J Korean Assoc Oral Maxillofac Surg.  2023 Aug;49(4):214-217. 10.5125/jkaoms.2023.49.4.214.

Case series and technical report of nasal floor approach for mesiodens

• Ku JK
• Jeon WY
• Baek JA

• KMID: 2545587
• DOI: http://doi.org/10.5125/jkaoms.2023.49.4.214

Abstract

Objectives
This case series aims to introduce the nasal floor approach for extracting inverted mesiodens.
Materials and Methods
Through a retrospective chart review between January 2022 and February 2023, we included the mesiodens patients using nasal floor approach, and analysis the location of mesiodens from the anterior nasal spine (ANS), total operation time, and complications.
Results
Each mesiodens was located 10 to 12 mm from the ANS and was covered with a cortical layer of the nasal floor. All mesiodens were successfully extracted without exposing the adjacent incisors or nasopalatine nerve within 30 minutes from draping to postoperative dressing.
Conclusion
The nasal floor approach is an efficient extraction method that reduces bone removal and prevents anatomical damage while removing the mesiodens just below the nasal floor bone.

Keyword

Impacted tooth; Minimally invasive surgical procedure; Technical report; Tooth extraction

Figure

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  Fig. 1 Intraoperative images from the nasal floor approach. A. A marking suture was placed on the base of the frenulum to identify the midline and incision line (dotted line). B. After mucoperiosteal flap elevation, the nasal floor was exposed. C. Using osteotomy on the nasal floor, the impacted mesiodens was detected (arrow). D. The mesiodens was extracted in the common manner. E. After extraction, minimized osteotomy was verified without exposure of the adjacent root or nasopalatine nerve. F. Primary closure.

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  Fig. 2 Radiographs of the patients. A. Patient No. 1 (8 years, male) had a mesiodens about 11.89 mm from the anterior nasal spine (ANS) in Fig. 1. B. Patient No. 2 (7 years, female) had a mesiodens about 10.90 mm from the ANS. C. Patient No. 3 (9 years, male) had a mesiodens about 10.24 mm from the ANS.

Reference

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