Managing the Cutaneous Sinus Tract of Dental Origine

Abstract

BACKGROUND:Draining cutaneous sinus tract in chin area may be caused by chronic periapical dental infections. Misdiagnosis of these lesions usually leads to destructive invasive treatment of the sinus tract that is not correct and curative.CASE REPORT:A 31-year-old male patient referred to us with a chronically draining lesion on his chin. The lesion previously was misdiagnosed by medical doctors and had undergone two times surgery with a focus on the skin lesion and had received antibiotic therapy for a prolonged period of time. After clinical and radiologic examination the dental origin of the lesion was evident and proper endodontic and surgical treatment was performed. Three months later, after the treatment, the lesion showed total healing and reoccurrence occurred.CONCLUSION:The key to successful treatment of cutaneous sinus tract of dental origin must be in appropriate communication between the dentist and the physician in order to achieve correct diagnosis and therapy in such cases.

Uncommon Odontogenic Orocutaneous Fistula of the Jaw Treated with Platelet-Rich Fibrin

“…Brown et al [2] reported that sinus tracts related to teeth were extracted in three cases and lesions were healed uneventfully similar to that observed by Sato et al [8]. According to Janev and Redzep, [3] after root canal treatment, apical resection and extraoral excision were performed and total recovery was observed. Kumar et al [4] reported that sinus tracts of dental origin completely resolved only with conservative endodontic treatment similar to that observed by Tidwell et al [5], Pasternak-Júnior et al [9], and Tian et al [10].…”

“…Frequently, the possibility of an odontogenic origin is overlooked so that patients prefer to refer to physicians for treatment of the cutaneous lesion, because most of the patients do not experience any symptoms associated with teeth [3]. Many patients can also show similar conditions in specific clinical anomalies such as epidermal cyst, furuncle, carbuncle, foreign body reaction, osteomyelitis, bisphosphonate-associated osteonecrosis, pyogenic granuloma, salivary gland fistula, thyroglossal tract fistula, branchial cleft fistula, actinomycosis, basal cell, and squamous cell carcinoma [1–4].…”

Limits of Conventional Treatment of Odontogenic Cutaneous Sinus Tract: A Case Report

“…Despite the fact that this condition is well documented, it still remains commonly misdiagnosed as it can mimic other disorders such as granulomatous disorder, basal cell and squamous cell carcinoma, salivary gland and duct fistula, infected cyst, furuncle, or actinomycosis like reported in our case [1,8,3,7].…”

“…The successful treatment of cutaneous sinus tract of dental origin depends on the diagnosis of the source which may be very challenging because; the patient may not have any apparent dental symptoms; only half of all patients ever recall having had a toothache, the lesion does not always arise in close proximity to the underlying dental infection and it often have a clinical appearance similar to other facial lesions, such as osteomyelitis, basal cell and squamous cell carcinoma, furuncles, bacterial infections, congenital fistulas, and pyogenic granulomas [8,4,7].…”

Fístula cutânea odontogênica: relato de um caso clínico após múltiplos diagnósticos errôneos

“…O tratamento endodôntico ou a extração dentária possibilitam a cicatrização e o desaparecimento das fístulas cutâneas entre 5 a 14 dias. Em geral, não é necessário tratar a cicatriz da lesão cutânea, exceto por motivos estéticos 7 . Diante do exposto, o presente estudo tem como objetivo relatar um caso clínico de fístula cutânea de origem odontogênica, ressaltando a importância do diagnóstico diferencial e da colaboração interprofissional para resolução do caso.…”