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VOLUME 56 , ISSUE 4 ( October-December, 2022 ) > List of Articles


Bilateral Occurrence of Supernumerary Cusps on the First Permanent Molars of 6-year-old Libyan Child: Case Report

Majda T Elfseyie, Fatimah A Mohammed

Keywords : Accessory cusp, Dens evaginatus, First permanent molars, Supernumerary cusps, Tooth anomalies

Citation Information : Elfseyie MT, Mohammed FA. Bilateral Occurrence of Supernumerary Cusps on the First Permanent Molars of 6-year-old Libyan Child: Case Report. J Postgrad Med Edu Res 2022; 56 (4):185-188.

DOI: 10.5005/jp-journals-10028-1601

License: CC BY-NC 4.0

Published Online: 31-12-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Supernumerary cusps are morphological variations classified into three patterns: Carabelli's cusp, dens evaginatus (DE), and talon cusps. DE is a disturbance of tooth formation that appears as an accessory tuberculated cusp composed of enamel, dentin, and pulp tissue. The first permanent molars (FPMs) may show alteration in their shape or structure. However, the alteration could be observed as accessory cusps on the occlusal surface or accessory roots or hypomineralization as molar incisor hypomineralization. DE is a rare dental anomaly that can occur in primary or permanent dentitions. It is infrequently seen on anterior teeth or premolars. However, their occurrence on molars is rarer. This presented a rare case of bilateral double supernumerary cusps on the right and the left maxillary FPMs of a 6-year-old Libyan boy, while the mandibular FPMs appeared with normal cusps. The aims of this study were to report and discuss the diagnostic methods and the management of this anomaly. In addition, shed light on the importance of early diagnosis and follow-up observation. That could help in reducing the potential dental problems and to improve patients’ quality of life.

  1. Bilge NH, Yeşiltepe S, Ağırman KT, et al. Investigation of prevalence of dental anomalies by using digital panoramic radiographs. Folia Morphol (Warsz) 2018;77(2):323–328. DOI: 10.5603/FM.a2017.0087
  2. Rahul M, Ashima G, Singh S, et al. Multiple accessory cusps in maxillary primary second molars and permanent first molars and its clinical implications. J Postgrad Med Edu Res 2018;52(3):143–146. DOI: 10.5005/jp-journals-10028-1289
  3. Elfseyie M, Hassan MIA, Al-Jaf NMA, et al. Prevalence of malocclusion and occlusal traits of Malay adults (18-23 years) in Shah Alam, Malaysia. Int J Dent 2020;5(2):81–85. DOI:10.31254/dentistry.2020.5211
  4. Felemban NH, Manjunatha BS. Prevalence of the number of cusps and occlusal groove patterns of the mandibular molars in a Saudi Arabian population. J Forensic Leg Med 2017;49:54–58. DOI: 10.1016/j.jflm.2017.05.013
  5. Elfseyie MTM, Abdullah NM, Hassan MIA. Occlusal features of 12 years old Malaysian Malay school-children in Shah Alam. Compendium Oral Sci 2014;1(2):6–12. DOI: 10.24191/cos.v1i0.17529
  6. Elfseyie MT, Al-Jaf NMA, Hassan MIA. Prevalence and gender differences of buccally displaced canines of 12 years school children and 18-23 years adults in Shah-Alam, Malaysia. Int J Dent Res 2021;6(2):39–42. DOI: 10.31254/dentistry.2021.6204
  7. Ovsenik M, Farcnik FM, Verdenik I. Comparison of intra-oral and study cast measurements in the assessment of malocclusion. Eur J Orthod 2004;26(3):273–277. DOI: 10.1093/ejo/26.3.273
  8. Elfseyie MTM. A study of occlusal features of Malay adults and 12 year old school children/Majda TM Elfseyie [Master thesis]. Malaysia: Universiti Teknologi MARA; 2013.
  9. Cruz CV, Soares AL, Braga DN, et al. Diagnosis and surgical management of nonsyndromic nine supernumerary teeth and Leong's tubercle. Case Rep Dent 2016;2016(3):8641867. DOI: 10.1155/2016/8641867
  10. Jain S. Variation in cuspal morphology in maxillary first permanent molar with report of 3 cusp molar- a prevalence study. J Clin Diagn Res 2016;10(9): ZC34–ZC36. DOI: 10.7860/JCDR/2016/18668.8459
  11. Leão JC, Gueiros LA, Porter SR. Oral manifestations of syphilis. Clinics 2006;61(2):161–166. DOI: 10.1590/S1807-59322006000200012
  12. Nortjé C. Maxilo-facial radiology case 145. S Afr Dent J 2016;71:425.
  13. Ronald P, Jean L, Joseph L. Dermatology. Set. St. Louis: Mosby Press; 2008.
  14. Casamassimo P, Fields H, McTigue D, et al. Pediatric dentistry infancy through adolescence. Elsevier. 2005;4th Edition 648.
  15. Lauc T, Fornai C, Premužić Z, et al. Dental stigmata and enamel thickness in a probable case of congenital syphilis from XVI century Croatia. Arch Oral Biol 2015;60(10):1554–1564. DOI: 10.1016/j.archoralbio.2015.07.002
  16. Hillson S, Grigson C, Bond S. Dental defects of congenital syphilis. Am J Phys Anthropol 1998;107(1):25–40. DOI: 10.1002/(SICI)1096-8644(199809)107:1<25::AID-AJPA3>3.0.CO;2-C
  17. Sedano HO, Ocampo-Acosta F, Naranjo-Corona RI, et al. Multiple dens invaginatus, mulberry molar and conical teeth. Case report and genetic considerations. Med Oral Patol Oral Cir Bucal 2009;14(2):E69–E72.
  18. Thakur NS, Thakur S. Double dens evaginatus on permanent maxillary first molar: a case report of this rare occurrence. Indian J Dent Sci 2017;9(2):114–116. DOI: 10.4103/IJDS.IJDS_84_16
  19. Roopa KB, Poornima P, Pathak S, et al. Bilateral supernumerary cusps on deciduous and permanent molars: a case report with a short review. Int J Contemp Dent Med Rev 2015;2015:1–3. DOI: 10.15713/ins.ijcdmr
  20. Echeverri EA, Wang MM, Chavaria C, et al. Multiple dens evaginatus: diagnosis, management, and complications: case report. Pediatr Dent 1994;16(4):314–317.
  21. Levitan ME, Himel VT. Dens evaginatus: literature review, pathophysiology, and comprehensive treatment regimen. J Endod 2006;32(1):1–9. DOI: 10.1016/j.joen.2005.10.009
  22. Shrestha A, Marla V, Shrestha S, et al. Developmental anomalies affecting the morphology of teeth - a review. RSBO 2015;12(1):68–78. DOI: 10.21726/rsbo.v12i1.732
  23. Rao YG, Guo LY, Tao HT. Multiple dens evaginatus of premolars and molars in Chinese dentition: a case report and literature review. Int J Oral Sci 2010;2(3):177–180. DOI: 10.4248/IJOS10052
  24. Maia RA, de Souza-Zaroni WC, Mei RS, et al. Talon cusp type I: restorative management. Case Rep Dent 2015;2015:425979. DOI: 10.1155/2015/425979
  25. Devi KM, Kiran G, Jyothsna M. Talon cusp / dens evaginatus of anterior teeth : a case report of a developmental dental anomaly. Indian J Dent Res 2014;6(3):1629–1633. DOI: 10.5866/2014.631629
  26. Saberi EA, Ebrahimipour S. Evaluation of developmental dental anomalies in digital panoramic radiographs in Southeast Iranian population. J Int Soc Prev Community Dent 2016;6(4):291–295. DOI: 10.4103/2231-0762.186804
  27. Elfseyie M, Alaskandrani R, Huew R, et al. Evaluation of health status of the first permanent molars of children aged 6 to 12 years in Benghazi, Libya. Int J Manag Soc Sci Res 2020;2(4):110–116.
  28. Gupta SK, Saxena P. Prevalence of cusp 7 in permanent mandibular first molars in an Indian population: a comparative study of variations in occlusal morphology. J Investig Clin Dent 2013;4(4):240–246. DOI: 10.1111/j.2041-1626.2012.00154.x
  29. Kocsis GS, Marcsik A, Kókai EL, et al. Supernumerary occlusal cusps on permanent human teeth. Acta Bio Szeged 2002;461(1-2):71–82.
  30. Ayer A, Vikram M, Suwal P. Dens evaginatus: a problem-based approach. Case Rep Dent 2015;2015(9):1–4. DOI: 10.1155/2015/393209
  31. Stecker S, DiAngelis AJ. Dens evaginatus: a diagnostic and treatment challenge. J Am Dent Assoc 2002;133(2):190–193. DOI: 10.14219/jada.archive.2002.0143
  32. Morinaga K, Aida N, Asai T, et al. Dens evaginatus on occlusal surface of maxillary second molar: a case report. Bull Tokyo Dent Coll 2010;51(3):165–168. DOI: 10.2209/tdcpublication.51.165
  33. Koneru A, Hunasgi S, Manvikar V, et al. Nonsyphilitic occurrence of mulberry molars: a rare case report. J Oral Maxillofac Pathol 2019;23(1):106–110. DOI: 10.4103/jomfp.JOMFP_74_18
  34. Sakamuri S, Mallineni S. An unusual mandibular second molar mimicking maxillary first molar – a Rare occurrence. Periodon Prosthodon 2018;4(1):1–3. DOI: 10.21767/2471-3082.100037
  35. Shekhar MG, Vijaykumar S, Tenny J, et al. Conservative management of dens evaginatus: report of two unusual cases. Int J Clin Pediatr Dent 2010;3(2):121–124. DOI: 10.5005/jp-journals-10005-1067
  36. Chandra B, Das M. Accessory central cusp in the maxillary second primary molars: a rare entity among the rare. Int J Clin Pediatr Dent 2014;7(3):202–205. DOI: 10.5005/jp-journals-10005-1265
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