syndrome or types based on their size and morphology illness that involved odontogenesis or dental eruption Type I ‑ Talon: A morphologically well‑delineated additional cusp that prominently projects from the palatal surface of a primary or were excluded. Only subjects of Turkish origin were permanent anterior tooth and extends at least half the distance from selected. Following a clinical diagnosis of talon cusp, the cementoenamel junction to the incisal edge panoramic or periapical radiographic images and Type II ‑ Semi talon: An additional cusp of 1 mm or more, but extending less than half the distance from the cementoenamel intraoral photographs were obtained for each case. The junction to the incisal edge. It may blend with the palatal surface or age and gender of the subject, the tooth involved, the stand away from the rest of the crown type of talon cusp, other associated dental anomalies, Type III ‑ Trace talon: An enlarged or prominent cingula in any of its and treatment procedures were also recorded. variants originating from the cervical third of the root 146 Dental Research Journal / March 2016 / Vol 13 / Issue 2 [Downloaded free from http://www.drjjournal.net on Tuesday, March 08, 2016, IP: 176.102.244.1] Guven, et al.: Prevalence of talon cusps in children RESULTS cusps were located on the palatal surfaces of the affected teeth. Talon cusps were detected in 49 subjects (26 males and Nine patients (18.36%) with talon cups exhibited other 23 females) of 14,400 (0.34%). Ages ranged between developmental dental anomalies. Three patients had tooth 1 and 14 years with a mean age of 10.5 ± 2.55 years. agenesis, and four patients had SN teeth. One patient A total of 108 teeth showed talon cusps. None of the showed a talon cusp on the lingual surface of a macrodont subjects had significant systemic diseases. Distribution incisor [Figure 3]; one had a taurodontic permanent of talon cusps according to gender shows that there lower first molar and an impacted upper incisor; and one was a slightly higher prevalence in males (0.39%) showed fusion of the maxillary central incisor associated than in females (0.3%) with no statistically significant with agenesis of maxillary lateral incisors. differences (2 = 0.8508, P > 0.05). Clinical complications associated with talon cusps Of the subjects with talon cusps, 47 had 106 talon were detected as caries formation in 20 teeth cusps in permanent dentition while two subjects had talon cups in primary dentition. Talon cusps in (18.51%) and occlusal interference in 31 teeth mandibular teeth were detected in only one subject. (28.7%). Management of patients included selective Talon cusps were found solely in permanent maxillary grinding, restorative treatment, fluoride, and fissure lateral incisors in 25 of 49 children (51.02%), in sealant applications or variable combinations of maxillary central incisors in 9 children (18.36%), these treatments when required. All SN teeth were in maxillary central and lateral incisors in 9 extracted.
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