PMC5220459_01
(a-c) Presence of complete Talon cusp (black arrows); (d, e) incisal view showing the contact of Talon cusp with the lower anterior teeth.
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Both lateral incisors presented additional cusp on the palatal surface extending up to the incisal edge (Figures 1(a)-1(c)). Deep stained developmental grooves were observed at the junction of the talon and the palatal surface of the tooth (Figure 1(a)). In occlusion, the talons were almost in contact with the lower anterior teeth (Figures 1(d) and 1(e)).
(a) Use of sand trap while using air abrasion; (b) prepared groove (long arrow) and unprepared groove (short arrow); (c) sealing of the grooves with GIC.
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Air abrasion was used for minimal preparations of the grooves (Figures 2(a) and 2(b)). 50 mum alumina particles were used in Microetcher ERC (Danville materials, San Ramon, CA) at 60 psi for 3 seconds at a stretch. To avoid spilling of alumina particles inside oral cavity and to keep the stream focused on to the target site, a sand trap was used (Figure 2(a)). At the end of the preparation, the discolored groove was clean and wide enough to receive the restorative material (Figure 2(b)). Glass ionomer cement (GIC) was used to restore the cavity (Figure 2(c)).
(a-c) Putty index used for tracking the amount of reduction; (d) following completion of treatment.
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Talon's cusp was visible (Figure 3(a)). The objective was to track the reduction of the cusp in every appointment. In each visit, the putty index guided the amount of reduction which was limited to 1 mm (Figures 3(b) and 3(c)). At the end of the orthodontic treatment, patient was found to be completely asymptomatic and the teeth were in alignment with spaces closed (Figure 3(d)).