Central Accessory Cusp – Unique Site

Accessory cusps are common variations of tooth morphology that are occasionally seen clinically. However, their incidences differ depending on the type and the tooth affected. This article reports a rare case of bilateral central accessory cusp of Maxillary first permanent in a 14year old boy. The maxillary right and left first permanent molars showed prominent, rounded projection on the occlusal aspects which were obliterating the central grooves. There were no signs of wear or fracture of these tubercles. No specific treatment was administered, as they were not interfering with the occlusion. Preventive measures like oral prophylaxis and sealant placement was done. The possible complications in the future were explained to the parents regarding the tubercle and the need for periodic monitoring was emphasized. Also the possible etiological factors along with differential diagnosis and future treatment options anticipated are discussed.