English

Abstract

Supernumeraries erupting in ectopic regions are one of the commonly found anomalies of orofacial region.1 The mesiodens, being located between the maxillary central incisors is the most common supernumerary tooth.2,3 But impacted mesiodens erupting into nasal cavity is a rare finding. We are detailing an instance of an inverted impacted mesiodens in the nasopalatine canal of an adult patient with encroachment on the nasal floor diagnosed as an incidental finding in panoramic radiograph. Intranasal tooth in adults is reported rare in the literature. Although surgical removal is advised generally on diagnosis of impacted mesiodens, we stress the importance of periodic monitoring of such cases which adds significantly to the patient wellbeing, function and aesthetics. There are few published case reports and most of the cases reported in the literature are in children which prompt for immediate removal upon its recognition. A supernumerary tooth that erupts ectopically into the nasal cavity is referred to as an intranasal tooth. Its occurrence rate is low with only 0.1 to 1 % people being affected from the community.4 The aetiology of intranasal tooth stays undefined. Supernumerary teeth may develop from the region of the nasal cavity as a result of a damage caused by an injury, rhinogenic maxillary sinusitis, a dental disease, oral blisters, obstructed path of dental eruption, and disruption of developmental tissue in the palatine gap.4 The potential complications that can arise due to nasal eruption of tooth are perforation of nasal septum, naso-oral fistula and aspergillosis4. The probable dental complications include midline diastema (17.6 %), late eruption of the permanent incisors (38.8 %), axial rotation of the permanent incisors (16.4 %), root resorption of the neighbouring teeth (4.7 %),5 cyst formation, 6 and infection.1 A team approach with inclusion of disciplines in medicine and dentistry is necessary for planning and execution of an appropriate treatment method in order to prevent complications related to inadvertent surgical entry into vital structures.