Management of a unique case of talon cusp, dens invaginatus associated with other dental anomalies

An 11-year-old girl reported to the Department of Pediatric and Preventive Dentistry, with a chief complaint of discoloration of teeth and poor esthetics due to irregular teeth in the upper and lower front teeth. There was no history of trauma in either the primary or permanent dentition. Family history did not reveal any evidence of hereditary dental anomalies. Clinical examination revealed multiple dental anomalies in both the maxillary and mandibular anterior region. Hypoplastic, irregular globular mass on labial surfaces of maxillary right central, lateral and canine (A). Similar irregular hypoplastic mass was attached to the cervical one-third of mandibular right central and lateral incisors (B). The presence of a talon cusp in the permanent maxillary right central incisor interfered with occlusion in the lower right incisor region. Dens invaginatus with maxillary permanent right lateral incisor (C,D). Management of hypoplastic, irregular globular masses on labial surfaces of maxillary and mandibular teeth was done initially by grounding the tooth surfaces and reformed by composite build-up.