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病例报告:锥形束 CT 评估上颌窦内异位第三磨牙伴感染性含牙囊肿。

Case Report: Ectopic third molar in the maxillary sinus with infected dentigerous cyst assessed by cone beam CT.

机构信息

Oral and Maxillofacial Surgery Department, Cairo University, Cairo, Egypt.

Basic Dental Sciences Department, College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.

出版信息

F1000Res. 2020 Mar 25;9:209. doi: 10.12688/f1000research.22466.2. eCollection 2020.

Abstract

Ectopic development of teeth in nondental areas is uncommon, especially in the maxillary sinus. A panoramic radiograph is the routine diagnostic radiographic examination performed for this type of eruption, although cone beam computed tomography (CBCT) is highly recommended for further localization of the ectopic tooth and assessment of the characteristics of any associated lesion before a surgical procedure. We report a case of a 13-year-old female student who presented with purulent discharge posterior to the upper right second molar with a bad taste and foul odour. Radiographic examination revealed a maxillary third molar tooth located at the posterosuperior aspect of the right maxillary sinus with a hyperdense lesion surrounding the crown, obliterating the sinus cavity. Both the tooth and dentigerous cyst were surgically removed under general anaesthesia through Caldwell-Luc antrostomy. After a three-month follow-up, the patient was symptom free and had an uneventful recovery. The rare and critical location of the reported third molar along with the infected dentigerous cyst indicates its complete enucleation to avoid complications as recurrence or malignant transformation.

摘要

牙齿在非牙科区域的异位发育并不常见,尤其是在上颌窦。全景片是对此类萌出进行的常规诊断性放射学检查,尽管锥形束 CT(CBCT)强烈建议用于进一步定位异位牙,并在手术前评估任何相关病变的特征。我们报告了一例 13 岁女学生的病例,其右上第二磨牙后出现脓性分泌物,伴有异味。影像学检查显示上颌第三磨牙位于右侧上颌窦后上方,冠周有高密度病变,使窦腔闭塞。在全身麻醉下通过经上颌窦前壁开窗术切除了牙齿和含齿囊肿。经过三个月的随访,患者无症状,恢复顺利。报告的第三磨牙位置罕见且关键,再加上感染的含齿囊肿,需要完全切除以避免复发或恶性转化等并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5051/7194494/9052567d300a/f1000research-9-25744-g0000.jpg

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