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CASE REPORT |
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Year : 2015 | Volume
: 5
| Issue : 1 | Page : 40-41 |
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Nasal eruption
K Arun Kumar1, Ramakrishnan Bharathi2, KMK Masthan3, Jenita Jacobina4
1 Department of Oral and Maxillofacial Surgery, Tamil Nadu Government Dental College and Hospital, Chennai, Tamil Nadu, India 2 Department of Oral Pathology and Microbiology, Tamil Nadu Government Dental College and Hospital, Chennai, Tamil Nadu, India 3 Department of Oral Pathology and Microbiology, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu, India 4 Department of Oral Pathology, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu, India
Date of Web Publication | 26-Aug-2015 |
Correspondence Address: Jenita Jacobina Department of Oral Pathology, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu India
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/2229-6360.163654
Intranasal tooth is a result of ectopic tooth eruption. Ectopic tooth eruption may occur in the maxillary sinus, condyle, coronoid process of mandible, orbit, palate, or nasal cavity. Incidence of nasal eruption is 0.1-1.0%. Herein, we report a rare case of an intranasal tooth in a 9-year-old boy. The clinical and radiographic findings of the case along with its possible etiology, management and complications are also discussed. Keywords: Eruption; hemangioma; supernumerary teeth
How to cite this article: Kumar K A, Bharathi R, Masthan K, Jacobina J. Nasal eruption. Indian J Multidiscip Dent 2015;5:40-1 |
Introduction | | |
Intranasal tooth is a rare form of a supernumerary tooth. [1] There is an increase in the detection of ectopic teeth due to the increase in the use of panoramics, computed tomography (CT) scans and magnetic resonance imaging. Various developmental disorders such as cleft palate, cysts, crowding of teeth, trauma, Gardner's syndrome, cleidocranial dysplasia, genetic factors, and increased bone density can cause teeth to erupt intranasally. [2],[3],[4] They may an incidental finding during a routine general examination or detected following symptoms such as nasal obstruction, rhinitis, epistaxis, nasal septal abscess or perforation or speech, and deglutition difficulty. [5]
Case Report | | |
A 9-year-old boy reported with the complaint of spacing between the upper front teeth and with some nasal obstruction. Intraoral examination revealed a rotated upper left permanent central incisor and presence of midline diastema. Intranasal examination revealed a projection in the floor of the nose on the left nostril. There was no regional lymphadenopathy.
CT scan revealed the presence of a supernumerary tooth in the left nasal cavity [Figure 1]a and b. Under general anesthesia with adequate protection behind the nasal projection, using a Howarth's elevator, an incision was made over the bulge to expose the tooth. The nasally erupted tooth was extracted using an elevator. The extracted specimen resembled a tooth with crown and root [Figure 2]. Nasal endoscopy was kept in place. Merocel was packed in the nasal cavity to arrest postoperative nasal bleeding. The patient had an uneventful recovery. | Figure 1: Coronal computed tomography revealing a calcified mass in the left nasal cavity (a) intranasal tooth (b) reconstructed image
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Discussion | | |
The nasal eruption of teeth is a rare phenomenon. Supernumerary teeth occur more commonly intranasally than do deciduous or permanent teeth. [6] There is a slightly higher prevalence of intranasal teeth in males. [7] Increased incidence in families suggests heredity to play a role.
The theories that explain the presence of supernumerary teeth are:
- Disproportionate growth of dental lamina f
- Separation of the tooth germ [8]
- Epithelial rests that remain after breaking up of tooth band get activated to form tooth. [8]
Diagnosis of nasal teeth is based on clinical, radiographic, and CT examination. CT helps in evaluating the depth where the tooth is. Differential diagnosis of intranasal teeth include a radiopaque foreign body, a rhinolith, inflammatory lesions occurring due to syphilis, tuberculosis, fungal infection with a calcification, calcified polyp, osteoma, hemangioma, dermoid cyst, enchondroma, osteosarcoma, and chondrosarcoma. [9]
Extraction is generally indicated for nasally erupting teeth to relieve symptoms and to prevent complications. The ideal time to remove such teeth is after complete formation of permanent teeth roots to prevent any damage during their development. [10] When the intranasal tooth has a bony socket in the nasal floor, extraction may be difficult. [11] Endoscopic removal of a tooth is generally advocated as it offers better illumination, visualization, and preservation of neighboring structures. [12]
Conclusion | | |
The clinical presentation and radiographic features of the above case posed little challenge to the clinician. Therefore, such cases should be diagnosed and treated at the earliest to reduce morbidity.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References | | |
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12. | Tümer C, Eset AE, Atabek A. Ectopic impacted mandibular third molar in the subcondylar region associated with a dentigerous cyst: A case report. Quintessence Int 2002;33:231-3. |
[Figure 1], [Figure 2]
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