Maksiller Santral Kesici Dişte Talon Tüberkülü: Klinik ve Radyolojik Bulguları ve Tedavisi ile bir Vaka Sunumu

Abstract

Dens evaginatus (DE) gelişimsel bir dental anomali olup, mine ve dentin dokusunun yanı sıra pulpa dokusunu da içerebilen tüberkül benzeri yapı olarak tanımlanmaktadır. Genellikle premolar dişlerle ilişkilendirilmekle birlikte, kesici dişlerde de görülmektedir (talon tüberkülü). Asya kökenlilerde daha sık rastlanan bu anomali, her iki cinsiyeti de etkileyebilmekte ve unilateral veya bilateral olarak izlenebilmektedir. Klinik olarak; çürük, maloklüzyon, oklüzal travma ve pulpa nekrozu gibi komplikasyonlara sebep olabilir. Radyolojik olarak, etkilenen kuron üzerine süperpoze olan “V” şeklindeki radyo-opak yapı mesiodens, kompound odontoma veya sürnumerer diş görüntüsünü taklit edebilir. Estetik kaygılar ve çürük dişlerinin tedavisi için kliniğimize başvuran 16 yaşındaki erkek hastanın klinik ve radyolojik muayenesi gerçekleştirilmiştir. İntra-oral muayenede, sol maksiller santral kesici dişin lingual yüzeyinde konik şekilli aksesuar tüberkül saptanmıştır. İlgili bölgeden alınan periapikal radyografide, etkilenen kuron üzerine süperpoze olmuş tipik “V” şekilli radyo-opak yapı izlenmiştir. İlgili tüberküldeki pulpa uzantısının incelenmesi ve restoratif tedavilerin bu doğrultuda şekillendirilmesi için konik ışınlı bilgisayarlı tomografi (KIBT) görüntülemeye başvurulmuştur. Hasta, retantif alanların ve çürüklerin restorasyonu için Restoratif Diş Tedavisi Anabilim Dalı’na sevk edilmiştir. Nadir rastlanan bir anomali olan DE, klinik ve radyolojik bulgularla birlikte değerlendirilmelidir. Genetik aktarımın göz önünde bulundurulması erken tanı açısından oldukça önemlidir. Koruyucu/önleyici ve minimal invaziv uygulamaların KIBT görüntüleme ile desteklenmesi klinisyene önemli avantaj sağlayacaktır.

Keywords

• dens evaginatus
• talon tüberkülü
• aksesuar tüberkül
• konik ışınlı bilgisayarlı tomografi
• tedavi

Talon Cusp on a Maxillary Central Incisor: A Case Report with Clinical and Radiological Findings, and Management

Abstract

Dens evaginatus (DE) is a developmental dental anomaly and is defined as a tubercle-like structure that may contain pulp tissue as well as enamel and dentin. Although it is usually associated with premolars, it is also seen in incisors (talon cusp). This anomaly, which is more common among Asians, may affect both genders and may be observed unilaterally or bilaterally. Clinically, it may cause complications such as caries, malocclusion, occlusal trauma, and pulp necrosis. Radiologically, the V-shaped radiopaque structure superimposed over the affected crown may mimic the appearance of a mesiodens, compound odontoma, or supernumerary tooth. Clinical and radiological examination of a 16-year-old male patient who admitted to our clinic with aesthetic concerns and treatment of decayed teeth was performed. In the intra-oral examination, a conical accessory cusp was noted on the lingual surface of the left maxillary central incisor. A typical V-shaped radiopaque structure superimposed on the affected crown was observed on the periapical radiograph taken from the relevant area. Cone beam computed tomography (CBCT) imaging was used to evaluate the restorative treatment options by examining the pulp extension in the relevant tubercle. The patient was referred to the Department of Restorative Dentistry for restoration of the retentive areas and caries. DE, which is a rare anomaly, should be evaluated together with clinical and radiological findings. Consideration of genetic transmission is quite important for early diagnosis. CBCT imaging will provide significant advantage to the clinician in preventive and minimally invasive applications.

Keywords

• dens evaginatus
• talon cusp
• accessory cusp
• cone beam computed tomography
• management

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