Mineral trioxide aggregate pulpotomy: An ideal treatment option for management of talon cusp
A 12-year-old boy reported to out patient department with a chief complaint of irregular teeth. Clinical examination showed mal-aligned teeth with diastema between maxillary central incisors []. An anomalous pyramidal shaped structure was detected on the palatal surface of the left maxillary central incisor extending from the cervical margin of the tooth toward the incisal edge []. It occluded on lower central incisor causing significant labial displacement of tooth #21. An intraoral periapical radiograph of tooth revealed a typical V-shaped radiopaque structure arising from cingulam of central incisor with its pulpal extension superimposed over the image of an affected crown without any signs of periapical pathology []. The tooth showed a positive response to electric and thermal pulp vitality tests. A diagnosis of a Type 1 talon cusp was established.\nComplete single sitting reduction of talon cusp was planned. Tooth was anesthetized by local infiltration of 2% Xylocaine with 1:100,000 epinephrine. Isolation was achieved with rubber dam. Cusp reduction was performed using a sterile diamond bur with copious water coolant. A 5-mm deep pulpotomy was performed at the exposure site with a sterile #2 round bur. Hemorrhage was carefully controlled by 3% sodium hypochlorite. Mineral trioxide aggregate (MTA) (Dentsply Maillefer, Ballaigues, Switzerland) was mixed as per manufactures instructions and placed directly onto exposed pulp [Figures and ]. Cavity was restored with glass ionomer cement at the same appointment. At 4-year follow-up, patient was asymptomatic without any radiographic signs of periapical pathology [].