Background: Talon cusp is an evolving anomaly comprising a projected cusp or a vertical ridge present either labially or palatally from an anterior tooth. It is more frequently seen in permanent dentition than in primary teeth. Reported prevalence in the literature ranges from 0.06% to 40.8%.

Methods: An 11-year-old boy visited the department due to irregular tooth placement. He was born with a unilateral cleft lip and palate and had undergone cleft lip repair surgery at a young age. Pretreatment evaluation revealed a talon cusp on tooth #62 and a mesially rotated #11, which contributed to malocclusion and potential functional issues such as occlusal interference and difficulty in maintaining oral hygiene. Extraction was performed for the talon cusp and was planned to keep the patient under observation until all the permanent teeth erupted into the oral cavity. The extent of orthodontic treatment required would be decided.

Results: After 1 week, the patient was recalled and an uneventful healing was present without any complications. He was referred to Department of Orthodontics to address the malocclusion.