Diagnosis and treatment of odontogenic cutaneous sinus tracts of endodontic origin: three case studies

Int Endod J. 2009 Mar;42(3):271-6. doi: 10.1111/j.1365-2591.2008.01519.x.

Abstract

Aim: To describe three cases of extraoral sinus tracts, related to infected teeth, which were initially misdiagnosed as skin lesions and inappropriately treated.

Summary: The extraoral sinus tracts were initially misdiagnosed as skin lesions. Dermatological surgery was performed and antibiotics prescribed but the lesions did not resolve. Then, a dental cause was sought, and identified. Endodontic intervention resulted in resolution of the problem, confirming the initial misdiagnosis.

Key learning points: Dermatologists and other medical practitioners should be aware that dental extraoral sinus tracts can be confused with skin lesions. A dental aetiology, as part of a differential diagnosis, should be kept in mind with oro-facial skin lesions. If an extraoral sinus tract is of endodontic origin, then elimination of infection through effective endodontic treatment will lead to resolution of the sinus tract. Early correct diagnosis can prevent unnecessary and ineffective antibiotic therapy and/or surgical intervention.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Cutaneous Fistula / diagnosis
  • Cutaneous Fistula / etiology*
  • Cutaneous Fistula / therapy
  • Dental Fistula / diagnosis
  • Dental Fistula / etiology*
  • Dental Fistula / therapy
  • Dental Pulp Diseases / complications*
  • Dental Pulp Diseases / diagnosis
  • Dental Pulp Diseases / therapy
  • Dental Pulp Necrosis / complications
  • Dental Pulp Necrosis / diagnosis
  • Diagnosis, Differential
  • Facial Dermatoses / diagnosis
  • Facial Dermatoses / etiology*
  • Facial Dermatoses / therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Periapical Periodontitis / diagnosis
  • Periapical Periodontitis / etiology
  • Root Canal Therapy
  • Treatment Outcome