Teeth in Sinus Cavities: Fact or Fiction?

Posted in Sinus Cavities

It is a fact. Although the development of a tooth in our sinus cavity is one in a million, it is possible. This kind of teeth is a rare form of supernumerary teeth. Supernumerary teeth, or commonly known as hyperdontia, is the unusual development of excess teeth in addition to the regular number of teeth.

The development of a tooth in the sinus cavity can be caused by some hereditary factors and other environmental factors. There are also some cases that the tooth in the sinus cavity will not erupt but it can delay the development of other nearby teeth and may cause dental problems. Dental x-rays and ct scans are the most effective means to diagnose if a nasal obstruction is actually a tooth developing in your sinus cavity.

The extra tooth in our nasal cavity is characterized with atypical crown that can be in a vertical, horizontal, or inverted position. The development of the tooth in our sinus cavity is asymptomatic. But with its growth, we may experience facial pain, nasal obstruction, headache,epistaxis, foul-smelling rhinorrhea, external nasal deformities,and nasolacrimal duct obstruction. The development of a tooth in our sinus cavity may bring complications like rhinitis caseosa with septal perforation, aspergillosis, and naso-oral fistula.

Usually, the tooth in the sinus cavity is believed to develop from a third tooth bed thatcomes from the dental lamina near the permanent tooth bud or,possibly, from splitting of the permanent bud itself. Some experts also believe that the development of the tooth in our sinus cavity comes from the reversion to the dentitionof extinct primates, which had three pairs of incisors.

It can also be a persistent teeth or dense bone that springs from the obstruction at the time of tooth eruptionsecondary to crowded dentition. And like what we have mentioned earlier, the development of a tooth in our sinus cavity can also due to genetics or developmental disturbances,such as a cleft palate; rhinogenic or odontogenic infection. It can also be a displacement as a result of trauma or cysts.

Other than dental x-rays and CT scans, clinical opinion is also important to accurately diagnose if the mass developing in your sinus cavity is really a tooth. Clinically, a tooth in our sinus cavity may appear as a white mass in the nasal cavity surrounded by granulationtissue and debris But radiographically, the sinus teeth may be seen as radiopaque lesions with the same attenuationas that of the oral teeth. It can be that the bone window setting and thecentral radiolucency related in the pulp cavity has a spot or slit, depending on the orientation of theteeth. It can also be observed that the soft tissue surrounding the radiopaque lesion isconsistent with granulation tissue found on clinical and pathologicexaminations.

The complications in the confirmation of the presence of a tooth in our sinus cavity lies on the following factors: the radiopaqueforeign body; rhinolith; inflammatory lesions due to syphilis,tuberculosis, or fungal infection with calcification; benigntumors, including hemangioma, osteoma, calcified polyps, enchondroma,and dermoid; and malignant tumors, such as chondrosarcoma andosteosarcoma. If the findings of both the doctor and dental x-ray is somewhat confounding it is helpful if the patient will undergo CT scan. It can produce highly discriminating featuresthat help to confirm the diagnosis.

Once it is already confirmed that a patient has a tooth in its sinus cavity, it is not advisable that he or she will keep it. It should be removed immediately to avoid further discomfort and complications. Removing a tooth in a nasal cavity is only a minor operation. But when the tooth has a bony socket in the floor of the nose, we can expect that it is quite difficult to extract. Again, a CT scan is very helpful to gauge the depth of the eruption site. The best time to remove thetooth is after the roots of the permanent teeth have completelyformed. This is to avoid injury during the development of the unusual tooth in your sinus cavity!

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