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CASE REPORT |
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| Year : 2011 | Volume
: 15
| Issue : 3 | Page : 346-347 |
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Tooth in oropharynx
D Nagarajappa1, BS Manjunatha2
1 Department of Oral and Maxillofacial Surgery, SJM Dental College and Hospital, Chitradurga, India
2 Department of Oral Pathology and Microbiology, K M Shah Dental College and Hospital, Vadodara, Gujarat, India
| Date of Web Publication | 25-Oct-2011 |
Correspondence Address:
B S Manjunatha
Department of Oral and Maxillofacial Pathology, K M Shah Dental College and Hospital, Sumandeep Vidyapeeth, Pipariya 391 760, Vadodara, Gujarat
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0973-029X.86720
 Abstract | | |
The incidence of ectopic teeth has increased. In many cases, the etiology of ectopic teeth cannot be identified. Ectopic tooth in deciduous dentition period is very rare and information is limited about its causes and characteristics. The conditions commonly associated with an increased prevalence of ectopic teeth include cleft lip and palate, cleidocranial dysplasia, and Gardner syndrome. The diagnosis is made by the clinical and radiological examinations. The indication for extraction in ectopic teeth cases is in general determined by the presence of symptomatology, or by the need for preventing future complications. We present a case of an ectopic maxillary tooth in a 4 year-old boy. In addition, this report also addresses a young patient with a tooth in the oropharynx with the objective of non traumatic etiology, and such a clinical presentation is extremely rare. The authors believe the case presented here is the first documented case of an ectopic supernumerary tooth seen in the oropharynx.
Keywords: Ectopic eruption, ectopic tooth, extraction, oropharynx
How to cite this article:
Nagarajappa D, Manjunatha B S. Tooth in oropharynx. J Oral Maxillofac Pathol 2011;15:346-7 |
| Introduction | |  |
Ectopic teeth are those that are impacted in unusual positions, or that have been displaced and are at a distance from their normal anatomic location. Ectopic eruption can be associated with developmental disturbances, pathologic processes, or iatrogenic activity. [1],[2] In many cases the etiology cannot be identified. [3]
The presence of supernumerary or ectopic tooth is not uncommon, and it is estimated to occur in 1% of the general population, especially in children and involving the first dentition. [4],[5],[6] These ectopic teeth may be permanent, deciduous, or supernumerary. [7] Ectopic eruption of teeth into regions other than the oral cavity has been rarely reported. [4],[7]
Here we describe a unique case of ectopic supernumerary tooth in the oropharynx and what we believe is the first reported case of this rare kind in the English literature.
| Case Report | | |
A 4-year old boy was referred to the Department of Oral and Maxillofacial Surgery, SJM Dental College and Hospital, Chitradurga, with a complaint of pain and discomfort during swallowing since a week. Intra-oral clinical examination of the patient revealed a tooth-like structure resembling a molar posterior to soft palate, and soft tissue surrounding was reddish in color and inflamed [Figure 1]. The patient also felt that there is something blocking his throat. Patient's dental examination revealed one complete set of deciduous teeth [Figure 2] without any oral disease or history of maxillofacial trauma or surgery. Patient's general medical status was reviewed and found adequate. Computed tomography (CT) scan was advised to evaluate any lesion associated and to plan further treatment. Due to financial constraints, CT was not affordable for the patient. | Figure 1: Intra-oral clinical photograph showing a tooth-like structure posterior to soft palate, with inflamed red surrounding soft tissue
Click here to view |
 | Figure 2: Intra-oral clinical photograph showing complete set of deciduous teeth in both arches
Click here to view |
A diagnosis of supernumerary ectopic tooth was consistent with the clinical finding in the oro-pharyngeal region.
After 1 month of initial visit, the parents of the patient reported back that the tooth fell off on its own within 10 days and the healing was uneventful.
| Discussion | | |
Tooth development results from a complicated multistep interaction between the oral epithelium and the underlying mesenchymal tissue. A series of complex tissue interactions result in the formation of mature teeth. [8]
Abnormal tissue that interacts during development could potentially result in an ectopic tooth. [1],[3] Most commonly ectopic tooth is found single but multiple teeth has been reported. [8] The tooth may be asymptomatic at the time of diagnosis and may be noticed on routine clinical or radiological examination. [9]
Ectopic eruption of teeth into regions other than the oral cavity has been rarely reported in a variety of locations such as maxillary sinus, [1],[2] mandibular condyle, coronoid process, orbit, palate and nasal cavity. [4],[7],[8],[9]
Not a single case of ectopic tooth in oropharynx has been reported in the English-language literature and was searched from Pubmed and Medline databases. A case of tooth in the nasopharynx in a 36 year-old man due to trauma has been reported by Mahamood and Lello. [10]
Ectopic teeth are rare dental anomaly and more likely managed by medical practitioners than their dental counterparts. In addition, this report also addresses a young patient with a tooth in the oropharynx with the objective of emphasizing the fact that the etiology is non-traumatic and such clinical presentation is extremely rare.
We strongly suggest that the treatment must aim at the dental extraction, whether for the symptoms are recurrent and the location of the ectopic tooth, in many instances, a potential region of complications. Treatment should be carefully planned based on the position of the ectopic tooth and the potential for surgical trauma. [11] If a conservative approach is decided on, periodic monitoring of the patient will be necessary.
| References | | |
| 1. | Büyukkurt MC, Tozoglu S, Aras MH, Yolcu U. Ectopic eruption of a maxillary third molar tooth in the maxillary sinus: A case report. J Contemp Dent Pract 2005;6:104-10. 
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| 2. | Bodner L, Tovi F, Bar-Ziv J. Teeth in the maxillary sinus-imaging and management. J Laryngol Otol 1997;111:820-4.
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| 3. | Chye CH, Singh B. Rapid cystic development in relation with an impacted lower third molar: A case report. Ann Acad Med Singapore 2005;34:130-3.
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| 4. | Moreano EH, Zich DK, Goree JC, Graham SM. Nasal tooth. Am J Otolaryngol 1998;19:124-6.
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| 5. | Thor AL. Delayed removal of a fully intruded primary incisor through the nasal cavity: A case report. Dent Traumatol 2002;18:227-30.
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| 6. | Wang LF, Tai CF, Lee KW, Ho KY, Kuo WR. Delayed removal of a fully intruded tooth in the nasal cavity after facial trauma: A case report. Otolaryngol Head Neck Surg 2004;131:330-1.
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| 7. | Carver DD, Peterson S, Owens T. Intranasal teeth: A case report. Oral Surg Oral Med Oral Pathol 1990;70:804-5.
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| 8. | Smith RA, Gordon NC, De-Luchi SF. Intranasal teeth. Report of two cases and review of the literature. Oral Surg Oral Med Oral Pathol 1979;47:120-2.
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| 9. | Thawley SE, Ferriere KA. Supernumerary nasal teeth. Laryngoscope 1977;87:1770-3.
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| 10. | Mahmood S, Lello GE. Tooth in the nasopharynx. Br J Oral Maxillofac Surg 2002;40:448-9.
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| 11. | Wang CC, Kok SH, Hou LT, Yang PJ, Lee JJ, Cheng SJ et al. Ectopic mandibular third molar in the ramus region: Report of a case and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105:155-61.
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[Figure 1], [Figure 2]
| This article has been cited by | | 1 |
Prevalence of supernumerary teeth in the child population of Asturias [Prevalencia de los dientes supernumerarios en la población infantil asturiana] |
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| Cueto Blanco, S. and Pipa Vallejo, A. and González García, M. and Pipa Muñiz, C. and Álvarez Álvarez, I. | | Avances en Odontoestomatologia. 2013; 29(3): 131-137 | | [Pubmed] | |
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