Malocclusion is clinically more damaging with an abnormal central cusp, which can easily lead to pulpitis or periapical inflammation of the tooth. If early and gradual resharpening is performed, the pulp can produce enough restorative dentin to be able to avoid the occurrence of pulpitis or periapical inflammation. If the central cusp of a malocclusion is found, it should be treated early, as if left untreated, the central cusp may fracture or wear away, causing pulpitis and periapical inflammation. In the case of early newly erupted permanent teeth, this may sometimes also lead to incomplete root development, requiring apical induction for treatment and early treatment of the malformed central cusp.