Ectopic maxillary tooth as a cause of recurrent maxillary sinusitis: a case report and review of the literature

Abstract

This article presents a rare case report of an ectopic third molar tooth located in the medial wall of maxillary sinus in a young male manifesting as recurrent sinusitis along with upper jaw pain and postnasal discharge diagnosed with an ectopic tooth and bilateral dentigerous cysts. This article aims to discuss this rare presentation of an ectopic tooth as a cause of recurrent maxillary sinusitis and the endonasal endoscopic management of the case.

Ectopic dental inclusion: A literature review

“…The differential diagnosis of ectopic teeth in the maxillary sinus includes infections such as: tuberculosis, syphilis or fungal infections with calcification, benign lesions such as hemangioma, osteoma, calcified polyp, enchondroma, foreign bodies (rhinoliths) and malignant lesions such as osteosarcoma and chondrosarcoma must be taken into account (19).…”

“…Surgery in the case of radiographic findings, in which the patient is asymptomatic, will depend on the risk of: fracture or bone deformation, functional problems, infection and the patient's predisposition. In the case that the option of not intervening surgically is chosen, either due to a high age that puts the life of the patient at risk or the absence of symptoms without evidence of cystic lesion, regular follow-up is required through clinical check-ups every 6-8 months (7,18,19,20). In a systematic review conducted by Veerabhadrappa et al (11) concluded that asymptomatic cases of ectopic mandibular dental inclusions require annual follow-up visits with orthopantomography to monitor migration or the appearance of any lesion.…”

“…Additionally, in a study called "An evaluation of surgical practices at the National Congress of the French Society of Stomatology, Maxillofacial and Oral Surgery, and meta-analysis of ectopic third molars located in the lower jaw", it was concluded that the surgical approach of preference was the intraoral, except when the ectopically included teeth are located in the condyle, or a skin fistula was present, which in turn was preferred to simultaneously perform osteosynthesis or a graft (19,20). Furthermore, in the case that the ectopic tooth is in the condyle and an extraoral surgical approach is decided, a preauricular approach can be chosen, with the aim of reducing surgical morbidity and risk of iatrogenic injury, however, Ruiz et al (24), propose a better extraoral therapeutic option called modified endoaural approach, which consists of obtaining an approach with high aesthetic parameters, and a wide field of visibility that generates minimal complications (23,24).…”

Ectopic tooth in maxillary sinus compressing the nasolacrimal canal

“…Ectopic tooth can occur in different positions, such as maxillary sinus [ 3 ] and nasal cavity. [ 4 ] Ectopic tooth often induces no symptom originally; however, as tooth development or secondary infection or cyst, symptoms may emerge.…”

“…The interaction between the oral epithelium and tooth germ cells plays important roles in tooth development [1] . Abnormal interaction or tooth germ cells migrating to abnormal position caused by developmental disturbance, pathological process or iatrogenic activity during embryonic development may be the pathogenesis of ectopic tooth development [2,3] …”