Intranasal tooth: ectopic eruption 1 year after maxillofacial trauma

Abstract

Injury to the permanent central incisors due to trauma in the maxillofacial region, though common, may result in an uncommon sequel. We report a case of traumatic injury in a 5-year-old child with displacement of the tooth bud into the nasal floor. The identification of ectopic tooth buds poses little diagnostic challenge due to the available imaging facilities, however, in the present case the ectopic bud remained unnoticed and resulted in ectopic eruption of the tooth in the nasal cavity 1 year later. This report highlights a rare case of nasal eruption of a permanent tooth and places stress on the need for close attention to detail during maxillofacial trauma for early detection and proper management.

Intranasal Ectopic Tooth in Adult and Pediatric Patients: A Report of Two Cases

“…The 32-year-old woman reported a traumatic injury involving her teeth when she was 6 years old, age when the front incisor are in eruption route [6] and Nolla stage 7 (complete crown and 1/3 of the root's development) [12]. On the other hand, the 8-year-old girl's mother said that the white mass appeared after 3 months her daughter had been through iliac crest bone craft for oronasal fistula repair.…”

“…On the other hand, the 8-year-old girl's mother said that the white mass appeared after 3 months her daughter had been through iliac crest bone craft for oronasal fistula repair. Although both conditions are different, both are capable of causing tooth displacement [6, 13]. Since cleft palate has a multifactorial etiology, including environmental and genetic factors [11], genetic predisposition as an etiology for the ectopic eruption of the dysmorphic tooth in the case 2 cannot be neglected.…”

“…To accomplish a precise diagnosis in both cases, CT scans were requested for both patients in order to make a differential diagnosis between tooth in the nasal cavity, benign tumors, rhinolith [4, 6, 9, 14], and calcified inflammatory lesions due to tuberculosis and syphilis [9]. These hypotheses were negated by matching clinical and tomographic findings [2].…”

“…The exact etiology of eruption of a tooth into the nasal cavity remains obscure. A few theories have been proposed to explain it, including the theory of developmental origin, which states that ectopic eruption may occur either due to reversion to the dentition of extinct primates having three pairs of incisor teeth, defect in migration of neural crest derivatives destined to reach the jaw bones, or due to a flaw in the multistep epithelial-mesenchymal interaction [6]. Other causes include developmental disturbances such as cleft lip and palate, trauma, or cystic lesions leading to tooth displacement, genetic factors, persistent deciduous teeth, and supernumerary teeth [7].…”

Retained tooth in the nasal cavity: a rare cause of nasal congestion

“…Previous case reports describe displacement of teeth following facial trauma 5 6. A displaced tooth might later erupt into the nasal cavity.…”