Hindawi Publishing Corporation Case Reports in Dentistry Volume 2013, Article ID 734143, 4 pages http://dx.doi.org/10.1155/2013/734143 Case Report Maxillary and Mandibular First Premolars Showing Three-Cusp Pattern: An Unusual Presentation Ramakant Nayak, 1 Vijayalakshmi Kotrashetti, 1 Aarati Nayak, 2 Viraj Patil, 3 Mayuri Kulkarni, 1 Pradeep Somannavar, 1 and Jagadish Hosmani 1 1 Department of Oral Pathology and Microbiology, Maratha Mandal’s NGH Institute of Dental Sciences and Research Centre, Belgaum, Karnataka 590010, India 2 Department of Periodontology, Maratha Mandal’s NGH Institute of Dental Sciences and Research Centre, Belgaum, Karnataka 590010, India 3 Department of Prosthodontics, Maratha Mandal’s NGH Institute of Dental Sciences and Research Centre, Belgaum, Karnataka 590010, India Correspondence should be addressed to Vijayalakshmi Kotrashetti; drviju18@yahoo.com Received 17 December 2012; Accepted 15 January 2013 Academic Editors: J. Asaumi, D. W. Boston, and J. C. de la Macorra Copyright © 2013 Ramakant Nayak et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Dental anatomy is the study of morphology of various teeth in human dentitions. Te application of dental anatomy in clinical practice is important, and dentist should have a thorough knowledge regarding the morphology of the teeth. At times as a result of genetic variation, environmental factors, diet of an individual and race, variations in the morphology of the teeth can be observed. Tese variations have been extensively studied by the researcher in the feld of anthropology to defne a particular race. Te most commonly observed changes include peg-shaped laterals, shovel-shaped incisors, and extra cusp on molar. Common variations documented with regard to maxillary and mandibular frst premolars are the variation in the number of roots. But the variations with respect to crown morphology are few. We report a frst documented unusual presentation of maxillary and mandibular frst premolars with three-cusps pattern in a female patient. 1. Introduction Dental anthropology is the study of the origin and variations in the human dentitions. Tese structural variations are used to determine a population or a race. Dental anthropologic structures useful in identifcation include metric and non- metric traits. Te study of dental morphology (nonmetric trait) is easily observed and documented. Nonmetric dental traits (NDTs) are of value because they possess high taxo- nomic value and have been used to estimate biological rela- tionships among diverse population which allows compara- tive analysis of the historical, cultural, biological development of primitive and modern human groups. NDT can be used to evaluate population diferences according to microevo- lutionary processes which in turn give information about racial variations among the population. Tus it is important to describe systematically the morphological variation in each person’s clinical dental history. Te most commonly studied traits include study of cusp size, number and location, occlusal pattern, root confguration, and number of roots [1, 2]. Maxillary frst premolars are described morphologically as showing two cusps and two roots, whereas the mandibu- lar frst premolars shows presence of two cusps and one root, with lingual cusp being rudimentary in most cases. Superimposed on these basic shapes of teeth are minor morphological variations that afect both deciduous and permanent teeth [3, 4]. Such variations are inherited and dependent on many genes, culture, conditions of life, diet, and adaptation processes [4]. Te common variation documented in the morphology of maxillary frst premolar is presence of three root canals with the incidence of 5-6% [5]. Donald HM found morphological variations in maxillary frst premolar in two girls and one boy of Papago Indians. He observed that