# A Unique Case of Supernumerary Teeth Erupting Inside a Maxillary Sinus Osteoma

## TL;DR

A rare case of supernumerary teeth found inside a maxillary sinus osteoma is reported, highlighting the importance of CT scans for diagnosis and surgical removal for symptom relief.

## Contribution

This paper presents a unique clinical case of supernumerary teeth within a maxillary sinus osteoma, a rare occurrence not previously well-documented.

## Key findings

- Computed tomography revealed a pedicled bone lesion with supernumerary teeth in the maxillary sinus.
- Surgical removal of the osteoma resolved the patient's chronic sinusitis symptoms.
- The absence of trauma history suggests teeth migrated during a reactive osteogenic process from chronic sinusitis.

## Abstract

Introduction: Ectopic foreign bodies in the maxillary sinus occur rarely. Ectopic tooth eruption rarely occurs in the orbit, nasal cavity, maxillary sinus, and elsewhere. Ectopic eruption of teeth in the maxillary sinus is most commonly associated with wisdom teeth and is rarely associated with supernumerary teeth. This rare phenomenon may be accompanied by chronic recurrent sinusitis with headaches and facial pain. However, fibro-osseous lesions in the paranasal sinuses are discovered incidentally on X-ray images and are often asymptomatic. Osteoma is the most common fibro-osseous lesion that develops in the paranasal and nasal sinuses. Osteomas rarely cause serious symptoms such as orbital lesions and intracranial invasion. Case Presentation: We report a rare case of exostosis containing supernumerary teeth within the maxillary sinus. A characteristic pedicled bone lesion with a clear border on computed tomography was the undefined orthopantomogram radiopacity in the maxillary sinus, and the lesion contained supernumerary teeth. As the patient had chronic nasal congestion, the tumor was surgically removed. Pathologically, the surgical specimen revealed an osteoma. The patient’s symptoms of chronic sinusitis disappeared. Because the patient had no history of midface trauma or surgery, the supernumerary teeth were speculated to have migrated during a reactive osteogenic process caused by chronic sinusitis. Conclusions: A foreign body in the maxillary sinus can be easily diagnosed by computed tomography. Surgical removal is recommended if the foreign body is symptomatic or occupies more than half of the maxillary sinus. This can help resolve chronic sinusitis symptoms and prevent serious complications in the future.