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Removal of the entire tooth (extraction) or necrotic dental pulp (root canal / endodontic treatment) is the only successful treatment for a dental sinus. Antibiotics such as penicillin or metronidazole may be also required. The sinus will usually heal 1–2 weeks after extraction or successful endodontic treatment.
It is common for practitioners to misdiagnose the cause of facial cutaneous sinus tracts, failing to recognise that many have an odontogenic cause.
A cutaneous sinus tract of odontogenic origin occurs when purulent by-products of dental pulp necrosis spread along the path of least resistance from the root apex to the skin on the face.
The evaluation of a cutaneous sinus tract must begin with a thorough patient history and awareness that any cutaneous lesion of the face and neck could be of dental origin. 1,4,7 the patient’s history may include complaints of dental problems. However, patients may not have any history of an acute or painful onset.
Cutaneous dental sinus tracts are uncommon and can be missed, which can lead to unnecessary surgical procedures and antibiotic therapy. 1 the tract usually results from an apical abscess that forms because of dental caries that cause periapical inflammation and suppuration.
Cutaneousiinus tract of dental origin is the most common among the many types of sinus tracts that are formed on the face and neck.
Mar 5, 2007 acutaneous dental sinus tract is a channel which leads from a dental focus of infection to drain onto the face or neck.
Biopsies or excisions are not necessary and can cause scarring. Management of the dental focus of infection through endodontic (root canal) treatment or tooth extraction will resolve the sinus tract. Clinically, a cutaneous dental sinus tract may resemble a pimple, ulcer, nodule, or indurated cystic area.
Elimination of dental infection via tooth extraction or root canal treatment leads to resolution of the cutaneous sinus.
Odontogenic cutaneous fistulas often lead to intense levels of patient discomfort and suffering. Due to its rarity and the absence of dental symptoms, a considerable number of patients are usually misdiagnosed which results in inappropriate management. This case report presents a 16-year-old patient with a 2-year history of a nonhealing, persistently discharging lesion in the left.
A dental aetiology must be included in the differential diagnosis of cutaneous sinus tracts in the neck and face. Elimination of odontogenic cutaneous sinus tract infection by endodontic therapy results in resolution of the sinus tract without surgical excision or systemic antibiotic therapy.
Cutaneous sinus tracts of the face can be a diagnostic dilemma. 1 cutaneous dental sinus is a common and well-documented condition. The clinical differential diagnosis includes pustule, actinomycoses, osteomyelitis, oro-cutaneous fistula, neoplasms, carbuncle, infected epidermoid cyst, pyogenic granuloma, chronic tuberculosis and gumma of tertiary syphilis.
An understanding of the draining of cutaneous sinus tracts will lead to more appropriate treatment. Most cases respond to conservative, nonsurgical root canal therapy. Our objective is to report 2 cases of cutaneous sinus tract secondary to chronic periapical dental infection that were recently observed at our hospital.
Conclusion: because patients with cutaneous facial sinus tracts of dental origin often do not have obvious dental symptoms, a possible dental etiology may be overlooked. If dental origin is suspected, the diagnosis is easily confirmed by dental examination and dental roentgenograms of the involved area.
Sep 6, 2016 draining cutaneous sinus tract in chin area may be caused by chronic periapical dental infections.
Cutaneous sinus tracts of dental origin are often initially misdiagnosed and inappropriately treated because of their uncommon occurrence and the absence of symptoms in approximately half the individuals affected. Due to the extraoral location of the sinus, patients tend to seek medical care first.
An understanding of the draining of cutaneous sinus tracts will lead to more appropriate treatment. Most cases respond to conservative, nonsurgical root canal therapy. Our objective is to report a case of cutaneous sinus tract evolving for 6 years secondary to chronic periapical dental infection caused by old trauma.
Odontogenic cutaneous sinus tracts (ocsts) are generally primarily misdiagnosed and inappropriately treated by virtue of their rarity and the absence of dental symptoms. Accurate diagnosis and treatment and the elimination of the source of infection can reduce the incidence of complications and relieve the pain of the patient.
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