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Case 210818

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Canaray 210818

Impacted tooth developing in nasal cavity

A partially developed tooth with a crown that resembles a premolar has been displaced into the nasal cavity or is developing in a horizontal orientation in the left middle meatus of the nasal cavity. The root of this developing tooth is at an early stage of development. The tooth has not had any significant effects on the surrounding structures, and is embedded within the thickened mucosal lining of the nasal cavity. Incidentally, a prominent sinus meatus is present in the left nasal cavity, and it is possible that this tooth has been displaced into the nasal cavity through the meatus.

1. Postsurgical appearance of left maxillary sinus

A defect is present in the posterior lateral wall of the left maxillary sinus apical to site 27. This likely represents a postsurgical appearance. The sinus walls are thickened and sclerotic, which is suggestive of a history of chronic sinus pathology. Mild mucositis is present within the left maxillary sinus. Note the prominent sinus osteum which communicates with the left middle meatus. The displaced tooth within the middle meatus is also evident in these images.

2. Antroliths in right maxillary sinus

Antroliths are embedded within the mucosal thickening of the right maxillary sinus, adjacent to the medial wall of the sinus. This represents a non-significant incidental finding.

Impacted tooth 13

The impacted tooth 13 is partially captured in this imaging volume. The crown of the mesioangularly impacted tooth 13 is positioned distopalatal to the root of tooth 12. Moderate root resorption is present on tooth 12. The periodontal ligament space cannot be fully visualized surrounding the portion of the root captured in this imaging volume. The crown of the tooth has partially erupted through the alveolar crest and residual follicle surrounding the crown of the tooth appears hypoplastic. These findings suggest that the tooth is ankylosed. No further comments can be made based on this limited field of view.

3. Moderate root resorption on tooth 12DP

Moderate root resorption is present on the distopalatal aspect of the middle third of the root of tooth 12, due to the proximity of the crown of the impacted tooth 13. Periradicular bone loss is present on this surface of the root, which extends from the alveolar crest to the superior aspect of the resorptive defect. The remaining periradicular bone surrounding tooth 12 appears normal radiographically. There are no signs of periapical pathology or root fracture.