Nasal floor approach via maxillary vestibular access for removal of a high-positioned impacted supernumerary tooth in the maxillary anterior region: a case report

Abstract

High-positioned impacted supernumerary teeth near the nasal floor in the maxillary anterior region pose significant surgical challenges, as conventional labial or palatal approaches often require extensive bone removal and risk injuring adjacent teeth. This case report describes a 14-year-old female with recurrent swelling and discomfort in the maxillary anterior region. Cone-beam computed tomography (CBCT) imaging revealed a high-positioned supernumerary tooth adherent to the nasal floor bone plate. Via a maxillary vestibular incision, a bone window was created adjacent to the nasal floor with meticulous protection of the nasal mucosa, consistent with the modified surgical nomenclature. The tooth was successfully removed using a segmental sectioning technique. At the 3-month follow-up, healing was uneventful with no reported nasal symptoms or clinical evidence of infection or oronasal communication. This single case provides short-term technical feasibility evidence only and does not establish safety, comparative invasiveness, or a low complication risk.