Ectopic supernumerary tooth on the inferior nasal concha

Abstract

Variations regarding the location of an ectopic tooth in the human nasal cavity, although rare, are documented in the literature, but presence of an ectopic tooth on the inferior nasal concha (INC) has not been reported. We observed an anomalous tooth projecting from the posterior margin of the right INC in two adult female skulls. A small quadrangular tooth projected beyond the posterior margin of the hard palate in one of the skulls and a medium sized conical tooth was observed in the other skull. The affected INC in both skulls were located more inferiorly compared to the opposite side and were in close approximation with the hard palate. No similar findings were noted on the contralateral side nor were there any associated congenital or iatrogenic deformity. The phylogenetic, ontogenetic, and clinical importance of this variant is described. Knowledge of such an anomaly is of paramount importance to otorhinolaryngologists, reconstructive and dental surgeons, and radiologists for identification of such rarities encountered during invasive or non-invasive procedures.

Case presentation of an intranasal ectopic tooth in a pediatric patient

“…In most of the reported cases, no etiological explanation has been suggested or found, but the literature mentions some theories, such as displacement of tooth bud due to mid-facial trauma [4], maxilla osteomyelitis [5], and developmental disturbances, such as cleft palate [1,2]. Idiopathic etiology has also been described as an etiologic factor for ectopic teeth [3]. It is known that the mesenchyme of the inferior turbinate, maxilla, and mandible has a common origin in the neural crest.…”

“…On a PubMed search, only about one literature reporting an ectopic tooth on the inferior turbinate was published from 1966 to 2014. This literature reported an ectopic tooth attached to the inferior turbinate in two adult female skulls [3]. In most of the reported cases, no etiological explanation has been suggested or found, but the literature mentions some theories, such as displacement of tooth bud due to mid-facial trauma [4], maxilla osteomyelitis [5], and developmental disturbances, such as cleft palate [1,2].…”

Intranasal Tooth—An Ectopic Eruption of Mesiodens in Nasal Cavity: A Case Report and Review

“…16 However, some factors regarding the origin of supernumerary teeth have been proposed, including obstruction at the time of tooth eruption, secondary to crowded dentition, persistent deciduous teeth, dense bone, a genetic predisposition, developmental disturbances, such as a cleft palate, infections and displacement as a result of trauma, cysts or operations. 5,6,28,29 Mechanisms of ectopic eruption are not completely understood. However, some theories have been proposed, including a development resulting from a reversion to the dentition of extinct primates which had three pairs of incisor teeth, 5 a defect in migration of neural crest derivatives destined to reach the jaw bones, 29 or a multistep epithelial-mesenchymal interaction.…”

“…5,6,28,29 Mechanisms of ectopic eruption are not completely understood. However, some theories have been proposed, including a development resulting from a reversion to the dentition of extinct primates which had three pairs of incisor teeth, 5 a defect in migration of neural crest derivatives destined to reach the jaw bones, 29 or a multistep epithelial-mesenchymal interaction. 29,30 Considering these situations, the more plausible theory is epithelial-mesenchymal interaction.…”

Tooth in the nose

“…Nevertheless, some theories have been suggested, including a developmental return to the dentition of primates with three pairs of incisor teeth 4 , defect in migration of neural crest derivatives to reach the jaw 5 , or a multi-step epithelialmesenchymal interaction 5,6 . Ectopic eruption of teeth may happen nearby the orbit, chin, maxillary sinus, palate and even nose 7 .…”