Endoscopic-Assisted Transnasal Vestibular Approach for Deeply Impacted Maxillary Supernumerary Teeth Adjacent to the Nasal Floor: A Technical Note

Deeply impacted maxillary supernumerary teeth located adjacent to the nasal floor present a surgical challenge due to limited visualization and the risk of injury to adjacent anatomic structures when approached through conventional palatal or labial routes. We present a case series of 3 patients (aged 6, 21, and 24 y) with deeply impacted supernumerary teeth located immediately beneath the nasal floor. All patients were treated using an endoscopic-assisted transnasal vestibular approach. Preoperative cone beam computed tomography was used to evaluate the anatomic relationship between the supernumerary teeth, nasal floor, and adjacent dentition. This approach provided a direct surgical corridor with enhanced visualization, allowing precise osteotomy and controlled tooth removal. All procedures were completed successfully without intraoperative complications. Operative time ranged from 15 to 25 minutes, with minimal blood loss. Postoperative recovery was uneventful, and no complications were observed during follow-up. The endoscopic-assisted transnasal vestibular approach may represent a feasible, minimally invasive technique for selected cases of deeply impacted maxillary supernumerary teeth and may reduce surgical trauma and improve visualization in anatomically challenging scenarios.