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Nasrabadi N, Asnaashari M, Daghighi Y. Management of a Sinus Tract of Endodontic Origin Using Ultrasonically-Activated Photodynamic Therapy and Photobiomodulation: A Case Report. J Lasers Med Sci 2024; 15:e32. [PMID: 39193104 PMCID: PMC11348444 DOI: 10.34172/jlms.2024.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/16/2024] [Indexed: 08/29/2024]
Abstract
Introduction: Odontogenic extraoral sinus tracts are rare conditions that can be misdiagnosed as skin lesions and lead to unnecessary treatments. They are caused by dental infections spreading through bone and draining externally. Conservative nonsurgical endodontic treatment should be pursued first. However, conventional instrumentation and irrigation techniques cannot fully decontaminate root canal systems. New disinfection techniques, including ultrasonic activation of irrigation, photodynamic therapy (PDT), and lasers, have been developed as adjunctive techniques. Photobiomodulation (PBM) (also known as low-level laser therapy) has also demonstrated beneficial effects on tissue healing. Case Presentation: This report presents a case of an extraoral sinus tract associated with a necrotic mandibular molar that was treated successfully with nonsurgical endodontic therapy using ultrasonically-activated PDT, PBM, and high-intensity laser therapy (HILT). Six- and 12-month follow-ups showed resolution of the sinus tract and healing of the apical lesion radiographically. The extraoral lesion had diminished significantly. Conclusion: Combining nonsurgical endodontic treatment with PDT with ultrasonic activation, PBM, and HILT allowed successful management of an odontogenic extraoral sinus tract without surgical intervention. Using PDT combined with ultrasonic activation enhanced disinfection while PBM and HILT improved wound healing. This report demonstrates a conservative approach to treating these lesions.
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Affiliation(s)
- Navid Nasrabadi
- Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Asnaashari
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yasaman Daghighi
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Jain A, Reche A, Singhai S, Paul P, Raisoni K, Agrawal K. Misdiagnosis of an Odontogenic Infection as a Skin Lesion: The Diagnostic Dilemma. Cureus 2024; 16:e66024. [PMID: 39221313 PMCID: PMC11366281 DOI: 10.7759/cureus.66024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Accepted: 08/02/2024] [Indexed: 09/04/2024] Open
Abstract
Extraoral sinus tracts of endodontic origin might be confused for a variety of dermatological conditions. Differential diagnosis of this clinical condition plays an essential role in providing appropriate clinical care because misdiagnosis is the most prevalent cause of prolonged therapy and healing failure. As a result, every cutaneous sinus structure affecting the face or neck should be investigated for dental issues. Its diagnosis can sometimes be difficult until the treating clinician examines the potential of a dental cause. Once an appropriate diagnosis has been established, definitive treatment, consisting of root canal therapy or tooth extraction, to remove the primary source of infection is a straightforward and successful operation.
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Affiliation(s)
- Anushka Jain
- Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Amit Reche
- Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Soumya Singhai
- Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Priyanka Paul
- Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Khushee Raisoni
- Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Komal Agrawal
- Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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3
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Bolhari B, Ghabraei S, Noori F, Hashemi N. Dens evagination and complete invagination in the same tooth with extraoral fistula: A rare case report. Clin Case Rep 2024; 12:e9247. [PMID: 39119030 PMCID: PMC11306110 DOI: 10.1002/ccr3.9247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/21/2024] [Accepted: 07/11/2024] [Indexed: 08/10/2024] Open
Abstract
Key Clinical Message Successful management of a rare case involving both dens evaginatus and dens invaginatus in the same tooth, monitored over a 24-month follow-up. Abstract Dens invaginatus (DI) is a congenital dental anomaly characterized by the presence of a tooth that resembles a "tooth within a tooth." Conversely, dens evaginatus (DE) is a developmental anomaly distinguished by an additional tubercle or cusp on the tooth's crown. Both DI and DE can result in pulpal and periapical diseases in the affected tooth. This article presents a case of a healthy 14-year-old male with recurrent swelling under the chin and a wound with pus drainage on the right side of the submental area, associated with his left mandibular lateral incisor affected by both DI and DE. Clinical and radiographic examinations revealed that the tooth was necrotic and had a chronic apical abscess. Cone beam computed tomography (CBCT) confirmed Oehlers' type III DI and a talon cusp on the lingual surface of the same tooth. The patient underwent orthograde endodontic treatment. Passive ultrasonic activation of a 5.25% NaOCl solution and a mixture of Ca(OH)2 and a 2% chlorhexidine solution were utilized to effectively clean and eliminate the persistent pus discharge. After the resolution of the patient's symptoms, the apical third of the root canal and the invaginated space were filled with a plug of mineral trioxide aggregate (MTA), while the remaining root canal was filled using a sealer-based obturation technique. A 24-month follow-up visit revealed complete bone regeneration in the previously affected periradicular tissues.
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Affiliation(s)
- Behnam Bolhari
- Department of Endodontics, School of DentistryTehran University of Medical SciencesTehranIran
| | - Sholeh Ghabraei
- Department of Endodontics, School of DentistryTehran University of Medical SciencesTehranIran
| | - Faranak Noori
- Department of Endodontics, School of DentistryTehran University of Medical SciencesTehranIran
| | - Nasim Hashemi
- Department of Endodontics, School of DentistryTehran University of Medical SciencesTehranIran
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Ruck P, Morris HT, Thikkurissy S. Case report of an extra-oral cutaneous sinus tract of endodontic origin in a patient with autism spectrum disorder. SPECIAL CARE IN DENTISTRY 2024; 44:768-772. [PMID: 37880917 DOI: 10.1111/scd.12934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 10/13/2023] [Accepted: 10/14/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND AND OVERVIEW Extraoral cutaneous sinus tracts (EOCST) are often misdiagnosed due to their unexpected appearance without history of odontogenic pain, discomfort, or cellulitis. Diagnosis can be further confounded in those with sensory processing difficulties since patients can have a hypersensitivity to sensory input, but simultaneously demonstrate hyposensitivity and indifference toward pain. EOCST misdiagnosis and resultant mismanagement can lead to multiple surgical excisions, biopsies, and elongated antibiotic regimens, with eventual lesion recurrence. CASE DESCRIPTION A 19-year-old white male with autism spectrum disorder in the period of transitional dental care presented with a history of a chronic EOCST. The patient required sedation for evaluation, biopsy, and was initially managed by infectious disease under the impression of an actinomycosis infection. The patient completed a twelve-month course of antibiotic therapy with subsequent lesion re-occurrence. Eventually, the diagnosis of an EOCST of dental origin was confirmed. It was determined that pulpal necrosis was due to localized dental trauma of the lower left central incisor, as a result of a self-injurious behavior. Root canal treatment eventually led to the resolution of the lesion. It took three years from initial clinical presentation for the resolution of the lesion. CONCLUSIONS AND PRACTICAL IMPLICATIONS Collaboration between the medical and dental healthcare team in diagnosis and treatment planning for a patient with special needs is essential to ensure prompt and appropriate care for this patient group.
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Affiliation(s)
- Patrick Ruck
- Department of Pediatrics, University of Cincinnati College of Medicine, and Division of Pediatric Dentistry, Cincinnati Children's Hospital Medical Center (CCHMC), Cincinnati, Ohio, USA
| | - Heather T Morris
- Department of Pediatrics, University of Cincinnati College of Medicine, and Division of Pediatric Dentistry, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Sarat Thikkurissy
- Department of Pediatrics, University of Cincinnati College of Medicine, and Division of Pediatric Dentistry, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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Moon P, Kalambe S. Periapical Cyst Forming Cutaneous Sinus Tract: Unusual Presentation-Case Report. Indian J Otolaryngol Head Neck Surg 2024; 76:1341-1343. [PMID: 38440540 PMCID: PMC10909049 DOI: 10.1007/s12070-023-04317-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/21/2023] [Indexed: 03/06/2024] Open
Abstract
A cutaneous sinus tract due to periapical cyst being very rare may easily be misdiagnosed, leading to incorrect treatment. Identifying the etiology is difficult, but it is the key to effective therapy. The case presented here is a cutaneous sinus tract in the nasolabial region of odontogenic origin. After surgery and extraction of the tooth, the sinus tract healed remarkably (Belmehdi et al. in Contemp Clin Dent 9:314-318, 2018; Latifa et al. in Clin Case Rep 10:e05333, 2022).
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Affiliation(s)
- Prasanna Moon
- Department of ENT, Datta Meghe Medical College and SMHRC Hospital, Datta Meghe Institute of Higher Education and Research (DU) Sawangi, Hingna Road, Wanadongri, Nagpur, 441110 India
| | - Sanika Kalambe
- Department of ENT, Datta Meghe Medical College and SMHRC Hospital, Datta Meghe Institute of Higher Education and Research (DU) Sawangi, Hingna Road, Wanadongri, Nagpur, 441110 India
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Latifa H, Dorsaf T, Amira K, Karim J, Nabiha D. Surgical management of an odontogenic cutaneous sinus tract misdiagnosed for 4 years. Clin Case Rep 2022; 10:e05333. [PMID: 35140950 PMCID: PMC8811183 DOI: 10.1002/ccr3.5333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 11/30/2021] [Accepted: 12/11/2021] [Indexed: 11/29/2022] Open
Abstract
A cutaneous sinus tract of dental origin may easily be misdiagnosed and incorrectly treated. This paper reported a case of a 20-year-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 related to a mandibular first right molar presenting an infected radicular cyst. Surgical treatment was performed leading to a significant healing of the sinus tract.
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Affiliation(s)
- Hammouda Latifa
- Dental Faculty of MonastirResearch Laboratory LR12ES11University of MonastirMonastirTunisia
| | - Touil Dorsaf
- Dental Faculty of MonastirResearch Laboratory LR12ES11University of MonastirMonastirTunisia
| | - Kikly Amira
- Dental Faculty of MonastirResearch Laboratory LR12ES11University of MonastirMonastirTunisia
| | - Jlassi Karim
- Dental Faculty of MonastirResearch Laboratory LR12ES11University of MonastirMonastirTunisia
| | - Douki Nabiha
- Dental Faculty of MonastirResearch Laboratory LR12ES11University of MonastirMonastirTunisia
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7
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Odontogenic Cutaneous Fistula: A Case in Aged Patient With Delayed Diagnosis. J Craniofac Surg 2021; 32:e340-e342. [PMID: 33038169 DOI: 10.1097/scs.0000000000007114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT Odontogenic cutaneous fistula is a pathologic communication between the cutaneous surface of the face and the oral cavity and it is a rare entity frequently misdiagnosed.Therefore, the lesion may persist for a long period before the correct diagnosis is made and odontogenic source is treated appropriately. Delay in diagnosis adds to the chronicity of the lesion and if not diagnosed in times fistula can even leave deforming scars.Considering the scarceness and diagnostic predicament of odontogenic cutaneous fistulas, the authors report a significant case of 80 years old female.
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Kallel I, Moussaoui E, Kharret I, Saad A, Douki N. Management of cutaneous sinus tract of odontogenic origin: Eighteen months follow-up. J Conserv Dent 2021; 24:223-227. [PMID: 34759595 PMCID: PMC8562828 DOI: 10.4103/jcd.jcd_56_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/27/2021] [Accepted: 05/30/2021] [Indexed: 12/05/2022] Open
Abstract
An odontogenic cutaneous sinus tract is a pathologic canal that initiates in the oral cavity but opens externally at the cutaneous surface of the face or neck. It is frequently misdiagnosed, leading to inappropriate treatment. A 44-year-old female patient referred to us with a chronically draining lesion on his chin. The lesion previously was misdiagnosed by medical doctors and had undergone cryotherapy and 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 treatment was performed followed by surgical treatment after the recurrence of pus discharge 2 weeks after the conventionnel root canal treatment. Five months later, after the treatment, the lesion showed an obvious healing. After 18 months, the patient was comfortable and a significant healing of the sinus tract was noted, the periapical radiograph shows clear regression of the periapical lesion and an improvement in bone trabeculation. The key to successful treatment of cutaneous sinus tract of dental origin must be appropriate communication between the dentist and the physician in order to achieve correct diagnosis and therapy in such cases.
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Affiliation(s)
- Ines Kallel
- Department of Dental Medicine, Hospital Sahloul, Sousse, Tunisia
- Department of conservative odontology and Endodontics at Hospital Sahloul, Sousse, Tunisia, Research Laboratory Oral Healh and Rehabilitation, Faculty of Dental Medicine, LR12ES11 University of Monastir, Monastir, Tunisia
| | - Eya Moussaoui
- Department of Dental Medicine, Hospital Sahloul, Sousse, Tunisia
- Department of conservative odontology and Endodontics at Hospital Sahloul, Sousse, Tunisia, Research Laboratory Oral Healh and Rehabilitation, Faculty of Dental Medicine, LR12ES11 University of Monastir, Monastir, Tunisia
| | - Islem Kharret
- Department of Dental Medicine, Hospital Sahloul, Sousse, Tunisia
- Department of conservative odontology and Endodontics at Hospital Sahloul, Sousse, Tunisia, Research Laboratory Oral Healh and Rehabilitation, Faculty of Dental Medicine, LR12ES11 University of Monastir, Monastir, Tunisia
| | - Asma Saad
- Department of Dental Medicine, Hospital Sahloul, Sousse, Tunisia
- Department of conservative odontology and Endodontics at Hospital Sahloul, Sousse, Tunisia, Research Laboratory Oral Healh and Rehabilitation, Faculty of Dental Medicine, LR12ES11 University of Monastir, Monastir, Tunisia
| | - Nabiha Douki
- Department of Dental Medicine, Hospital Sahloul, Sousse, Tunisia
- Department of conservative odontology and Endodontics at Hospital Sahloul, Sousse, Tunisia, Research Laboratory Oral Healh and Rehabilitation, Faculty of Dental Medicine, LR12ES11 University of Monastir, Monastir, Tunisia
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9
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Varghese LL, Bhattacharya A, Sharma P, Apratim A. Non-surgical management of an extraoral cutaneous sinus tract of odontogenic origin. BMJ Case Rep 2020; 13:13/7/e234699. [PMID: 32690568 DOI: 10.1136/bcr-2020-234699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
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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Affiliation(s)
- Lynn Lilly Varghese
- Department of Conservative Dentistry and Endodontics, Melaka Manipal Medical College, Bukit Baru, Melaka, Malaysia
| | - Auric Bhattacharya
- Oral and Maxillofacial Surgery, Melaka Manipal Medical College, Bukit Baru, Melaka, Malaysia
| | - Praveena Sharma
- Department of Conservative Dentistry and Endodontics, College of Dental Sciences, Davangere, Karnataka, India
| | - Abhishek Apratim
- Department of Prosthodontics, Melaka Manipal Medical College, Bukit Baru, Melaka, Malaysia
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10
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Shemesh A, Hadad A, Azizi H, Lvovsky A, Ben Itzhak J, Solomonov M. Cone-beam Computed Tomography as a Noninvasive Assistance Tool for Oral Cutaneous Sinus Tract Diagnosis: A Case Series. J Endod 2019; 45:950-956. [PMID: 31104817 DOI: 10.1016/j.joen.2019.03.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 02/19/2019] [Accepted: 03/22/2019] [Indexed: 11/26/2022]
Abstract
An oral cutaneous sinus tract is a relatively uncommon condition that is generally associated with long-standing periapical inflammation. The traditional process of oral cutaneous sinus tract diagnosis is an invasive method based on the insertion of a lacrimal probe or wire. The present article describes the use of cone-beam computed tomographic imaging as a noninvasive assistant tool for the verification of the odontogenic origin.
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Affiliation(s)
- Avi Shemesh
- Department of Endodontics, Israel Defense Forces Medical Corps, Tel Hashomer, Israel.
| | - Avi Hadad
- Department of Endodontics, Israel Defense Forces Medical Corps, Tel Hashomer, Israel
| | - Hadas Azizi
- Department of Endodontics, Israel Defense Forces Medical Corps, Tel Hashomer, Israel
| | - Alex Lvovsky
- Department of Endodontics, Israel Defense Forces Medical Corps, Tel Hashomer, Israel
| | - Joe Ben Itzhak
- Department of Endodontics, Israel Defense Forces Medical Corps, Tel Hashomer, Israel
| | - Michael Solomonov
- Department of Endodontics, Israel Defense Forces Medical Corps, Tel Hashomer, Israel
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Abstract
A cutaneous sinus tract of dental origin is relatively uncommon and may easily be misdiagnosed, owing to its uncommon occurrence and absence of dental symptoms. Such a lesion continues to be a diagnostic dilemma. The case described here presented a nasolabial cutaneous sinus tract of dental origin that was treated by a surgical approach with an excellent esthetic improvement.
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Affiliation(s)
- Akram Belmehdi
- Department of Oral Surgery, Dental Center of Treatment and Diagnosis, IBN Sina Hospital, Rabat, Morocco
| | - Karima El Harti
- Department of Oral Surgery, Faculty of Dentistry of Rabat, Mohammed V University, Rabat, Morocco
| | - Wafaa El Wady
- Department of Oral Surgery, Faculty of Dentistry of Rabat, Mohammed V University, Rabat, Morocco
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12
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Curvers F, Haes PD, Lambrechts P. Non-Surgical Endodontic Therapy as Treatment of Choice for a Misdiagnosed Recurring Extraoral Sinus Tract. Eur Endod J 2017; 2:1-6. [PMID: 33403325 PMCID: PMC7757942 DOI: 10.5152/eej.2017.17007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 02/27/2017] [Accepted: 04/10/2017] [Indexed: 12/29/2022] Open
Abstract
The purpose of this article is to present the treatment of an odontogenic cutaneous sinus tract with exuberant extraoral granulation tissue and its successful endodontic treatment and follow up with Cone-Beam Computed Tomography (CBCT). In this case, a 31-year-old woman was referred for management of a reddish nodule on her chin. Previous surgical and antibiotic intervention by the dermatologist had not resolved the problem. Profound clinical and radiological examination (including CBCT) revealed apical periodontitis of tooth 32 to be the cause of the recurring cutaneous sinus tract. Conservative non-surgical root canal treatment was performed. With the aid of a topical corticosteroid and supplemental antibiotic therapy, healing of the apical periodontitis and resolution of the granulation tissue was evident after 1 year both clinically and radiographically. This case report emphasises the need for more awareness by dermatologists and other medical practitioners for the differential diagnosis of extraoral sinus tracts. Correct diagnosis of the dental cause can prevent unnecessary and multiple antibiotic and surgical interventions. Antibiotic therapy should never be administered without addressing the underlying dental cause. Conservative non-surgical endodontic treatment is the treatment of choice for an extraoral sinus tract of endodontic origin.
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Affiliation(s)
- Frederik Curvers
- Department of Oral Health Sciences, University of Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Petra De Haes
- Department of Dermatology, University of Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Paul Lambrechts
- Department of Oral Health Sciences, University of Leuven, University Hospitals Leuven, Leuven, Belgium
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Janev E, Redzep E. Managing the Cutaneous Sinus Tract of Dental Origine. Open Access Maced J Med Sci 2016; 4:489-492. [PMID: 27703580 PMCID: PMC5042640 DOI: 10.3889/oamjms.2016.100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 07/08/2016] [Accepted: 08/24/2016] [Indexed: 11/11/2022] Open
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.
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Affiliation(s)
- Edvard Janev
- Faculty of Dentistry, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Enis Redzep
- Faculty of Dentistry, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
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14
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Conservative, Surgical, and Prosthetic Treatment of a Patient with a Periapical Lesion Associated with an Atypical Intraoral Sinus Tract. Case Rep Dent 2015; 2015:495206. [PMID: 26064699 PMCID: PMC4438176 DOI: 10.1155/2015/495206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 04/24/2015] [Indexed: 11/18/2022] Open
Abstract
This report describes a clinical case with an atypical intraoral sinus tract formation from diagnosis and treatment to short-term outcome and definitive prosthetic rehabilitation. In detail, the patient underwent conservative nonsurgical root canal treatment followed by guided bone augmentation of the regions involved in periapical inflammation and sinus tract formation. The removal of the inflammatory source of the lesion as well as the affected tissue clearly led to a healing of the surrounding bone tissues. Subsequently, the tooth was reconstructed using a fibreglass post and a metal-ceramic crown; an implant was successfully placed in the previously inflamed bone region.
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15
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Miri SS, Atashbar O, Atashbar F. Prevalence of Sinus Tract in the Patients Visiting Department of Endodontics, Kermanshah School of Dentistry. Glob J Health Sci 2015; 7:271-5. [PMID: 26153170 PMCID: PMC4803844 DOI: 10.5539/gjhs.v7n6p271] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Revised: 02/12/2015] [Accepted: 01/29/2015] [Indexed: 11/12/2022] Open
Abstract
Introduction: Sinus tract is one of the manifestations of chronic dental infections, which is a path for the drainage of the infection and pus. The present study was aimed to investigate the prevalence of sinus tract with dental origin analyze the correlation between sinus tract and related factors. Methods: This study was conducted on 1527 patients, visiting Kermanshah school of dentistry, in 2014.The related teeth were examined in terms of vitality test and exact location of sinus tract. Moreover, the causes of this lesion and the needs for root canal treatment were assessed in these teeth. Having obtained the data from the patients, analyzed by Mann-Whitney, Chi-square tests. Results: The frequency of sinus tract was 9.89% patients. There was a significant correlation between the prevalence of sinus tract and factors such as age, general health status, location of sinus tract and history of root canal treatment. The prevalence of sinus tract in maxilla was higher than the mandible (p=0.087). The prevalence of sinus tract in the posterior teeth (69.54%) was significantly higher than that of anterior teeth (30.46%) (p=0.000). From 724 teeth with periapical inflammation and radiolucency, 9.89% teeth had odontogenic sinus tract, and 23.42% teeth with history of root canal treatment had sinus tract. Conclusions: The most common cause of sinus tract incidence was previous root canal treatment. Therefore, clinicians need to pay a more attention to examining the posterior teeth referred for endodontic treatment.
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Tian J, Liang G, Qi W, Jiang H. Odontogenic cutaneous sinus tract associated with a mandibular second molar having a rare distolingual root: a case report. Head Face Med 2015; 11:13. [PMID: 25885921 PMCID: PMC4414428 DOI: 10.1186/s13005-015-0072-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Accepted: 04/09/2015] [Indexed: 11/29/2022] Open
Abstract
Introduction Odontogenic cutaneous sinus tracts are often misdiagnosed as lesions of non-odontogenic origin, leading to the treatment of patients with unnecessary and ineffective therapies. Sinus tracts of endodontic origin usually respond well to endodontic therapy. However, root canal treatment of mandibular molars with aberrant canal anatomy can be diagnostically and technically challenging. Herein we present a patient with a cutaneous odontogenic sinus tract in the right submandibular area. Case report A 23-year-old Chinese female patient presented with a cutaneous odontogenic sinus tract that was initially misdiagnosed as a sebaceous cyst. The patient had undergone surgical excision and traditional Chinese medical therapy before endodontic consultation. With the aid of cone beam computed tomography (CBCT), it was confirmed that the causative factor of the cutaneous odontogenic sinus tract was chronic periapical periodontitis of the right mandibular second molar, which had a rare and curved distolingual root. The resolution of the sinus tract and apical healing was accomplished following nonsurgical root canal treatment. Conclusion 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. This case report also indicates that CBCT imaging is useful for identifying the tooth involved, ascertaining the extent of surrounding bone destruction and accurately managing the aberrant canal morphology.
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Affiliation(s)
- Jun Tian
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Affiliated Stomatological Hospital, Guangdong Province Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China.
| | - Guobin Liang
- Department of Prosthodontics, Guanghua School of Stomatology, Affiliated Stomatological Hospital, Guangdong Province Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China.
| | - Wenting Qi
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Affiliated Stomatological Hospital, Guangdong Province Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China.
| | - Hongwei Jiang
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Affiliated Stomatological Hospital, Guangdong Province Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China.
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Abstract
We describe a 22-year-old woman with neck skin sinus tract that developed as a consequence of dental infection. The patient was treated twice in an inappropriate way with recurrence of the sinus tract. We opted for an extraction of the tooth. This case illustrates the need for cooperative diagnostic referrals between physicians and dentists.
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Affiliation(s)
- Mato Susic
- Department of Oral Surgery, School of Dental Medicine, University of Zagreb, Croatia
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18
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Sammut S, Malden N, Lopes V. Facial cutaneous sinuses of dental origin – a diagnostic challenge. Br Dent J 2013; 215:555-8. [DOI: 10.1038/sj.bdj.2013.1141] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2013] [Indexed: 11/09/2022]
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19
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Kishore Kumar RV, Devireddy SK, Gali RS, Chaithanyaa N, Chakravarthy C, Kumarvelu C. Cutaneous sinuses of cervicofacial region: a clinical study of 200 cases. J Maxillofac Oral Surg 2012; 11:411-5. [PMID: 24293932 DOI: 10.1007/s12663-012-0353-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Accepted: 02/10/2012] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To evaluate the sinuses in the cervicofacial region and to identify the focus of infection. It is also to help the clinician in differentiating the sinuses' of odontogenic and nonodontogenic focus of infection. MATERIALS AND METHODS The study has been conducted in 200 patients, aged between 11 and 77 years for a period of 6 and a half years at Narayana Dental College and Hospital, Nellore. History of present illness, clinical, radiological and laboratory examinations were carried out on all the patients. RESULTS Majority of the cervical sinuses are of odontogenic origin (80%) and non-odontogenic being (20%) of the cases. CONCLUSION The literature reveals that many cases have been misdiagnosed and inappropriately treated by many specialties of Medicine and Surgery wherein the odontogenic foci of infection is the main etiological factor for cervicofacial sinuses. A proper diagnosis is important and forms a key to the successful management of these sinuses in the head and neck region.
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Affiliation(s)
- R V Kishore Kumar
- Department of Oral & Maxillofacial Surgery, Narayana Dental College and Hospital, Chintareddypalem, Nellore, 524003 Andhra Pradesh India
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20
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Truong SV, Chang LC, Berger TG. Bisphosphonate-related osteonecrosis of the jaw presenting as a cutaneous dental sinus tract: A case report and review of the literature. J Am Acad Dermatol 2010; 62:672-6. [DOI: 10.1016/j.jaad.2008.09.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2008] [Revised: 09/03/2008] [Accepted: 09/21/2008] [Indexed: 10/19/2022]
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21
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Pasternak-Júnior B, Teixeira CS, Silva-Sousa YTC, Sousa-Neto MD. Diagnosis and treatment of odontogenic cutaneous sinus tracts of endodontic origin: three case studies. Int Endod J 2009; 42:271-6. [DOI: 10.1111/j.1365-2591.2008.01519.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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Foster MG, Readmans P. Case Report: The Hazards of Oral Piercing. Eur Arch Paediatr Dent 2007. [DOI: 10.1007/bf03262605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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23
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Barrowman RA, Rahimi M, Evans MD, Chandu A, Parashos P. Cutaneous sinus tracts of dental origin. Med J Aust 2007; 186:264-5. [PMID: 17391091 DOI: 10.5694/j.1326-5377.2007.tb00886.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2006] [Accepted: 11/22/2006] [Indexed: 11/17/2022]
Affiliation(s)
- Roland A Barrowman
- Oral and Maxillofacial Surgery, Royal Dental Hospital of Melbourne, Melbourne, VIC, Australia.
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24
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Guyot L, Catherine JH, Richard O, Olivi P, Chossegros C. Fistules cutanées d’origine dentaire. Ann Dermatol Venereol 2006; 133:725-7. [PMID: 17053752 DOI: 10.1016/s0151-9638(06)71001-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- L Guyot
- Service de Stomatologie, Chirurgie Maxillo-faciale et Plastique de la Face, CHU Nord, Chemin des Bourrelys, 13015 Marseille, France.
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