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The course of patient described in this case report is typically: patient reports an intermittent remission of the symptoms, intraoral examination may reveal dental restorations and periodontal diseases, but the clinician should keep in mind that even the tooth involved can appear healthy. Some authors claim that extra-oral fistulas are more common in the children and adolescents because the teeth are not yet fully erupted and the alveolar processes is not fully developed and so roots are more deeply seated. 6-10 However, most case reports available in the literature are predominantly of adults and thus do not support this theory.Odontogenic cutaneous fistula typically arises from periapical infections around the root apices as a result of pulpal necrosis due to penetrant caries or traumatic injury. Routine tests used to locate the involved teeth include pulp sensitivity tests and radiographic analysis. In the clinical case described here, the radiographies clearly revealed pericoronaritis and boneless which the cause of suppuration and fistula. [11][12][13] As far as definitive treatment is concerned, root canal or surgical extraction is the treatment of choice. After surgical treatment of the pathogenic tooth the fistula often heals without furthers intervention by 14 days. Healing occurs by secondary intention and occasionally a residual scar may be persist after a few months. In these cases, surgery may be indicated to improve aesthetics. In this case report we have preferred to have surgical excision in order to speed up the healing process.In conclusion, a dental etiology must always be considered for any cutaneous fistula in the head or in the neck region. 2,3,13 -16 Elimination of the dental source of infection results in resolution of the fistula and the healing of the fistula is expected within 5 to 14 days. In case with of restorable teeth, even just the elimination of the infection through endodontic treatment leads to resolution of the fistula. 2,8,17 The case here described is particular because the fistula was caused by a pericoronaritis and not by a dental necrosis. The pericoronaritis started from the third molar, whose existence was ignored, in an old edentulous woman. This case teaches that clinicians should always look for odontogenic causes of cutaneous fistula, even though they seem unlikely.

Craniosynostosis is a congenital cranial malformation involving premature fusion of cranial sutures. Indications for surgical repair of craniosynostosis include elevation of intracranial pressure, which can result in impaired vision and mental disability, as well as correction of abnormal skull shape. Resorbable plating systems have become the preferred technique for bony fixation in the repair of craniosynostosis. Multiple studies demonstrate the safety and low complication rate of resorbable plating systems. However, there is no consensus on which plating system is superior for patient outcomes. This study aims to investigate how the polymer composition of resorbable plating systems utilized in cranial vault reconstruction contributes to wound healing complications. A retrospective chart review was performed at the institution between January 1, 2005 and December 31, 2015. About 202 patients who underwent surgical repair of craniosynostosis were identified. The results showed that patients receiving the Biomet Lactosorb plating system were over twice as likely to have a wound complication within a year of surgery compared to other plating systems used at the institution. Wound complications continued to occur in the Biomet Lactosorb group at ≥180 days after surgery, whereas complications among the other plating systems occurred ≤80 days postoperatively. Half of all patients with wound complications had to undergo reoperation. These data demonstrate the effect of unique polymer compositions on wound healing, and will help to guide future clinical practice and industry development of resorbable plating systems.

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