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. 2021 Mar 1;13(3):e227-e233.
doi: 10.4317/jced.57905. eCollection 2021 Mar.

Endoscopic treatment of ectopic teeth in the maxillary sinus

Affiliations

Endoscopic treatment of ectopic teeth in the maxillary sinus

Muhamed Masalha et al. J Clin Exp Dent. .

Abstract

Background: Ectopic teeth in maxillary sinus is rare and are usually removed via sub-labial trans-canine fossa approach (SLCFA). The aim of our study was to present our experience with extraction of ectopic teeth in the maxillary sinus via transnasal endoscopic approach (TEA).

Material and methods: Rhinologists were asked to share their experience in the management of ectopic teeth in the maxillary sinus. Data were reviewed retrospectively.

Results: Eleven cases were reported in 10 patients from 2010 to 2019, six males and four females with a mean age of 33.5 +/-17 years (range 16 to 61). Seven patients complained of sinonasal symptoms, two were diagnosed incidentally during routine dental work-up, and one had oro-antral fistula. In eight patients, a cyst coexisted within the maxillary sinus. Teeth were located arbitrarily within the sinus. All cases were operated by TEA. One patient had self-limited periorbital emphysema, one had transient cheek numbness, and one had early post-operative bleeding that stopped after endoscopic cauterization. Long-term follow-up revealed good clinical outcomes.

Conclusions: Transnasal endoscopic removal of ectopic teeth from the maxillary sinus is a feasible and rational approach when SLCFA is contraindicated. Key words:Ectopic teeth, dentigerous cyst, endoscopic sinus surgery, Caldwell-Luc.

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Conflict of interest statement

Conflicts of interest All authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A, B) Non-contrast CT scan of the maxillary sinus in a 16-year-old male (patient 2). (A) Coronal view. The ectopic tooth sits on top of a large cyst, which erodes the alveolar crest and the lateral maxillary sinus wall. The tooth abuts the orbital floor and the infraorbital nerve canal (arrow). (B) Axial view. (C, D) Intraoperative endoscopic images in the same patient. (C) Following wide middle antrostomy, the dentigerous cyst comes into view. Note orbital floor (OF), infraorbital nerve canal (arrow), tooth roots (asterisks). (D) Maxillary sinus cavity following cyst marsupialization. The bottom of the cyst (asterisk) is seen.
Figure 2
Figure 2
(A) Non-contrast CT, coronal view, of the sinus in a 61-year-old male (patient 1). Ectopic tooth (arrow) in the maxillary sinus wall, surrounded by bony formations. The sinus is partially inflamed. (B, C) Endoscopic images in the same patient. (B) Trans-nasal inferior antrostomy exposes the ectopic tooth in the sinus cavity. Note the inferior turbinate (IF), suction cannula (S), and medial maxillary wall (MMW). (C) Following tooth extraction, the aberrant tooth socket is at the posterior maxillary sinus wall.

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