Intranasal Ectopic Tooth in Adult and Pediatric Patients: A Report of Two Cases

Ectopic teeth with disparate migration: A literature review and new case series

Purpose

Ectopic eruption can be defined as the emergence of a tooth in an abnormal location, where the tooth does not follow its typical eruption pathway. While ectopic eruption within the dentate region is well-documented in the literature, ectopic eruption in non-dentate regions is relatively rare. This study aimed to report 6 cases of ectopic teeth and present a systematic review of the English-language literature on ectopic teeth, emphasizing demographic characteristics, radiographic features, potential complications, and treatment options.

Materials and Methods

A literature search was conducted using the PubMed, Medline, Web of Science, and Cochrane databases. The demographic data and radiographic findings of patients presenting with ectopic teeth were recorded.

Results

The literature review yielded 61 cases of ectopic teeth, with patients ranging in age from 3 to 74 years. The findings from these previously reported cases demonstrated that the most common location for ectopic teeth was the maxillary sinus, which is consistent with this case series. The Pearson chi-square test was performed to evaluate the correlation between age and location of ectopic teeth, and the results were found to be statistically significant (P<0.05). However, no statistically significant relationship was observed between sex and the location of ectopic teeth.

Conclusion

The distinct features of these cases warrant reporting. This study presents the first case of supernumerary teeth in the condyle without any associated pathosis. Another notable characteristic is the pre-eruptive resorption of 2 inverted supernumerary teeth ectopically located in the palate, which predisposes to sinus opacification.

An Intranasal Ectopic Tooth in an Adult

Ectopic teeth can be supernumerary, deciduous or permanent, and can occur in a wide variety of locations outside of the cavity of the mouth. While supernumerary teeth are rare, supernumerary intranasal teeth are rarer. It is not clear what causes the eruption of teeth intranasally; however, trauma, infection, radiation, and developmental defects may be significant factors in their etiology. We report the case of a 33-year-old woman who presented in the otorhinolaryngology department with complaints of rhinorrhea, nasal obstruction, snoring, pain in the forehead, and bad odor that did not improve with conservative treatment. She had a history of extraction of a supernumerary tooth located in the hard palate. During the endoscopic examination, a second tooth-like body was found in the right nasal cavity, which was later surgically removed with endoscopic guidance. During the follow-up visits at three, six, and 12 months, the patient showed a significant reduction of symptoms with remaining rare reoccurrence of mild sinusitis more prominent on the left side as seen in CT scan, thus presumably unrelated to the ectopic intranasal tooth. Although an intranasal ectopic tooth is a very rare finding, it may cause significant morbidity and its removal improves the quality of life of the patient. The benefits of endoscopic removal are greater visibility, better illumination, and precision in surgical removal.

A Rare Case of an Intra-nasal Ectopic Tooth in a Young Woman

Teeth in non-dentate areas including the intra-sinus and intranasal teeth are rarely encountered in clinical practice. Although the majority of patients remain asymptomatic, the usual presenting complaints are nasal obstruction, epistaxis, hyposmia and headache. In this article, we present a case of an intranasal tooth in a 15-year-old female who presented with complaints of hyposmia and nasal obstruction. Computed tomography (CT) of the paranasal sinuses and nasal cavity showed a tooth-like structure in the left inferior nasal cavity extending from the hard palate. The mainstay of treatment is the surgical removal of the ectopic tooth under anaesthesia. Even in asymptomatic patients, surgical removal of the nasal tooth is advised to prevent complications. Along with a clinician’s understanding of the condition, imaging aids in the diagnosis of an ectopic tooth. Imaging, particularly with CT, also helps plan the surgical approach to treatment.

Endoscopic Surgical Excision of Ectopic Tooth in Left Nasal Cavity

Ectopic teeth in the nasal cavity are a rare phenomenon. They are often associated with a variety of symptoms and future complications, ranging from nasal crusting and obstruction to chronic infections. In most reported cases, their removal is recommended. Here, we report a case of an ectopic intranasal tooth in a symptomatic adult. The tooth was removed endoscopically with good results.

Ectopic tooth in maxillary sinus compressing the nasolacrimal canal: A case report

RATIONALE

Ectopic tooth is tooth erupting out of normal anatomical position. Ectopic tooth can occur in different positions, such as maxillary sinus and nasal cavity. In this article, we present a rare case of an ectopic tooth with a dentigerous cyst in the maxillary sinus compressing the nasolacrimal canal.

PATIENT CONCERNS

An 8-year-old girl presented with a 2-month history of spontaneous lacrimation in her right eye. When she wept, more tear shed from her right eye than that from the left one. Computed tomographic (CT) imaging showed a huge low-density image containing a tooth in the maxillary sinus in her right maxilla; the right nasolacrimal canal vanished due to the compression of the ectopic tooth.

DIAGNOSES

Ectopic tooth with dentigerous cyst of right maxilla, and obstruction of nasolacrimal duct.

INTERVENTIONS

The patient underwent nasal endoscopic maxillary sinus cystectomy.

OUTCOMES

The patient recovered well after cystectomy and has been symptom-free.

LESSONS

The unique finding is that this is the first report about ectopic tooth compressing the nasolacrimal canal and inducing spontaneous lacrimation. Treatment: aspect: surgery under endoscope is a minimally invasive approach to ectopic tooth.

A Rhinolith Turning Out to Be an Intranasal Tooth

A tooth in the nasal cavity is an uncommon phenomenon. The exact mechanism is unclear, and patients may present with non-specific nasal symptoms. We encountered a 24-year-old patient with history of cleft palate repair, presenting to us with unilateral nasal discharge not improving with conventional medications. Rigid nasal endoscopy revealed a rhinolith-like foreign body at the floor of the left nasal cavity. Removal of the rhinolith was done under general anesthesia, and it turned out to be an intranasal tooth. Intranasal tooth is often misdiagnosed due to its non-specific symptoms. Detailed dental and oropharyngeal examination as well as imaging studies are essential in diagnosing an intranasal tooth. Early surgical removal is the mainstay of treatment in order to prevent further complications. Patients with unilateral nasal symptoms not responding to conventional treatment require proper ear, nose, and throat (ENT) evaluation to rule out other pathology.