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      Inverted Supernumerary Intranasal Teeth as Unusual Indications of Endoscopic Surgery

      case-report

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          Abstract

          Introduction:

          Supernumerary teeth are frequently reported in dental clinical practice; however, eruption in nasal cavities and paranasal sinuses is an extremely rare clinical entity.

          Case Report:

          We report two cases with a history of recurrent nasal discharge and obstruction. In both cases, clinical and radiological findings confirmed the presence of an inverted supernumerary tooth erupted in the sinonasal cavities (i.e., the right nasal fossa and left maxillary sinus, respectively). We managed the cases with transnasal endoscopic approach. A survey of the English literature identified 69 documented cases with intranasal supernumerary teeth within January 1 st, 1886 to December 31 st, 2017.

          Conclusion:

          Inverted supernumerary teeth should be considered among the potential causes of unilateral nasal obstruction and rhinosinusitis and included in differential diagnoses among the fibro-osseous lesions of the sinonasal cavities.

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          Most cited references50

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          Supernumerary teeth: review of the literature and a survey of 152 cases.

          A review of the literature relating to supernumerary teeth is presented along with a survey of 152 cases. The study population consisted of 152 children who visited the department of Paediatric Dentistry at the Jordan University Hospital. Patients ranged in age from 5 to 15 years. Supernumeraries were detected by clinical examination and radiographs. Males were affected more than females with a sex ratio of 2.2 : 1. Seventy-seven percent of the patients had one supernumerary tooth, 18.4% had double teeth, and 4.6% had three or more supernumeraries. Ninety percent of the supernumerary teeth occurred in the premaxilla, of which 92.8% were in the central incisor region and of these latter 25% were located in the midline. The other 10.4% of the supernumeraries were located in the premolar, canine, molar, and lower central incisor regions. Two cases were of non-syndrome supernumerary teeth. Seventy-five percent of the supernumeraries were conical, 83.1% were in the normal vertical position and 26.5% were erupted. Conical-shaped supernumerary teeth had a significantly higher rate of eruption compared to the tuberculate type.
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            Anterior supernumerary teeth--assessment and surgical intervention in children.

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              Mesiodens--diagnosis and management of a common supernumerary tooth.

              Mesiodentes are the most common supernumerary teeth, occurring in 0.15% to 1.9% of the population. Given this high frequency, the general dentist should be knowledgeable about the signs and symptoms of mesiodentes and appropriate treatment. The cause of mesiodentes is not fully understood, although proliferation of the dental lamina and genetic factors have been implicated. Mesiodentes can cause delayed or ectopic eruption of the permanent incisors, which can further alter occlusion and appearance. It is therefore important for the clinician to diagnose a mesiodens early in development to allow for optimal yet minimal treatment. Treatment options may include surgical extraction of the mesiodens. If the permanent teeth do not erupt in a reasonable period after the extraction, surgical exposure and orthodontic treatment may be required to ensure eruption and proper alignment of the teeth. In some instances, fixed orthodontic therapy is also required to create sufficient arch space before eruption and alignment of the incisor(s). Early diagnosis allows the most appropriate treatment, often reducing the extent of surgery, orthodontic treatment and possible complications. This paper outlines the causes and modes of presentation of mesiodentes, and presents guidelines for diagnosis and management of nonsyndromic mesiodentes.
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                Author and article information

                Journal
                Iran J Otorhinolaryngol
                Iran J Otorhinolaryngol
                IJO
                Iranian Journal of Otorhinolaryngology
                Mashhad University of Medical Sciences (Mashhad, Iran )
                2251-7251
                2251-726X
                May 2020
                : 32
                : 110
                : 181-186
                Affiliations
                [1 ] Division of Otorhinolaryngology, “San Maurizio” Hospital, Bolzano, Italy.
                [2 ] Department of Otorhinolaryngology, Humanitas Clinical and Research Center, Rozzano, Milano, Italy.
                [3 ] Department of Otorhinolaryngology and Head and Neck Surgery, University of Brescia, Italy.
                [4 ] Department of Otorhinolaryngology, University of Insubria, Varese, Italy.
                Author notes
                [* ]Corresponding Author: Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences University of Insubria, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Via Guicciardini 9 Varese, 21100 Italy. E-mail: enricofazio@hotmail.it
                Article
                10.22038/ijorl.2019.38918.2284
                7302530
                32596178
                34211a4e-77b4-4521-ad8a-d436601903cb

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 March 2019
                : 28 November 2019
                Categories
                Case Report

                endoscopic sinonasal surgery,inverted supernumerary tooth,rhinosinusitis

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