Criteria for Treatment of Intranasal Supernumerary Teeth: A Comprehensive Literature Analysis.

Objectives: Among oral surgical conditions, supernumerary teeth of the dental arch is quite common. However, supernumerary teeth in the nasal cavity is a rarity and their diagnosis and treatment have not yet been systematized. We therefore examined the literature on intranasal supernumerary teeth to establish systematic methods for their diagnosis and treatment. Methods: Using the PubMed database, we searched for literature on intranasal supernumerary teeth, published from 1990 to 2019. We combined 131 cases identified in the literature with 1 case that we experienced and summarized the characteristics of 132 cases. We recorded data on sex, age, reason for consultation (chief complaint), reporting department, impact classification, surgical approach, and anesthesia. Results: Males outnumbered females in all decades evaluated. The median age of patients was 10 years. The characteristics of these cases resembled those of maxillary anterior supernumerary teeth. The most common reason for consultation in earlier years was nasal symptoms; however, over time, an increasing number of patients sought consultation due to indications in diagnostic imaging. The most common reporting department in all decades was Otolaryngology. However, reports from Departments of Oral Surgery became increasingly common over time. General anesthesia was applicable for all impaction positions and surgical methods used. Local anesthesia was performed only with the nasal method. Of the 132 patients, 4 experienced no effect from local anesthesia, which was then changed to general anesthesia. Intranasal supernumerary teeth were found to possess the same characteristics as impacted maxillary central supernumerary teeth. Conclusions: The increased use of computed tomography has enabled early detection in asymptomatic cases. Classifying intranasal supernumerary teeth by their vertical and horizontal impaction positions provides an accurate grasp of supernumerary tooth impact classification and the selection of suitable methods of surgery and anesthesia, thus enabling systematic diagnosis and treatment of intranasal supernumerary teeth.