A 17-year-old male reported with the complaint of unesthetic appearance of upper teeth since childhood. On intra-oral examination, several additional cuspal projections resembling a globular pattern were observed on the occlusal aspect of both left and right permanent first molars of both the arches. The morphologically altered molars were perceived with a carious involvement. Furthermore, irregularly placed permanent incisors and buccally placed-partially erupted permanent maxillary canines were also noted which caused occlusal discomfort (Fig. 1). Although the intra-oral morphology revealed findings similar to congenital syphilis, medical history, family history and extra-oral findings of the patient were non-contributory. The considered differential diagnoses were non-syndromic mulberry (moon) molars with Fournier's canines and congenital syphilis. Routine radiographic (Periapical Radiographs) (Fig. 2) and blood investigations (Complete Blood Count, Differential Leucocyte Count and Platelet Count) concluded no abnormalities. Additionally, screening (Venereal Disease Research Laboratory) and specific tests (Treponema pallidum-Hemagglutination) were also negative which led to a rare diagnosis of non-syphilitic and non-syndromic mulberry molars. The patient underwent restoration of the permanent molars followed by orthodontic management.

Conflict of Interest

The authors declare that they have no conflicts of interest in relation to this article.

Funding

This research did not receive any specific funding.

Ethical approval

The authors declare that Ethical approval was not required.

Informed consent

The authors declare that informed consent has been obtained.

Author contributions

Author contribution DD and RC have done the literature search, preparation of the manuscript; and RC has edited the manuscript.

© The authors, 2023

All Figures

	Fig. 1 Clinical images of the maxillary (a) and mandibular (b) arch of the patient demonstrating globular cusps of molars and impacted maxillary canines.
In the text

	Fig. 2 Intra-oral periapical radiographs of left (a) and right (b) permanent first molars revealing multiple irregular radiopaque projections of cusps on the occlusal aspect with carious involvement.
In the text