dental development and anomalies Peer reviewed

Endoscopic Endonasal Removal of an Intranasal Mesiodens: Importance of Three-Dimensional Evaluation for Approach Selection

Yong-Seung Kim, Jeong Joon Han

Journal of Craniofacial Surgery | Aug 14, 2026

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This case demonstrates that for a fully migrated intranasal mesiodens without bony attachment, the endoscopic ensonasal approach is a simple, effective, and minimally invasive treatment option that provides direct visualization and excellent clinical outcomes.

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Although mesiodens is a frequently encountered supernumerary tooth, its complete migration into the nasal cavity is a rare clinical finding that can lead to various nasal symptoms. This report describes a case of an intranasal mesiodens that had fully migrated out of the maxillary bone and was embedded within the nasal mucosa without any osseous contact. Based on 3-dimensional radiographic evaluation, a prophylactic endoscopic endonasal approach was selected for removal. Under endoscopic visualization, the tooth was identified as a submucosal bulge and successfully extracted through a limited mucosal incision. The procedure was completed with minimal morbidity and did not require nasal packing. The patient showed favorable healing during the follow-up period without complications. This case demonstrates that for a fully migrated intranasal mesiodens without bony attachment, the endoscopic ensonasal approach is a simple, effective, and minimally invasive treatment option that provides direct visualization and excellent clinical outcomes.

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Yong-Seung Kim

first | Seoul National University Dental Hospital

Jeong Joon Han

last | Seoul National University Dental Hospital | ORCID 0000-0001-8975-0198

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BibTeX

@article{Kim2026Endoscopic,
  title = {Endoscopic Endonasal Removal of an Intranasal Mesiodens: Importance of Three-Dimensional Evaluation for Approach Selection},
  author = {Yong-Seung Kim and Jeong Joon Han},
  journal = {Journal of Craniofacial Surgery},
  year = {2026},
  doi = {10.1097/scs.0000000000013253},
  url = {https://doi.org/10.1097/scs.0000000000013253}
}

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