PMC6766144_01
(a) Panoramic radiograph shows an ectopic tooth in the nasal cavity. (b) Sagittal cut of CT scan showing the horizontal orientation of the right superior incisor tooth inside the nasal nostril. (c) 3D reconstruction of CT scan showing the ectopic position of element 11.
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fig1
For detailed radiographic examination, a computed tomography (CT) was requested and a high-density area was found located in a nasal nostril, horizontally arranged, incomplete rhizogenesis, with the crown facing to the exit of the nasal cavity (Figure 1).
(a) Preoperative picture showing the exposition of the ectopic tooth inside the right nostril. (b, c) With the aid of nasal speculum, the tooth was removed by intranasal approach. (d) Tooth removed. (e) Panoramic radiograph confirms the complete removal of the element 11.
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Succeeding the extraction, nasal packing was placed to prevent postoperative epistaxis, which was removed 12 hours later, with no complications (Figure 2).
PMC6766144_02
(a, b) CT scan showing intranasal location and soft tissue surrounding the dysmorphic tooth. (c) 3D reconstruction of CT scan showing the ectopic position of element 21.
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Despite the superior portion, the dysmorphic lateral incisor was inserted in soft tissue (Figure 3).
(a) Nasal speculum provided direct access to the toothlike structure removal with a Kelly hemostatic forceps. (b) Hemostasis obtained after the toothlike structure has been removed. No stiches were needed. (c) Ectopic tooth removed.
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Because the dysmorphic tooth had no bone insertion and could be accessed using a nasal speculum, Kelly hemostatic forceps were chosen to remove the tooth (Figure 4). Findings by nude eye examination confirmed a 10 millimeter wide toothlike structure (Figure 4).