Pacific Coast Society of Orthodontists Bulletin Fall 2019 - 55

Angle Pearls

The Cusp of Carabelli
These days, many orthodontists do not place
bands. However, for orthognathic patients,
surgeons typically want bands on the molars

Figure 1. The solution is to make the occlusal
circumference larger

Figure 2. A blue stone is effective to carve a
crescent into the occlusal margin

PCSO Bulletin

The cusp of Carabelli was named in 1842 by
Carabelli Gy├Ârgy, the court dentist of the Austrian
Emperor, Franz.
The extra cusp can make fitting a band difficult
since it increases the perimeter of the tooth at
the occlusal margin, forcing the clinician to use
a larger band that consequently does not fit the
gingival circumference well (Figure 1).

Dr. Gerald Nelson
San Francisco, CA

Fall 2019

to avoid bonding failures during intermaxillary
fixation.

This can be dealt with by increasing the
occlusal circumference. One carves a crescent-shaped divot in the occlusal margin of the
band so the occlusal edge of the band at the
Carabelli cusp will be displaced gingivally and
make a much better fit to the tooth surface
(Figures 2 and 3).

Figure 3. It moves the margin to a cleaner part of the crown

55



Pacific Coast Society of Orthodontists Bulletin Fall 2019

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