aberration of a tooth resulting in
formation of an accessory cusp
excrescence, extrusion, or bulge.
covering a dentinal core that usually
contains pulp tissue that on occasion may have a
slender pulp horn which extends various distances
up to the full length of the tubercle’s dentin core.
presence of pulp within the cusp-like
tubercle has great clinical significance and
distinguishes the anomaly from supplemental
cusps, such as the cusp of Carabelli.
descent (including Chinese, Malay, Thai,
Japanese, Filipino, and Indian populations)
with varying estimates reported at 0.5 to 4.3%
Most commonly seen on lingual surface of anterior
teeth (mainly maxillary lateral incisors) & Occlusal
surface of mandibular premolars.
There is typically a bilateral, symmetric distribution,
with a slight sexual predilection for females.
dominant inheritance patterns are seen,
trauma, possibly from pressure
exerted upon the developing tooth bud
has been suggested.
odontoma (odontome) of the axial core
type, evaginatus odontoma (evaginated odontome)
enamel pearl, occlusal tubercle, tuberculum
cusp, supernumerary cusp, interstitial
cusp, tuberculated cusp,
premolar, Leong’s premolar, and talon
An abnormal proliferation and folding of a
portion of the inner enamel epithelium
and subjacent ectomesenchymal cells of
the dental papilla
Into the stellate reticulum of the enamel
During the bell stage of tooth formation
Malocclusion with the opposing tooth upon
the cusp-like elevation occurs as involved
teeth erupt into the dental arches.
The resultant occlusal traumatic force
causes abnormal wear or fracture of the
and is the usual manner of pulp exposure
for this anomaly
A 20 year old female was referred for
consult and treatment of mandibular right
posterior tooth. Patient was concerned
about the ‘bubble on her gums’.
Occlusal tubercle present in all four
mandibular premolars & an associated
Periapical radiolucency w.r.t. 44
EPT: Except #44 other
teeth were vital.
Root canal therapy of
opposing tooth contact
restoration of #34, 35,
root canal dressing
was performed 15
days for the period
of four months.
Obturation of the
tooth was done
sealer (Endoflas FS)
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Stewart R, Dixon G, Graber R. Dens evaginatus (tuberculated
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Davies P, Brook A. The presentation of talon cusp: diagnosis,
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