Odontogenic cutaneous sinus tract - misdiagnosis and follow-up in a seven-year-old boy

Cutaneous sinus tracts of dental origin are relatively rare, but frequently misdiagnosed. In this case report, we present a seven-year-old patient with a cutaneous lesion in the left submandibular region misdiagnosed by a physician as an abscess secondary to suppurative lymphadenitis, and thus incorrectly treated with surgery and systemic antibiotics. Following a detailed dental examination, the patient was correctly diagnosed with an odontogenic sinus tract from a periapical abscess of tooth 36. Treatment of the immature tooth was initiated with apexification combined with nonsurgical endodontic treatment. The cutaneous and the periapical lesions were all resolved after the treatment and there has been no recurrence during an eight-year follow-up.

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Radiographic characteristics in the periapical healing post endodontic treatment in patients of the Autonomous University of Yucatan, School of Dentistry

Nova Scientia ◽

10.21640/ns.v10i21.1592 ◽

2018 ◽

Vol 10 (21) ◽

pp. 379-390

Author(s):

Oscar David Jurado Patrón ◽

Andrés Vargas López ◽

Elma María Vega Lizama ◽

Gabriel Alvarado Cárdenas ◽

María Eugenia López Villanueva ◽

...

Keyword(s):

Longitudinal Study ◽

Sinus Tract ◽

Complete Healing ◽

Endodontic Treatment ◽

Periapical Lesions ◽

Periapical Healing ◽

School Of Dentistry ◽

One Year ◽

Causes Of Failure

Introduction: The radiographic control of the root canal treatment can evaluate the healing of the periapical lesions. The objective of this study was to determinate the characteristics of the radiographic healing that was observed after one year, during follow-up sessions; so, the healing of the lesions according to the periapical pathology at the beginning of the treatment and the causes of failure of the endodontic treatments were recorded.Method: This is a prospective, observational, descriptive and longitudinal study, carried out in patients who attended control one year after endodontic treatment through the Periapical Index (PAI).Results: A total of 395 teeth of patients who underwent endodontic treatment one year prior to data collection, 87 presented radiogaphically observable periapical lesions; of these, 40 (45.97%) attended the control at one year. The frequency of cases in which some degree of radiographic healing was observed one year after treatment was 97.46%. The pathology with more cases of complete healing was periodontitis with sinus tract. In general, 84.61% of the cases decreased two levels in their PAI after one year. The 100% of the cases of failure presented vertical root fractures.Conclusion: The frequency of periapical healing after endodontic treatment is high. The main cause for the failure of the treatments documented in this study was the lack of coronal restoration that caused vertical fractures.

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Non-surgical management of an extraoral cutaneous sinus tract of odontogenic origin

BMJ Case Reports ◽

10.1136/bcr-2020-234699 ◽

2020 ◽

Vol 13 (7) ◽

pp. e234699

Author(s):

Lynn Lilly Varghese ◽

Auric Bhattacharya ◽

Praveena Sharma ◽

Abhishek Apratim

Keyword(s):

Case Report ◽

Surgical Management ◽

Dental Pulp ◽

Complete Resolution ◽

Sinus Tract ◽

Odontogenic Origin ◽

One Year ◽

Minimal Scar ◽

Cutaneous Sinus

Chronic apical periodontitis associated with dental pulp necrosis is the main cause of odontogenic extraoral cutaneous sinus openings. These tracts are often initially misdiagnosed unless the treating clinician considers a dental aetiology. This case report of a 19-year-old woman describes the diagnosis and treatment of an extraoral cutaneous sinus tract of odontogenic origin. Non-surgical conservative endodontic therapy was opted as the involved teeth were restorable. One month after the completion of obturation, there was closure of the sinus tract. One year follow-up showed complete resolution of the sinus tract with minimal scar formation.

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A Case of Cutaneous Sinus Tract of Dental Origin

Annals of Dermatology ◽

10.5021/ad.2002.14.4.235 ◽

2002 ◽

Vol 14 (4) ◽

pp. 235 ◽

Cited By ~ 4

Author(s):

Soo Hong Kim ◽

Sang Jin Park ◽

Jeong Joon Oh ◽

Eil Soo Lee

Keyword(s):

Sinus Tract ◽

Dental Origin ◽

Cutaneous Sinus

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A clinical predicament- Extraoral cutaneous sinus tract of dental origin

International Dental Journal ◽

10.1016/j.identj.2021.08.044 ◽

2021 ◽

Vol 71 ◽

pp. S48-S49

Author(s):

Sabah Shahzad Kaiani

Keyword(s):

Sinus Tract ◽

Dental Origin ◽

Cutaneous Sinus

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Cutaneous sinus tract of dental origin

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2016-134122 ◽

2016 ◽

Vol 92 (1092) ◽

pp. 625-625

Author(s):

Pallav Mahesh Patni ◽

Pradeep Jain ◽

Mona Jain Patni

Keyword(s):

Sinus Tract ◽

Dental Origin ◽

Cutaneous Sinus

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Surgical management of an odontogenic cutaneous sinus tract misdiagnosed for 4 years

10.22541/au.163765217.73109510/v1 ◽

2021 ◽

Author(s):

Latifa Hammouda ◽

dorsaf touil ◽

amira kikly ◽

karim jlassi ◽

Nabiha Douki

Keyword(s):

Surgical Management ◽

Male Patient ◽

Sinus Tract ◽

Medical Doctors ◽

Dental Origin ◽

Odontogenic Origin ◽

Cutaneous Sinus

A cutaneous sinus tract of dental origin may easily be misdiagnosed and incorrectly treated. This paper reported a case of a 20-years-old male patient referred for a productive cutaneous sinus tract misdiagnosed by medical doctors for more than 4 years. The clinical and radiographic examinations confirmed the odontogenic origin

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Conservative management of persistent facial cutaneous sinus tract with a dental origin

BMJ Case Reports ◽

10.1136/bcr-2014-204347 ◽

2014 ◽

Vol 2014 (jul15 2) ◽

pp. bcr2014204347-bcr2014204347 ◽

Cited By ~ 2

Author(s):

U. Kumar ◽

C. K. Dharmani ◽

B. J. George ◽

S. Abraham

Keyword(s):

Conservative Management ◽

Sinus Tract ◽

Dental Origin ◽

Cutaneous Sinus

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Cutaneous dental sinus of submental region: An eight years follow-up

Medicine and Pharmacy Reports ◽

10.15386/cjmed-812 ◽

2018 ◽

Vol 91 (3) ◽

pp. 351-356

Author(s):

Pallav Mahesh Patni ◽

Pradeep Jain ◽

Hemalatha Hiremath ◽

Swadhin Raghuwanshi ◽

Prashansa Vijaywargia ◽

...

Keyword(s):

Root Canal ◽

Sinus Tract ◽

Purulent Discharge ◽

Cutaneous Lesions ◽

Dental Origin ◽

Dental Hospital ◽

Amoxicillin Clavulanate ◽

History Of ◽

Antibiotic Coverage

A 22-year-old female patient had a history of a 7-month recurrent pus discharge from her chin. She had been previously treated by physicians, dermatologist, and surgeons. The sinus kept re-occurring and she was referred to dental hospital for opinion.The patient had cutaneous opening of size 5mm × 6mm with purulent discharge in submental region. Patient had undergone three surgical excisions and multiple antibiotic regimens. Patient had a history of trauma due to fall six years back. A 30 number standard gutta-percha was used to trace the sinus tract and dental origin was confirmed radiographically. The tract led to in-between the root canal apices of both mandibular incisors. Treatment included non-surgical endodontic treatment with both mandibular central incisors and antibiotic coverage following bacterial culture of discharge. The pus culture showed Streptococcus anginosus which was found to be sensitive to penicillin. Patient was kept on 1-week course of oral amoxicillin-clavulanate along with root canal therapy.The cutaneous sinus healed following root canal treatment and antibiotic coverage. On an 8-year follow-up skin of sub-mental region appeared normal and peri-apical healing with both mandibular central incisors was evident radiographically. Cutaneous lesions on face may be of dental origin. A cross referral between dentists, physicians, surgeons, and dermatologists should be considered in such cases.

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