Multiple Accessory Cusps Expression at Mandibular Third Molar: A Unique Variation of Dental Crown Morphology - A Case Report

Authors

  • Nur Lyanna Mahfuzah Mohamad Johar Kota Samarahan Dental Clinic, Kota Samarahan, Sarawak, Malaysia.
  • Yy Jean Tan Department of Oral and Maxillofacial Surgery, Dental Specialist Clinic, Sarawak General Hospital, Kuching, Sarawak, Malaysia

DOI:

https://doi.org/10.22452/adum.vol30no3

Keywords:

Mandibular third molar, Gemination, Variance morphology

Abstract

Accessory cusps are occasional variations in tooth morphology that can be detected clinically. Third molars have a wide range of eruption patterns and shapes but are commonly impacted. Unlike root morphology, variations in the crown morphology of the third molar have rarely been reported. Variations in crown morphology are important because they can affect clinical outcomes. Here, we present a rare case of fully erupted mandibular third molar (MTM) with multiple accessory cusps. This case report describes a case of a 31-year-old female Kenyah with a unique crown morphology of her fully erupted, vital, and functional mandibular third molar (MTM) which has multiple accessory cusps seen on the buccal surface, giving the appearance of a double tooth. Her MTM presented with an incipient caries lesion, which was managed conservatively. Documenting variations in tooth morphology is crucial for individual identification. While most people opt to have their MTMs extracted, early management of well-erupted and functional teeth should be undertaken to prevent disease progression.

Downloads

Download data is not yet available.

References

Nirmala SV, Challa R, Velpula L, Nuvvula S. Unusual occurrence of accessory central cusp in the maxillary second primary molar. Contemp Clin Dent. 2011;2(2):127-30.

Decaup PH, Garot E, Rouas P. Prevalence of talon cusp: Systematic literature review, meta-analysis and new scoring system. Arch Oral Biol. 2021;125:105112.

Bhavyaa R, Sujitha P, Muthu MS, Kirthiga M. Prevalence of Cusp of Carabelli and its caries susceptibility - an ambidirectional cohort study. Aust Dent J. 2020;65(4):294-301.

Lin CS, Llacer-Martinez M, Sheth CC, Jovani-Sancho M, Biedma BM. Prevalence of premolars with dens evaginatus in a Taiwanese and Spanish population and related complications of the fracture of its tubercle. Eur Endod J. 2018;3(2):118-22.

Ghaeminia H, Nienhuijs ME, Toedtling V, Perry J, Tummers M, Hoppenreijs TJ, et al. Surgical removal versus retention for the management of asymptomatic disease-free impacted wisdom teeth. Cochrane Database Syst Rev. 2020;5(5):Cd003879.

Subramaniam Ramachandran V, Shankari V, Rathakrishnan M, Chandrasegaran V, Kumaraguru K. Management of three rooted mandibular first molar with six canals: A case report. Cureus. 2019;11(12):e6280.

Ismail SM, Hariri F. Rare morphology of the third maxillary molar and potential complications in its extraction. Ann Dent UM. 2020;27:66-8.

Calberson FL, De Moor RJ, Deroose CA. The radix entomolaris and paramolaris: clinical approach in endodontics. J Endod. 2007;33(1):58-63.

Huang RY, Lin CD, Lee MS, Yeh CL, Shen EC, Chiang CY, et al. Mandibular disto-lingual root: a consideration in periodontal therapy. J Periodontol. 2007;78(8):1485-90.

Mincer HH, Harris EF, Berryman HE. The A.B.F.O. study of third molar development and its use as an estimator of chronological age. J Forensic Sci. 1993;38(2):379-90.

Gunst K, Mesotten K, Carbonez A, Willems G. Third molar root development in relation to chronological age: a large sample sized retrospective study. Forensic Sci Int. 2003;136(1-3):52-7.

Harris EF. Mineralization of the mandibular third molar: a study of American blacks and whites. Am J Phys Anthropol. 2007;132(1):98-109.

Jung YH, Cho BH. Radiographic evaluation of third molar development in 6- to 24-year-olds. Imaging Sci Dent. 2014;44(3):185-91.

Liversidge HM. Timing of human mandibular third molar formation. Ann Hum Biol. 2008;35(3):294-321.

Jafari A, Mohebbi S, Khami M, Shahabi MS, Naseh M, Elhami F, et al. Radiographic evaluation of third molar development in 5- to 25 year olds in tehran, iran. J Dent (Tehran). 2012;9(2):107-15.

Arany S, Iino M, Yoshioka N. Radiographic survey of third molar development in relation to chronological age among Japanese juveniles. J Forensic Sci. 2004;49(3):534-8.

Bassed RB, Briggs C, Drummer OH. Age estimation and the developing third molar tooth: an analysis of an Australian population using computed tomography. J Forensic Sci. 2011;56(5):1185-91.

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):202-5.

Roopak B, Poornima P, Pathak S, NeenaI. E. Bilateral supernumerary cusps on deciduous and permanent molars: A case report with a short review. International Journal of Contemporary Dental and Medical Reviews. 2015;2015.

Swift JQ, Nelson WJ. The nature of third molars: Are third molars different than other teeth? Atlas Oral Maxillofac Surg Clin North Am. 2012;20(2):159-62.

KalaiSelvan S, Ganesh SKN, Natesh P, Moorthy MS, Niazi TM, Babu SS. Prevalence and pattern of impacted mandibular third molar: An institution-based retrospective study. J Pharm Bioallied Sci. 2020;12(Suppl 1):S462-s7.

Yaacob H, Nambiar P, Naidu MD. Racial characteristics of human teeth with special emphasis on the Mongoloid dentition. Malays J Pathol. 1996;18(1):1-7.

Santos AFP, Jesus LKd, Hadad H, Monteiro NG, Rodrigues LGdS, Mendes KB, et al. Surgical management of fused 3rd and 4th molars. A case report. Research, Society and Development. 2021;10(4):e41510414351.

Bamgbose BO, Okada S, Hisatomi M, Yanagi Y, Takeshita Y, Abdu ZS, et al. Fourth molar: A retrospective study and literature review of a rare clinical entity. Imaging Sci Dent. 2019;49(1):27-34.

Sandeep S, Kumar GJ, Potdar S, Bhanot R, Vathare AS, Tiwari RVC, et al. Rare case of gemination of mandibular third molar-A case report. J Family Med Prim Care. 2020;9(5):2577-9.

Viswanathan S, Nagaraj V, Adimoulame S, Kumar S, Khemaria G. Dens evaginatus in proximal surface of mandibular premolar: A rare presentation. Case Rep Dent. 2012;2012:603583.

Levitan ME, Himel VT. Dens evaginatus: Literature review, pathophysiology, and comprehensive treatment regimen. J Endod. 2006;32(1):1-9.

Ngeow WC, Chai WL. Dens evaginatus on a wisdom tooth: A diagnostic dilemma. Case report. Aust Dent J. 1998;43(5):328-30.

Krishan K, Kanchan T, Garg AK. Dental evidence in forensic identification - An overview, methodology and present status. Open Dent J. 2015;9:250-6.

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;49:54-8.

Downloads

Published

2023-06-28

Issue

Section

Case Report