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BACKGROUND The avulsion of the impacted lower third molar is one of the most common procedures in oral surgery. Even though it is characterized by possible complications due to the lesion of lingual and inferior alveolar nerves, the intra-oral surgical approach represents the first choice strategy when planning surgery. However, in case of ectopic tooth in the mandibular basal bone, it is appropriate to consider an extra-oral transcutaneous surgical approach. The ectopia of the inferior wisdom tooth represents a very rare clinical condition and sometimes it is even unknown by patients and dentists: further evidence of this fact is represented by the paucity of paper related to the topic that can be found in the international scientific literature. METHODS The experience of the Department of Maxillofacial Surgery of San Gerardo Hospital in Monza (Italy) in management and treatment of ectopic impacted lower third molar is exposed through the presentation of three cases of ectopic third molar. RESULTS Two out of three patients, aware of the risks related to the surgical procedure, refused the treatment proposed. One patient underwent surgical avulsion of the wisdom tooth through extra-oral transcervical approach. No early or late complications have been observed. CONCLUSIONS Extra-oral surgical approach for ectopic lower third molar should be considered for selected cases. Given the rarity of the clinical condition and the procedure-related risks, accurate pre-operative information has to be provided to the patient by physician and the procedure should only be performed by expert and competent surgeons.

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.

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.

Dentigerous cysts are characterised by the formation of cysts containing dental material with a variable level of development. They are the result of a distinct embryological phenomenon. Usually, they are of significant clinical relevance in horses, especially in tandem with ectopic tooth. Contrarily, supernumerary teeth or typical polyodontias usually have limited impact. In this case report, we describe the occurrence of a supernumerary first premolar (Triadan 105). Dissimilar to known scientific literature however was the formation of a cystic structure around the supernumerary tooth. Surgical removal of the dentigerous cyst is discussed, as are the possible causes for the formation of the cystic structure. Based on this case report, we suspect that the formation of a cystic structure may not be limited to atypical polyodontias, as they may also occur in supernumerary teeth.

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.

Ectopic nasal tooth is a rare phenomenon with only 0.1%–1% incidence rate. They are more frequently found coupled with cleft lip and palate. Here, we present a case of intranasal tooth in a 12-year-old male child with operated cleft lip and palate. The condition was diagnosed only on the basis of intraoral periapical radiograph and was extracted using gauge-holding forceps at a rural health-care center. We discuss the possible etiology, clinical findings, diagnosis, and treatment modalities of this condition. The purpose of this paper is to highlight that this rare condition can be managed with minimum available equipment in a rural setup.

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.

Presence of ectopic tooth in the nasal cavity of an adult is a rare phenomenon. Exact etiology of this condition is yet to be confirmed. We report a case of a 40-year-old woman, who presented to us with the history of left nasal obstruction of one-year duration along with pain in the left side of face revealing an on examination. Intranasal tooth was removed by surgical intervention with Luc’s forceps. The patient’s nasal obstruction and facial pain subsided after the treatment. We need to suspect an intranasal tooth when there is a white substance mimicking bone in the nasal cavity in patients presenting to us with facial pain and nasal obstruction Keywords: intranasal tooth; nasal obstruction; surgical extraction

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.

Highlights • Ectopic teeth are commonly seen in palate. • The pathogenesis of ectopic teeth eruption is not fully recognized. • In children, intranasal ectopic teeth occur more frequent in patients with cleft lip and alveolus. • Most cases of the ectopic tooth are asymptomatic and identified incidentally. • The management of the ectopic teeth is tooth extraction., Introduction Intranasal teeth are a rare form of ectopic teeth. Their clinical manifestation are truly variable. In children, intranasal teeth are typically associated with cleft lip and alveolus. Presentation of case Here, we report a case of 11 years –old girl presented with right nasal obstruction and occasional headache without any obvious etiology. 0Computed tomography of the paranasal sinuses (coronal and axial view) revealed displaced right upper maxillary tooth with the crown oriented inferiorly and medially toward and within the lower right anterior nasal cavity. She underwent surgery by anterior rhinoscopy and endoscopic guidance. The patient’s symptoms were resolved completely post-operatively and remained symptom-free for 18 months postoperatively. Discussion Ectopic intranasal tooth is a rare phenomenon, with a male predominance and around half of all patients are diagnosed before adulthood. Ectopic intranasal tooth arising from inferior turbinate is very rare. No clear etiological factor has been suggested in most of the reported cases. Idiopathic etiology has been described as an etiologic factor for ectopic teeth. The treatment of intranasal teeth is early surgical extraction to alleviate the symptoms and prevent the possible morbidities. Conclusion Intranasal teeth are a rare form of ectopic teeth encountered to otolaryngology clinic and may cause a variety of symptoms and complications. CT is very useful; it confirms the diagnosis and facilitates surgical planning. Early diagnosis and treatment are very important to avoid their possible complications.

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.

To identify the preferred surgical approach (intra- or extra-oral) to remove an ectopic third mandibular molar (ETMM) according on its location and presence of an associated cyst or cutaneous fistula, and to determine the indications for a graft or osteosynthesis. A surgical practice questionnaire was distributed to oral and maxillo-facial surgeons attending a National Congress of the French Society of Stomatology, Maxillo-facial and Oral Surgery. A systematic review of the literature and meta-analysis was carried on Pubmed, Cochrane, Embase and ScienceDirect databases using the MeSH terms: “Ectopic teeth”, “Third molar”, “Mandibular”. One hundred and forty-three surgeons answered the questionnaire and the meta-analysis included 66 articles. From the questionnaire, the preferred surgical approach was intra-oral except when the ETMM was in the condyle, when it was extra-oral (69.5%; p

This case report highlights mandibular tooth in an ectopic position in the floor of the mouth, associated with submandibular salivary gland, which was completely obliterating the Wharton duct. Very few such cases have been reported in the literatures. Since ectopic tooth may lead to pain, discomfort sensation upon mastication, and even infection (sialadenitis), its diagnosis and treatment is essential.

Intranasal tooth is a rare type of supernumerary teeth. Its aetiopathogenesis is uncertain but genetic predisposition, trauma and infection are described in previous literatures. It can be either symptomatic or asymptomatic. In our case report, it was asymptomatic which was diagnosed mainly by CT scan as a radiopaque lesion with morphology and attenuation same as that of intraoral tooth. We report a case of an incidental intranasal supernumerary tooth in a 45-year-old male who presented with history of road traffic accident and parasymphyseal fracture of left mandible. This case highlights the rarity of this entity.

An ectopic eruption tooth in the nasal cavity was rarely observed in daily dental treatment. Therefore, the number of case reports from the otorhinolaryngologist was much more than those from dentists. We encountered a 9-year-old girl complaining of nasal congression due to white foreign body in the left nasal cavity. On radiological examination, a tooth-like whitish structure was observed, and it was diagnosed as an ectopic supernumerary tooth. Under general anesthesia, the supernumerary tooth, which looked like a canine tooth, was extracted. The histopathological views of the teeth-like hard tissue confi rmed that it was a dental organism in acknowledgment of dentin, pulp., 日常歯科臨床において歯牙の位置異常症例はしばしば遭遇するが，固有鼻腔内過剰歯は比較的まれである。固有鼻腔内過剰歯の症例のほとんどが耳鼻咽喉科領域で発表され，口腔外科領域からの報告は少ない。今回，われわれは，左側鼻腔に違和感を訴える患者9歳女児に遭遇した。放射線検査にて，歯牙様硬組織を左側固有鼻腔内に認めたため，左側鼻腔内異所性過剰歯と診断した。治療は全身麻酔下にて鼻腔内過剰歯摘出術を施行した。摘出した歯牙様硬組織の病理組織学的所見は，象牙質，歯髄を認め歯牙組織であることを確認した。

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.

The aim of this study was to report two rare cases of ectopic tooth into the nasal cavity. The first case reports a 32-year-old female patient with the main complaint of having a tooth inside her nose. According to her, this condition causes pain and sporadic nosebleed. The patient had a facial trauma when she was 6 years old. The second case refers to an 8-year-old girl with left incomplete unilateral cleft lip and palate. The main complaint was left-sided nasal obstruction by a white hard mass. The treatment for both cases was surgical removal of the ectopic erupted tooth under general anesthesia. In conclusion, we can state that the surgical removal of intranasal tooth is a safe procedure and improves patient’s quality of life.

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.

Objective: Impacted teeth are important for plastic surgeons that frequently perform maxillofacial operations because of their tendency to affect dental occlusion, and thus, cephalometric results. Moreover, severe complications are also caused by the tooth and its surgical removal. In this study, retrospective analysis of 242 extracted teeth and 24 extracted roots was performed and an algorithmic approach to different types and the localizations of impacted teeth was presented. Possible complications and salvage procedures were also discussed. Material and Methods: A retrospective analysis of 128 patients who underwent impacted teeth removal surgery between 2013 and 2015 was performed. Mean age was 26 years (Range: 18–42 years), and the female to male ratio was 39/89. Sixteen of the patients were operated under regional nerve block, whereas the remaining were operated under general anesthesia. In 107 patients, the whole tooth was removed, whereas the residual root of the tooth was removed in 21 patients. In 89 patients, bone interventions like the creation of bone window or peridental milling to loosen the tooth were needed, whereas only oral mucosal incisions were performed in the remaining patients. Results: The most common onset symptom was localized pain, and the most common complications were swelling and edema. The most common extracted tooth was the mandibular 3rd molar. Lower lip hypoesthesia, which was continued up to eight months, was encountered in six patients who underwent mandibular 3rd molar extraction. Conclusion: In our opinion, a wide range of possible complications secondary to impacted teeth surgery makes them important for plastic surgeons who are more experienced than other disciplines, and learning teeth extraction is essential to learn in plastic surgery specialty training.

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.

Craniofacial duplication is a rare congenital anomaly. A case of hemi-mandibular duplication with an accessory oral cavity is presented with along with first-time reported pre- and postnatal MRI, surgical approach and a literature review. MRI clearly depicts the ectopic tooth buds and parotid aplasia in this condition, features that are diagnostic of partial facial duplication. MRI is diagnostic for this condition and can be useful to avoid misdiagnosis of a facial mass.

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.

Background Ectopic mandibular third molar is a rare clinical entity with incompletely known etiology. Here, we sought to delineate its epidemiological, clinical and radiographic characteristics, and therapy by integrating and analyzing the cases treated in our institution together with previously reported cases. Method A new definition and classification for ectopic mandibular third molar was proposed based on its anatomic location on panoramic images. Thirty-eight ectopic mandibular third molars in 37 patients and 51 teeth in 49 patients were identified in our disease registry and from literature (1990–2016), respectively. These cases were further categorized and compared according to our classification protocol. The demographic, clinicopathological and radiographic data were collected and analyzed. Results These ectopic teeth were categorized into four levels, 33 in level I(upper ramus), 32 in level II (middle ramus), 15 in level III (mandibular angle) and 9 in level IV (mandibular body). The common clinical presentations included pain, swelling and limited mouth opening, although sometimes asymptomatic. Most teeth were associated with pathological lesions. Treatments included clinical monitor and surgical removal by intra- or extraoral approach with favorable outcomes. Clinical presentations and treatment options for these teeth were significantly associated with their ectopic locations as we classified. Conclusions Ectopic mandibular third molars are usually found in patients with middle ages and in upper and middle ramus of mandible. Surgery is preferred to remove these ectopic teeth and associated pathologies when possible.

Eruption disturbances related to the position include ectopic eruption and transpositions. The occurrence of ectopic eruption is most commonly associated with maxillary incisors. The normal eruption, position and morphology of these teeth are crucial to craniofacial development, facial esthetics as well as phonetics. It is essential that the clinicians have thorough knowledge of the eruption disturbances in order to make an appropriate, as well as timely intervention, as dictated by the complexity of the problem. How to cite this article: Suresh KS, Uma HL, Nagarathna J, Kumar P. Management of Ectopically Erupting Maxillary Incisors: A Case Series. Int J Clin Pediatr Dent 2015;8(3):227-233.

Nasally ectopic teeth are rare, but can be a source of significant morbidity. Symptoms can include facial pain, nasolacrimal duct obstruction, fungal rhinitis, persistent rhinorrhea and episodic epistaxis. A nasally ectopic tooth should be considered as a differential diagnosis for a radiopaque lesion within the nasal cavity. This case illustrates the diagnosis and subsequent minimally traumatic recovery of a nasally ectopic tooth, believed to be an upper first premolar tooth, via an endoscopic approach.

Dental injury is one of the most common complications of tracheal intubation. Although teeth dislodged during tracheal intubation are usually found in the oral cavity, we encountered a case of a missing tooth found in the nasal cavity in an intubated patient. A 62-year-old man with 4 loose teeth in the upper jaw was scheduled for laparoscopic hernia repair. After our second attempt at insertion of a nasogastric tube via the left naris, we discovered that a tooth had been dislodged. A lateral-view radiograph revealed the dislodged tooth in the nasal cavity. The ectopic tooth was removed by an otorhinolaryngologist.

Intranasal ectopic tooth, which can be derived from either supernumerary, deciduous or permanent tooth, is generally a rare event. Their existence can cause a wide array of complication such as epistaxis, nasal blockage, nasal pain, rhinosinusitis, septal deviation, septal abscess as well as oronasal fistula. We highlight a case of a canine supernumerary tooth that erupted at floor of nasal cavity, causing an acute unilateral nasal blockage, and managed successfully with an endoscopic nasal tooth extraction.International Journal of Human and Health Sciences Vol. 03 No. 04 October’19 Page : 235-237

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.

An ectopic tooth in the nasal cavity is a rare phenomenon, especially on the inferior turbinate. In most of the reported cases, no etiological explanation of the intranasal teeth has been suggested or found. In children, intranasal ectopic teeth are usually associated with cleft lip and alveolus. Here, we report a rare case of a pediatric patient with unilateral nasal obstruction due to an intranasal ectopic tooth originating from the inferior turbinate without any facial and dental deformities. This case is unique due to the unusual location of the ectopic tooth and its presentation in a child without facial and dental deformities.

Abnormalities in tooth morphology and number are not uncommon. However, an exact clone of a normal tooth is a recondite clinical finding. Presence of supplementary teeth is mostly noticed in maxillary anterior, molar or premolar region, followed by mandibular premolar region in descending order of its site of occurrence. Supplemental tooth in mandibular anterior has a low prevalence of 0.01%. This paper reports one such rare case of nonsyndromic incisive jumeaux in mandibular anterior region during mixed dentition period.

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.

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. Diverse anatomical locations such as nasal cavity, nasal septum, mandibular condyle, coronoid process, the palate and the maxillary sinus can infrequently be non dentate sites of ectopic eruptions of teeth. While conducting an anthropometric study on 100 skulls an incidental and interesting case of ectopic maxillary third molar tooth was found. The tooth was partially erupted with the unerupted part lying impacted in the posterior wall of maxilla. The case is reported and discussed for its significant clinical implications., Italian Journal of Anatomy and Embryology, Vol 121, No 1 (2016)

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.

An intranasal tooth (INT) is an ectopic tooth erupting into the nasal cavity. It is a rare clinical entity. Ectopic and supernumerary teeth may be present in many regions of maxillofacial skeleton. Ectopic teeth may be supernumerary, deciduous or permanent. The clinical manifestations of intranasal tooth are quite variable and they may cause a variety of symptoms and complications. Their clinical and radiographic presentations are classical, posing little challenge to the diagnostician. The identification of such teeth can be important since they have potential to cause considerable morbidity. Here, we describe a case of intranasal tooth along with possible etiopathogenesis, clinical and radiographic features, differential diagnosis, potential complications and treatment modalities.

Dentigerous cyst is known to be caused by the accumulation of fluid between the epithelium and the crown of an unerupted tooth. Its size increases by the expansion of the follicle, and it is attached to the neck of the tooth. These cysts are often associated with impacted third molars and maxillary canines and rarely with supernumerary teeth. In the present paper, we report a case of a dentigerous cyst associated with an impacted ectopic supernumerary tooth. This cyst was missed initially due to a failed root canal treatment associated with the nonvital maxillary central incisor. This case of a cystic lesion can create a dilemma between radicular and dentigerous cyst. The pathogenesis of the ectopic tooth, differential diagnosis, and management are also 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.

Volume 3 | Issue 4 Supernumerary Ectopic Tooth in Nasal Cavity A Case Report Ahmed Z*1 and Zubair S2 1Professor of ENT, Shalamar Medical & Dental College, Lahore, Pakistan 2House Officer, CMH-Medical & Dental College Lahore, Pakistan *Corresponding author: Ahmed Z, Professor of ENT, Shalamar Medical & Dental College, Lahore, Pakistan, Tel: +92-3344551285, E-mail: zubmedke@hotmail.com Case Report Open Access

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.

Objective: Given the high frequency of dental anomalies of position and the lack of preventive measures of surveillance and monitoring of the eruption of permanent teeth, the aim of this study is to evaluate the frequency of dental anomalies of position in children. Material and methods: We conducted a retrospective longitudinal study in the 2006-2012 period. Data were collected from the medical records and orthopantomography x-rays of 408 patients (230 female and 178 male) who presented to the Pedodontics-Orthodontics Clinic in Tîrgu Mureș. After applying the exclusion criteria, 77 patients remained in the study. Results: From the 77 patients, 57 had dental inclusions, 15 presented ectopic teeth, dental rotations have been observed in 2 patients, and midline diastema in 5 patients. Regarding sex distribution, there was a higher frequency of dental inclusions in women (39) than men (38). The frequency of dental inclusions, regarding dental groups, in a descending order was: maxillary canine, mandibular second premolar, mandibular canine, maxillary second premolar, mandibular first premolar, maxillary first premolar, maxillary lateral incisor, maxillary central incisor and maxillary and mandibular first molars. The frequency of dental inclusions in the dental support area had the highest rate in the 12-14 years age group. Conclusions: From all the studied dental anomalies, dental inclusions presented the highest frequency. Regarding the dental support area, most cases of dental inclusion were observed in the 12-14 years age group.

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]

This article describes the case of a 41-year-old woman who presented with the complaint of crepitation sound and mild pain in the left temporomandibular joint area. Panoramic radiographs taken to rule out degenerative or arthritic changes in the joints demonstrated a radiopaque mass within the left condyle. Cone beam computed tomography scans revealed an ectopic tooth located centrally within the left condyle. Thus, while considered rare, the mandibular condyle can be a possible location of an ectopic tooth.

Location of ectopic tooth in a nondentate area like the maxillary antrum is rare. A 17-year-old boy, with one year history of recurrent right facial swelling and radiographic finding of a maxillary third molar tooth located at the posterior wall of the maxillary antrum, is presented. Under endotracheal intubation, the tooth was extracted through a Caldwell-Luc antrostomy approach and patient had an uneventful recovery and has been symptom free for eight months. Ectopic tooth in the maxillary antrum is rare and is commonest with maxillary third molar. It may be symptomless but is more commonly associated with inflammatory symptoms. The treatment of choice is surgical excision which is mostly carried out with Caldwell-Luc approach, even though endoscopic approach is being reported.

Unerupted molars are generally found at or close to their usual site of eruption, but occasionally these teeth are encountered in more distant locations. Tooth dislocation may occur as a result of migration or may be induced by pathology. The etiology and mechanism of intraosseous tooth migration is not fully understood, but it is an uncommon natural event that primarily affects unerupted mandibular second premolars, canines, and lateral incisors. Occurrences of migrated canines, second premolars, and lateral incisors appearing generally near their original eruption location are frequently described in the literature. A few distal molar displacement cases are reported and, in rare cases ectopic molars are located in the condyle or subcondylar regions, but they are usually inverted third molars associated with lesions or tumors that are the reason for tooth dislocation. The majority of these reports relate to third molars in the subcondylar area, while rare findings reveal a tooth located in the condyle. Apparently, a second molar intraosseous migration reaching the condyle, unrelated to any kind of lesion, has not been reported in literature. This case has particularly interesting aspects besides being a rare ectopic tooth in mandibular condyle. Three panoramic radiographs taken over an 8-year period revealed tooth migration from the mandibular ramus to its final location in the condyle. Furthermore, this second molar appeared without any associated lesion that could explain such unusual movement.

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.

The term odontogenic keratocyst was first used by Philipsen in the year 1956. The lesion was renamed by him as keratocystic odontogenic tumor (KCOT) and reclassified as odontogenic neoplasm in the World Health Organization's 2005 edition that occurs commonly in the jaws having a predilection for the angle and ascending ramus of mandible. In contrast, KCOTs arising in the maxillary premolar region are relatively rare. Here, we discuss a rare case of keratocystic odontogenic tumor occurring in the maxilla with an ectopic tooth position.

This report is of a patient with an inverted tooth penetrating the nasal cavity. The patient was a 7-year-old girl who presented with nasal obstruction and epistaxis. A tooth-like mass was found in the right nasal cavity and X-rays revealed an ectopic supernumerary tooth in the nasal cavity. After surgical removal of the tooth, the symptoms completely resolved. There have been 143 patients, involving 148 intranasal teeth, reported in the Japanese literature. In this report, these patients are reviewed clinically according to sex, age, tooth form, site of eruption, aetiology, symptoms, and treatment.

A 32-year old female visited our hospital complaining of anabnormal sensation in the anterior neck. Posterior rhinoscopy revealed a tooth-like mass in her epipharynx on the left side.A Davis mouth-opener was applied, and the mass was removed with an ecraseur under general anesthesia. The pathological diagnosis was ectopic tooth in the epipharynx.Including this case, 136 patients (143 teeth) with dental abnormalities have been reported in the Japanese literature. Most of these abnormalities were in the nasal cavity.The etiology in this case may have been movement of rudiment No. 8 with growth in the epipharynx.