Delayed removal of a fully intruded primary incisor through the nasal cavity: a case report

Intrusive luxation of a permanent maxillary central incisor into the nasal cavity: A case report

This case report out lines a rare complete intrusion of a permanent, maxillary central incisor (tooth 11) into the nasal cavity, with a late diagnosis and treatment. An eight-year-old boy was referred to an oral and maxillofacial surgery service with absence of tooth 11 after an episode of a fall from his own height. Approximately 50 days after the trauma, the patient presented, with a complaint of obstruction of the right nostril. The clinical examination and tomographic evaluation showed that the tooth had been intruded into the nasal cavity on the right side. The tooth in question was removed under general anesthesia by direct approach through the right nostril. The patient was followed up for approximately one year without complications. This case demonstrates the importance of a detailed evaluation during the first examination after intrusive luxation so the correct diagnosis is made and the correct treatment is performed to avoid greater morbidity and complications for the patient.

Tooth in oropharynx

The incidence of ectopic teeth has increased. In many cases, the etiology of ectopic teeth cannot be identified. Ectopic tooth in deciduous dentition period is very rare and information is limited about its causes and characteristics. The conditions commonly associated with an increased prevalence of ectopic teeth include cleft lip and palate, cleidocranial dysplasia, and Gardner syndrome. The diagnosis is made by the clinical and radiological examinations. The indication for extraction in ectopic teeth cases is in general determined by the presence of symptomatology, or by the need for preventing future complications. We present a case of an ectopic maxillary tooth in a 4 year-old boy. In addition, this report also addresses a young patient with a tooth in the oropharynx with the objective of non traumatic etiology, and such a clinical presentation is extremely rare. The authors believe the case presented here is the first documented case of an ectopic supernumerary tooth seen in the oropharynx.

Tooth in oropharynx

The incidence of ectopic teeth has increased. In many cases, the etiology of ectopic teeth cannot be identified. Ectopic tooth in deciduous dentition period is very rare and information is limited about its causes and characteristics. The conditions commonly associated with an increased prevalence of ectopic teeth include cleft lip and palate, cleidocranial dysplasia, and Gardner syndrome. The diagnosis is made by the clinical and radiological examinations. The indication for extraction in ectopic teeth cases is in general determined by the presence of symptomatology, or by the need for preventing future complications. We present a case of an ectopic maxillary tooth in a 4 year-old boy. In addition, this report also addresses a young patient with a tooth in the oropharynx with the objective of non traumatic etiology, and such a clinical presentation is extremely rare. The authors believe the case presented here is the first documented case of an ectopic supernumerary tooth seen in the oropharynx.

Delayed removal of a primary incisor embedded in the upper lip after dental trauma: a case report about the importance of soft tissue examination

This article describes a child patient who initially had inadequate treatment and suffered concomitant soft tissue trauma involving complete displacement of a primary central incisor into the lip tissue. The primary tooth was subsequently removed by surgery under general anesthesia. Despite the delay in diagnosis, there was an excellent outcome following removal of the embedded tooth. This paper again emphasizes the importance of an accurate history, physical, and radiographic evaluation of these patients in the acute phase. The importance of soft tissue inspection even in cases that are presented late for dental trauma management is also highlighted. This case shows that educated emergency room staff preferably including an oral and maxillofacial surgeon is required for a proper emergency management in orofacial traumas.

Traumatic displacement of maxillary permanent incisor into the nasal cavity

PURPOSE

The purpose of this paper was to describe a case of unviable alveolar repositioning of an intruded tooth into the nasal cavity and to bring the subject of intrusive tooth injury among patients with dentoalveolar fractures to the attention of trauma surgeons.

PATIENT

A 26-year-old male was involved in a car accident and crashed his mouth against the dashboard due to sudden deceleration. Intraoral examination revealed an anterior maxillary dentoalveolar fracture and absence of the central maxillary incisors, right lateral maxillary incisor, and left maxillary canine. Computed tomography showed a dislocated tooth in the nasal cavity. The "missing" left maxillary canine was easily recovered from the floor of the left nostril.

CONCLUSIONS

Because complete dislocation of a tooth can cause a frontal sinus abscess, an airway complication, a respiratory tract obstruction, and a complicated lung abscess or sinusitis, anytime a tooth is not accounted for after a dentoalveolar trauma, the possibility that it has been fully intruded should be considered. Computed tomographic scan should be a routine diagnostic study in all cases with associated missing anatomical structures in the oral and maxillofacial region. The need to involve the dental professional in the initial assessment of dental trauma in emergency rooms in hospitals is important in order to identify how many teeth might be missing after dental trauma and to correctly reposition the avulsed teeth when possible.

Traumatic injuries to the primary dentition and effects on the permanent successors - a clinical follow-up study

This study investigated problems in the permanent dentition that, according to history and records, were attributable to dental alveolar injuries of the primary dentition. 106 children have been involved in the study, who had experienced primary anterior tooth trauma affecting a total of 200 teeth. Thirty-nine patients (81 teeth) were available for follow-up examinations. In 25% of the cases followed up, damage was found on the successors in the secondary dentition (16 children/20 teeth). In half of the cases, a comparatively mild form of lesion like enamel discoloration was observed. This was the result of an injury during the tooth maturation process causing enamel hypoplasia. Clinically more relevant were the dental deformities: cessation of root formation or retention caused by ankylosis, which made up the remaining 50% of cases. This was confirmed by clinical long-term observation. The different effects on the permanent teeth can only be detected by radiography after an interval of several months or may even be clinically assessed only after the eruption of the clinical crown.