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BACKGROUND: Nowadays, cone beam computed tomography (CBCT) are commonly used in dentistry with an advantage about significantly lower dose comparing with CT-Scanner. Utilizing CBCT images which are indicated in dentistry like orthodontics can help diagnose diseases beyond dentistry field. One rare phenomenon can be seen in maxillary sinus, which is often overlooked by dentists, is ectopic teeth. CASE REPORT: This article describes one orthodontic case found accidentally an ectopic tooth in maxillary sinus by inspecting CBCT images. CONCLUSION: Dentists and oral radiologists should carefully inspect non-dental structures, like maxillary sinus, even its distance from the dentoalveolar region, especially in asymptomatic patients.

This case series describes an alternative approach for removing ectopically erupted tooth in the maxillary sinus using an improved endoscopic approach known as modified endoscopic-assisted sinus surgery (MESS). We reviewed medical charts and radiographs of patients who underwent surgical removal of an ectopic tooth in the maxillary sinus using MESS. The surgical technique consisted of creating a bony window in the maxillary sinus wall with a pre-adapted microplate, which was repositioned after the tooth was removed. For all the patients included in this study, there were no postoperative complications clinically and radiographically. At the time of microplate removal, satisfactory bone regeneration was observed around the bony window margins of the maxillary sinus wall. MESS is an effective technique that modifies and integrates the techniques of the conventional Caldwell-Luc procedure (CLP) and functional endoscopic sinus surgery (FESS) and can be used to remove ectopic tooth in the maxillary sinus by avoiding the risk of postoperative sinus-related complications.

Ghost images are artefacts of anatomical structures or foreign objects that oral and maxillofacial surgeons should take into consideration to prevent misdiagnosis and mistreatment. A 38-year-old male patient referred to our clinic for dental implant treatment. Orthopantomograph (OPG) revealed an impacted distomolar at the apex of maxillary right third molar and an ectopic supernumerary tooth in the left maxillary sinus. Despite the ectopic supernumerary tooth appearance on OPG, cone beam computed tomography images revealed that there was not a supernumerary tooth in the left maxillary sinus. Nasal cavity and paranasal sinuses in field of view were evaluated and maxillary ostium diameters were measured to detect if the tooth had migrated. The tooth appearance on the OPG was determined as a ghost image of the impacted distomolar at the contralateral side. Following the extraction of the distomolar, another OPG was performed and the ghost image was disappeared.

Objective This study was performed to investigate the process of ectopic tooth formation. Methods A patient with an ectopic tooth was followed for 6 years. The tooth size and mineralization were evaluated by paranasal sinus computed tomography every 3 years. Results The ectopic tooth was present in the nasal crest of the maxilla and did not change significantly during the 6-year follow-up period. However, the patient developed a new ectopic tooth in the maxillary sinus (ETm). This tooth, located in the posterior wall of the left maxillary sinus, initially appeared as a small region of soft tissue on computed tomography. After 3 years, the area of mixed density had significantly increased, and some of it had significantly mineralized to form an ETm. After 6 years, the ETm had further mineralized and enlarged in situ. The width between the left and right sides of the ETm in 2018 (9.08 ± 2.09 mm) was significantly larger than that in 2015 (7.51 ± 2.18 mm), indicating that ETm formation is a gradual process of mineralization. Conclusion Ectopic teeth can gradually form by in situ mineralization after adolescence, suggesting that ectopic teeth are genetically regulated and result from a programmed formation process occurring at a specific time point.

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.

The aim of this case report is to present an original conservative technique for the transnasal endoscopy-assisted extraction of an ectopic upper third molar associated with a dentigerous cyst occupying the whole maxillary sinus by means of combined lower and middle meatotomies. The proposed technique is a viable, minimally-invasive alternative to the Caldwell–Luc operation (with or without the repositioning of a bone lid), and also to endoscopic middle meatal antrostomy in cases where this would be unable to ensure adequate access because of the position and size of the ectopic tooth and associated cyst.

Ectopic tooth eruption in a non-dental area is a rare entity, and is most common in oral cavity. There have been a few case reports of teeth erupting in mandibular condyle, chin, palate, coronoid process, and maxillary sinus. Ectopic tooth in the maxillary sinus are found incidentally on routine radiological examination, same time they can be symptomatic and associated with pathologies usually dentigerous cyst or odontogenic keratocyst. Facial pain, purulent rhinorrhoea, epistaxis, headache, swelling, and epiphora-related naso-lacrimal duct obstruction can also be seen. By Caldwell-Luc procedure the ectopic teeth within the maxillary sinus are often removed. In this study, a case of ectopic maxillary third molar tooth on right maxillary sinus is presented.

Dentigerous cysts in the craniomaxillofacial complex are a benign pathology commonly associated with ectopically placed teeth. Owing to slow and asymptomatic growth, they often attain considerable size before diagnosis that may compromise adjacent anatomical structures. Various techniques for removal of dentigerous cysts from the maxillary sinus have been described. This case report demonstrates a hybrid endoscopically assisted modification of the Caldwell-Luc approach to provide the technical advantages of both techniques.

A 16-year-old male patient reported to our department with a chief complaint of pain and swelling in the upper left cheek region. On examination, a maxillary canine was found ectopically in the anterior wall of maxillary sinus. Ectopic eruption of teeth into regions other than the oral cavity is rare. We present one such case of ectopic eruption of maxillary canine.

Background: Ectopic eruption of a tooth or osteoma rarely occurs within the maxillary sinus. Coexistence of these two rare entities in the maxillary sinus has never been reported in the English literature. Case Report: Herein, we present a 21 year-old male patient with osteoma and ectopic tooth in the left maxillary sinus treated with the removal of the ectopic tooth by endoscopic sinus surgery and excision of the osteoma by the Caldwell- Luc procedure. Conclusion: Unique coexistence of two different entities in the maxillary sinus is most likely due to pediatric facial trauma. Pediatric patients with maxillofacial trauma should be carefully watched for dental injury both clinically and radiologically.

Purpose: Ectopic tooth within the tooth bearing region is often noticed in clinical practice but ectopic eruption in non-dentate regions like maxillary sinus is rare. Rarer is the presence of multiple ectopic teeth involving both the maxillary incisors and canine and has not been reported yet. Method: A seventeen year old male presented with a complaints of dull pain on the right side of the face for past two years. Water’s view X-ray of PNS revealed dense non-specific opacification of the right maxillary sinus. Result: Antrostomy through Caldwell–Luc approach revealed three ectopic teeth in the right maxillary sinus. Later the teeth were identified to be central incisor, lateral incisor and canine. Conclusion: Rare finding of ectopic incisors in the maxillary sinus is reported and the need for interdisciplinary approach to patients is stressed upon.

The eruption of tooth other than the alveolar arch is called Ectopic Tooth. It is frequently encountered in the maxillary sinus. Facial pain is the most common presentation which is commonly misdiagnosed as chronic sinusitis. We present a case of a 47-year-old lady who was incidentally diagnosed to have an ectopic free lying canine in the maxillary sinus and discuss the various theories mentioned in literature predisposing to this condition.

A 27-year-old woman was referred to neurology from her family physician’s office for evaluation of her seizures. The patient also had chronic headaches that were refractory to standard medical treatment. She described these as unilateral (right-sided), throbbing, of moderate to severe intensity

Odontogenic keratocyst is an aggressive cystic lesion and a common type of tooth derived cyst due to presence of odontogenic epithelial remnants in different regions of jaw. In majority of cases, it is located in mandibular posterior region. But it can also be found in the maxilla especially in the canine region. We present a rare case of OKC in maxillary sinus which associated with ectopic third molar. Also, it can be easily confused with other lesions of maxillary sinus like sinusitis or antral polyps, which usually resemble symptomatically. There can be malignant transformation of this benign condition towards squamous cell carcinoma or ameloblastoma. So an early and accurate diagnosis of odontogenic keratocyst is a challenge for pathologists.

Ectopic eruption of a tooth within the dentate region of the jaws is often noticed in clinical practice and is well documented in the literature. But the ectopic eruption into the non dentate region is rare and scantly documented. The maxillary sinus is one such a non dentate region, apart from nasal septum, mandibular condyle, coronoid process and the palate, to accommodate such ectopic eruptions of teeth. Due to its rarity and lack of consensus over its management, the incidence deserves to be added to the literature and discussed. Early surgical intervention for removal of ectopic tooth along with enucleation of the associated cyst, if any, is the treatment of choice.

Dentigerous cysts are commonest type of developmental, epithelial-lined, odontogenic cysts arising in the jaw from the crowns of impacted, unerupted or embedded tooth, most often third molar. But dentigerous cysts arising from ectopic tooth in maxillary sinus is quite rare. Ameloblastoma changes in the dentigerous cysts are rare and to the best of our knowledge have not been reported to be arising from ectopic tooth in maxillary antrum. In this article, we present the radiological diagnosis, clinical features and management of this rare case of ameloblastic transformation in dentigerous cyst arising from ectopic tooth in maxillary antrum.

Dentigerous cysts are the most common type of developmental odontogenic cysts arising from the crowns of impacted, embedded, or unerupted teeth. They constitute about 20% of all epithelium-lined cysts of the jaws. The teeth involved most often are mandibular third molar and maxillary canines. About 70% of dentigerous cysts occur in the mandible and 30% in the maxilla. Dentigerous cysts associated with ectopic teeth within the maxillary sinus are fairly rare, and only 20 cases had been reported in Medline since 1980. In the present paper, we report an additional case of dentigerous cysts associated with ectopic third molar in the right maxillary sinus. Also, pathogenesis of ectopic tooth, role of advanced imaging, differential diagnosis, and management are discussed.

A 30-year-old female patient reported to the dental clinics with a complaint of missing teeth. On clinical evaluation maxillary left pre-molars and mandibular left second molar were absent, the patient was free from any gross pathology and a set of radiographs was advised for analysis of periodontal health and treatment planning. Radiographs revealed the presence of an impacted 3rd molar tooth in the left coronoid process [Table/Fig-1], though clinically no signs or symptoms were observed. Since the location of tooth was abnormal the case was diagnosed as “ectopic 3rd tooth in coronoid process”. [Table/Fig-1]: Orthopantomogram showing ectopic 3rd molar in left coronoid process As the literature suggests such asymptomatic patients can be kept under regular follow-up without any surgical intervention till there is any associated pathology or discomfort. The patient was motivated for placement of implants in edentulous areas and was informed regarding the presence of the ectopic tooth. All the possible complications which could arise in relation to the ectopic tooth were explained to the patient. Further, the patient was advised to have a regular follow-up and visit the dental clinics in case even slight discomfort arose in the concerned region. Occurrence of impacted 3rd molar tooth is not uncommon but an impacted 3rd molar tooth in an abnormal location (ectopic tooth) is not encountered very frequently [1]. As per the reviews very few cases of ectopic 3rd molar tooth have been reported in English literature [1,2]. Hence, it becomes difficult to comment about the epidemiology of these ectopic teeth. The aetiology of this phenomenon also remains obscure, though many theories have been put forth to explain this exceptional event [2]. This paper presents a case of an ectopic tooth in coronoid process. Only 6 cases of this condition have been reported till date, thus the current case is another milestone of this rare occurrence [1]. A tooth may be impacted, by soft tissue alone or it might be a bony impaction, but the location of the tooth is close to its physiologic position [3]. When such impacted teeth have dislocated to distant regions such as condylar process, mandibular ramus, maxillary sinus, nasal cavity etc these are referred to as ectopic teeth [1,2]. Keros and Susic referred to this condition as “Heterotopic position of tooth” in his report [4]. Occurrence of ectopic tooth as such is an uncommon phenomenon and ectopic tooth in coronoid process is even rarer [1], the latter scenario was observed in the current case. It is not always possible to determine the exact cause of an ectopic tooth. Various authors have suggested different possible aetiologies which may be either pathologic such as cysts, developmental like an abnormal eruptive pattern or tooth germ development in abnormal location, or sometimes traumatic or iatrogenic in nature [1,2]. In the present case the causative factor appears to be developmental aberration since there was no associated pathology or any history of trauma or surgical interventions in relation to the jaws. Due to the sporadic nature it is not appropriate to definitively comment about the gender predilection, site, clinical signs and symptoms, etc of ectopic 3rd molars. Most of the reported cases in literature are in women and located in mandibular subcondylar or condylar region [1]. In present case too patient was a female but the tooth was located in an atypical position i.e. the coronoid process [Table/Fig-1]. The clinical symptoms may be in the form of pain and swelling, trismus or sometimes fever with acute inflammation and draining sinus [2]. In the case under discussion the patient was asymptomatic and it was an incidental finding. Asymptomatic cases are generally kept under regular follow-up with radiographic evaluation, as was done in the current case. Ectopic tooth associated with cysts are generally surgically treated conservatively until the cyst is very small. In latter case patient is kept under regular follow-up with radiographic evaluation as is done in asymptomatic cases. Intraoral approach is preferred if possible to avoid scarring of facial skin [5]. Based on various reported cases and reviews of ectopic tooth it can be said that coronoid process is not a common location for occurrence of this phenomenon. Further, it is a must that asymptomatic cases are kept under regular follow-up to monitor the development of any new symptoms or pathology or observe any increase or decrease in the associated pathology.

Ektopik dişler diş ve ağız harici lokalizasyonlarda nadiren tarif edilmişlerdir. Maksiller sinüs içinde ektopik diş çıkması, asemptomatik olması nedeniyle sıklıkla rutin radyolojik ve klinik değerlendirme sırasında tesadüfen karşılaşılır. Eğer maksiller sinüs içinde ektopik diş çıkması semptomatik oluşursa; pürülan rinore, yüz ağrısı, başağrısı, şişme, epistaksis ve epifora gibi bulgular görülebilir. Çoğunlukla Caldwell-Luc prosedürü ile tedavi edilir. Bu çalışmada, sağ maksiler sinüste ektopik maksiller üçüncü molar diş olgusu sunuldu, Ectopic teeth have been rarely described in non-dental and non-oral localizations. Ectopic tooth eruption in maxillary sinus usually runs across incidentally during routine radiological or clinical evaluation because it is generally asymptomatic. If it occurs symptomaticaly; the findings like purulent rhinorrhoea, facial pain, headache, swelling, epistaxis and epiphora can be seen. It is often treated via Caldwell-Luc procedure. In this study, a case of ectopic maxillary third molar tooth on right maxillary sinus is presented.

Teeth are rarely found out side the alveolar arch. Nasal septum, mandibular condyle, coronoid process and maxillary sinus are areas where ectopic teeth are usually observed. We hereby a case of a 38-year-old woman presented with hoarseness and post-nasal drainage, which was present for the last 1 year with ectopic teeth located in a cyst in the maxillary sinuses. [Cukurova Med J 2016; 41(0.100): 98-99]

Only few cases of ectopic third molar in relation to the roof of maxillary sinus and posteroinferior to the floor of the orbit have been reported in the literature. The diagnosis is usually done by plain-film radiography. "Caldwell-Luc" operation or endoscopic procedures have been used for the removal of such type of ectopic tooth. We report a case of 46-year-old female patient who presented with pain, swelling and watering of eye due to the ectopic tooth. The trans oral removal (via "Caldwell-Luc" operation) of the ectopic maxillary third molar situated superior to maxillary antrum and posteroinferior to the floor of orbit has been described in this case without any complication.

A 23 year-old-woman was referred to point out for pain on the left side of her face and mucopurulent rhinorrhoea lasting for 07 months with long history of recurrent sinusitis. Antibiotics and pain-killers were prescribed to him in the first time. On examination of the oral cavity, all the permanent teeth were present. At nasal endoscopic examination we found a mucopus trickling from the left middle meatus.clinical diagnosis is for sinusitis of dental origin, fungal sinusitis or chronic rhinosinusitis Coronal computed tomography (CT) of the paranasal sinuses revealed the presence of a supernumerary molar tooth (Arrow) within left maxillary sinus floor (A). The tooth was extracted by traditional approach (Caldwell-Luc procedure) from the maxillary sinus under general anesthesia (B, C, D), and the patient has been asymptomatic for more than 02 years. The presence of ectopic or supernumerary tooth in the maxillary sinus is most often asymptomatic but on rare occasions can be a cause of recurrent sinusitis. The supernumerary ectopic tooth is a very rare condition, usually it's localized on the maxillary sinus, and other sites were described like nasal cavity or chin. Coronal computed tomography is sufficient to determine extract localization. The extraction can be made by conventional approach or by transnasal endoscopic approach with less morbidity.

We describe a case of an incidentally-diagnosed ectopic tooth showing anomalous morphology in the maxillary antrum, using three-dimensional reconstruction of computed tomography images of the tooth obtained by multi-detector computed tomography.

Ectopic teeth erupted in the maxillary sinus are rarely reported. Although the causes of eruption of a tooth into the maxillary sinus are unclear, some clinical conditions are suspected to be responsible, such as developmental disturbances (cleft palate), displacement of teeth by trauma, interventions or cyst, infection, genetic factors, crowding, and dense bone. Most cases of ectopic teeth in the maxillary sinus are asymptomatic and are occasionally diagnosed thanks to routine radiographic investigations.The aim of this article is to present and discuss the surgical management of an ectopic third molar in the roof of the maxillary sinus.

Ectopic teeth erupt into regions other than the natural position or should be impacted in unusual location. Etiology of these teeth includes trauma, infection, and developmental diseases; however, in many cases, it is idiopathic. In addition, dentigerous cysts that are related with ectopic teeth may also affect adjacent anatomic regions. The occurrence of ophthalmic complications related with ectopic teeth is a rare situation. In this article, we aimed to present a patient who had a blurred vision thought that resulted from the dentigerous cyst associated with the ectopic third molar in the maxillary sinus roof.

A case of a large dentigerous cyst containing a canine tooth in the maxillary antrum is presented. This case is of interest due because of its extensiveness and thepresence of a canine tooth in the roof of the maxillary sinus. In addition, this caused aright-sided epiphora. Enucleation of the cyst containing the ectopic tooth was made.

Intranasal ectopic teeth are rare and ectopic eruption of teeth can occur in a variety of locations. Commonly seen in the palate and maxillary sinus, they have also been reported in the mandibular condyle, coronoid process, orbital and nasal cavities, and through the skin. With the advent of sinonasal endoscopy in the mid 1980s, and subsequent advances in surgical techniques, endoscopic management of intranasal lesions has become possible. In the current case study, we report a successful endoscopic removal of intranasal ectopic teeth located in the nasal cavity. The endoscopic surgical approach used in this case caused less morbidity than do the more common methods of removing an intranasal ectopic tooth.

Ectopic tooth are rarely found in the maxillary sinus. In rare cases, occlusion of the sinus ostia may predispose a patient to develop a maxillary sinus mucocele. Extraction of the tooth with excision of mucocele resulted in relieving of the symptoms. Here, we present a case of mucocele with an ectopic maxillary tooth located in medial antral wall, over the ostium area in a nine-year-old girl. We evaluated the clinical features, etiologic factors, challenging properties, signs and symptoms of the ectopic tooth in the maxillary sinus.

Supernumerary, ectopic tooth eruption in a non-dental area is a rare entity. The ectopic development of tooth found in non-dental environment has been reported in places such as the nasal cavity, chin, maxillary sinus, mandibular bone, palate and orbital cavity. Ectopic tooth eruptions in the maxillary sinus are usually asymptomatic and are found incidentally during routine clinical or radiological investigations. The diagnosis is usually made by plain-film radiography. Computed tomography is indicated when an ectopic tooth is found prior to surgery. Standard treatment for an ectopic tooth is extraction of the tooth. Here, the authors present a case of supernumerary, ectopic tooth found in the maxillary sinus associated with a mucocele. � Korean J Otorhinolaryngol-Head Neck Surg 2012;55:527-9 Key WordsZZEctopic tooth ㆍMaxillary sinus mucocele.

Background and ObjectivesZZThe presence of ectopic tooth in the sinonasal cavity is an unusual phenomenon and the underlying etiology remains unclear. Because of its rarity, clinical observation studies about sinonasal ectopic tooth are very rare. The aim of this study was to analyze the clinical characteristics of ectopic tooth occurring in the sinonasal cavity. Subjects and MethodZZMedical records and radiologic studies of 11 patients, who were treated between January 2006 and June 2012 for ectopic nasal teeth were reviewed retrospectively, with regard to sex, age, location, symptoms and treatment methods. ResultsZZAmong 11 patients, 8 patients were male and 3 patients were female. The average age was 24.2 years. Among 7 patients who had symptoms, nasal obstruction was the most common followed by rhinorrhea, postnasal drip, facial swelling or pain, headache. The nasal cavity was the most frequently affected site. Among 14 ectopic teeth from eleven patients, 7 were removed by intrasnasal endoscopy and 2 by external premaxillary approach. Five teeth which were unerupted within the hard palate or maxillary sinus were offered conservative treatment with periodic follow-up. ConclusionZZRemoval of ectopic nasal tooth is generally advocated to alleviate the symptoms and prevent complications; if conservative treatment is decided, periodic monitoring of the patient is recommended. We suggest that treatment be carefully planned based on the symptoms of patients, location of the ectopic tooth, and whether the tooth is erupted or not. � Korean J Otorhinolaryngol-Head Neck Surg 2012;55:487-92 Key WordsZZEctopic tooth ㆍNasal cavity ㆍParanasal sinuses ㆍSupernumerary tooth.

A 15-year-old boy was referred for evaluation of recurrent episodes of maxillary and dental pain accompanied by a purulent oral discharge. Examination revealed purulent material draining from a small opening in the gum next to the upper right maxillary first molar.

The ectopic eruption of a supernumerary tooth can occur in the sinonasal area, but due to its rarity, few cases of ectopic tooth eruption in the maxillary sinus have been reported. A fungus ball in the paranasal sinuses usually involves just one sinus, most frequently the maxillary sinus. Here, the authors present a case of an ectopic supernumerary tooth embedded in a fungus ball of the maxillary sinus.

Ectopic tooth is not uncommon and usually occurs in the palate and maxillary sinus. We report a case of ectopic tooth located in the nasal cavity, a rare site. The mass depicted by CT was highly attenuated, and central lucency was observed.