Ramishvili Marika, Atskvereli Leila, Menabde Giorgi, Zurmukhtashvili Marika, Samkharadze Sopio, Dugashvili Giorgi, Marks Luc
Department of Maxillofacial Surgery, Faculty of Medicine, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia.
Department of Oral Surgery and Implantology, Tbilisi State Medical University, Tbilisi, Georgia.
Case Rep Dent. 2025 Jul 3;2025:2436615. doi: 10.1155/crid/2436615. eCollection 2025.
Ectopic eruption of permanent molars is an uncommon developmental anomaly characterized by abnormal tooth positioning, which can lead to significant complications. In rare instances, ectopic molars may be associated with dentigerous cysts, particularly within the maxillary sinus, posing challenges for diagnosis and management. This report discusses a rare case of a 58-year-old male who presented with chronic right maxillary sinusitis, intermittent facial pain, and purulent nasal and oral discharge. Radiological evaluation, including cone beam computed tomography (CBCT), revealed a completely opacified right maxillary sinus containing an ectopic maxillary molar. Additionally, a large cystic lesion consistent with a dentigerous cyst was found, occupying the entire sinus cavity. Surgical management was performed using the Caldwell-Luc approach under general anesthesia. This involved creating a bone window in the anterior maxillary wall to facilitate the removal of the ectopic tooth and the associated cystic lesion. Histopathological examination confirmed the presence of a dentigerous cyst exhibiting chronic inflammatory infiltration and fibrosis. Ectopic molars in the maxillary sinus are often asymptomatic but can present with recurrent sinusitis, pain, and oroantral communication. The existence of a large dentigerous cyst heightens the risk of complications and may obscure radiological interpretation due to sinus opacification. This case highlights the necessity of comprehensive imaging and early surgical intervention to prevent long-term complications. Awareness of such rare conditions can help clinicians in prompt diagnosis and appropriate management, ultimately preserving sinus function and minimizing further issues.
恒牙异位萌出是一种罕见的发育异常，其特征为牙齿位置异常，可导致严重并发症。在极少数情况下，异位磨牙可能与含牙囊肿有关，尤其是在上颌窦内，这给诊断和治疗带来挑战。本报告讨论了一例罕见病例，一名58岁男性，表现为慢性右上颌窦炎、间歇性面部疼痛以及脓性鼻分泌物和口腔分泌物。包括锥形束计算机断层扫描（CBCT）在内的影像学评估显示，右侧上颌窦完全闭塞，内有一颗异位上颌磨牙。此外，发现一个与含牙囊肿相符的大囊性病变，占据了整个窦腔。在全身麻醉下采用柯-陆氏手术进行手术治疗。这包括在上颌前壁制作一个骨窗，以便于摘除异位牙和相关的囊性病变。组织病理学检查证实存在含牙囊肿，伴有慢性炎症浸润和纤维化。上颌窦内的异位磨牙通常无症状，但可表现为复发性鼻窦炎、疼痛和口鼻瘘。巨大含牙囊肿的存在增加了并发症的风险，并且由于窦腔闭塞可能会使影像学解读变得模糊。该病例强调了全面成像和早期手术干预以预防长期并发症的必要性。认识到此类罕见情况有助于临床医生及时诊断并进行适当治疗，最终保留窦腔功能并减少进一步问题。
