The diagnosis and management of supernumerary nasal teeth

Abstract

ObjectiveTo discuss the reasons for misdiagnosis of supernumerary nasal teeth.MethodsClinical data of four supernumerary nasal tooth patients were analysed retrospectively at visits to our otolaryngology department between 2005 and 2018.ResultsAll four patients were male and had a supernumerary nasal tooth in the right nasal cavity. Three of the four patients had previously been misdiagnosed. All the supernumerary nasal teeth were surrounded by granulation tissue or hypertrophic nasal mucosa, and were subsequently confirmed by computed tomography and endoscopy. The granulation tissue or hypertrophic nasal mucosa was removed using microwave ablation, and the supernumerary nasal teeth successfully removed by endoscopy.ConclusionSupernumerary nasal teeth are rare, and are usually misdiagnosed because such teeth are surrounded by hypertrophic nasal mucosa or granulation tissue. They can be confirmed by computed tomography and endoscopy.

Abordaje Transoral para la Extracción de un Diente Supernumerario Intranasal. Presentación de un Caso y Revisión de la Literatura

“…El abordaje transnasal, por otra parte, es menos invasivo, pero no permite una correcta visualización de la región posterior de la cavidad nasal (Iwai et al, 2012). La cirugía endoscópica nasal ofrece buena iluminación y visualización, evita el daño a la mucosa circundante y permite una precisa disección con preservación de estructuras anatómicas vecinas (Jin et al, 2019). Sin embargo, está contraindicada cuando el diente se encuentra incluido en el piso nasal y en una posición anterior.…”

A Rhinolith Turning Out to Be an Intranasal Tooth

“…Patients may be asymptomatic or may present with non-specific nasal symptoms such as unilateral nasal blockage, foul-smelling nasal discharge, epistaxis, facial pain, headache, or even communicating oronasal fistula [1,6,7]. Routine clinical examination or imaging occasionally detects an asymptomatic intranasal tooth [8].…”

“…However, it may be embedded within the nasal mucosa, or act as a nidus for mineralization, surrounded by granulation tissue, debris, or purulent materials [5]. It is therefore often misdiagnosed, with differential diagnoses including foreign body, rhinolith, odontoma, exostosis, calcifying odontogenic cyst, or even malignant tumor [5,7]. Oropharyngeal examination is important as it may reveal abnormal dentition or palatal defect.…”

“…However, imaging studies such as conventional radiographs or computed tomography could be useful in determining the position of the tooth [4], detecting related complications such as sinusitis, as well as ruling out possible malignancies. They will also be helpful in deciding surgical approaches for removal, be it transnasal or transpalatal excision [7]. Intranasal tooth appears as a dense radio-opacity with similar attenuation as an oral tooth on imaging studies [4].…”

Chronic odontogenic nasal discharge: report of two cases

“…The aetiology of intranasal teeth is numerous and poorly understood. In addition to the theories discussed above for the formation of supernumeries, they might also form secondary to trauma, cystic displacement, retrograde eruption of supernumerary teeth into the nasal cavity and repeated or chronic infections 8 …”