This anomaly, an enamel-covered tubercle on the
occlusal surface between the buccal and lingual cusps
of posterior teeth, can occur unilaterally or bilaterally.
It occurs primarily in premolars but also has been reported
-- although rarely -- on molars, canines, and
incisors. 9-u The occurrence is five times more frequent
in the mandible than in the maxilla22
The clinical importance of this condition is that this
tubercle easily fractures or is worn away, exposing the
fine pulpal extension, which may lead to infection. The
tubercle may fracture or be abraded as soon as the
tooth comes into occlusion. Infection and loss of tooth
vitality may occur before root development is complete
13 when pulp tests often are unreliable24 Periapical
lesions on the radiographs may be indistinguishable
from or misinterpreted as developing dental follicle.
Diagnosis and treatment may be delayed and severe
toothache or infection may occur because there is no