ABSTRACT
Se realizó una revisión sistemática de la literatura científica en relación con las variantes de tratamien-to que recibieron las piezas dentarias permanentes asociadas a la presencia de una fístula cutánea. Se incluyeron reportes de casos clínicos en inglés, pu-blicados en los últimos diez años. Se obtuvieron 481 artículos, 359 excluidos por escasez de datos en títu-lo e incumplimiento de criterios de selección. Se ex-cluyeron 89 por carecer de tratamiento. Se incluye-ron 33 artículos. Se analizaron fístulas de 45 piezas dentarias, superiores e inferiores, anteriores y pos-teriores. En base a los resultados obtenidos se llegó a la conclusión de que las fístulas cutáneas faciales de origen odontogénico se diagnostican de manera errónea; esto conduce a un tratamiento inadecuado y secuela estéticas. Realizar un correcto diagnóstico y adecuado plan de tratamiento permite una curación rápida y predecible. Los hallazgos obtenidos estable-cen que realizar un correcto tratamiento endodóntico en la pieza afectada, es la terapéutica adecuada para lograr el cierre definitivo de la fístula, sin necesidad de tratar quirúrgicamente la misma (AU)
A systematic review of the scientific literature was carried out in relation to the variants of treatment received by permanent teeth associated with the presence of a cutaneous sinus tract. Clinical case reports in English, published in the last ten years, were included. A total of 481 articles were obtained, 359 were excluded due to lack of title data and non-compliance with selection criteria. 89 were excluded due to lack of treatment. 33 articles were included Cutaneous sinus tracts of 45 teeth, upper and lower, anterior and posterior, were analyzed. Based on the results obtained, it was concluded that facial cutaneous sinus tracts of odontogenic origin are misdiagnosed, leading to inadequate treatment and aesthetic sequelae. Carrying out a correct diagnosis and adequate treatment plan allows a quick and predictable healing. The findings obtained establish that performing a correct endodontic treatment in the affected piece is the appropriate therapy to achieve the definitive closure of the cutaneous sinus tract, without the need to surgically treatment (AU)
Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Cutaneous Fistula/diagnosis , Cutaneous Fistula/therapy , Focal Infection, Dental/complications , Root Canal Therapy/methods , Diagnosis, Differential , Age and Sex Distribution , Mandible , MaxillaABSTRACT
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. Patients presenting with this condition usually visit a dermatologist first, as the lesion can mimic various dermatologic pathologies, ranging from an epidermal cyst to basal cell carcinoma. The location of the sinus in the head and neck region should lead the dermatologist to seek a dental origin in order to avoid misdiagnosis. The lesion may persist for long periods before a correct diagnosis is made and the odontogenic source is treated appropriately. Herein, we report a case of a cutaneous sinus tract of odontogenic origin.
Subject(s)
Humans , Carcinoma, Basal Cell , Dental Fistula , Dental Pulp Necrosis , Diagnosis , Diagnostic Errors , Epidermal Cyst , Head , Neck , Pathology , SkinABSTRACT
Common dental causes of odontogenic sinus tracts include endodontic or periodontal infections, trauma, retained roots and residual chronic infection of the jaws. They are uncommon, and often misdiagnosed. The sinus tracts are most frequently associated with mandibular teeth, which have been documented in 80 to 87% of the reported cases. Extraoral fistulas typically present as erythematous, symmetrical, crusting, smooth and non-tender nodules with periodic drainage. Cutaneous sinus tracts of odontogenic origin represents one among the many types of sinus tracts that may form on the face and neck region. They are usually present on the chin and cheek region. The cutaneous sinus resolves rapidly if the lesion is recognized early and diagnosed properly followed by surgical excision of sinus tract, removal of offending tooth and cutaneous closure is performed.
ABSTRACT
Objective:To study the clinical characteristics of odontogenic cutaneous fistula.Methods:6 cases of odontogenic cutane-ous fistula were represented and the reports of 60 cases of the lesion were reviewed.Results:The fistula was mainly located in cheek, chin,para-nasal part,sub-mandibular area and the lower border of the mandible,and respectively corresponding to mandibular third molar,mandibular incisor,maxillary canine,mandibular first and second molar,the corresponding teeth were mainly in mandible (71 .2%).In middle and old aged patients the lesion usually in para-nasal or mandible area,In younger patients the lesion mostly loca-ted in cheek or sub-mandibular area.After root canal therapy for the teeth with apical periodontitis or extraction of none-curable teeth,the odontogenic cutaneous sinus tract disappeared.Conclusion:Proper treatment of focal teeth can cure the odontogenic cutaneous fistulas.
ABSTRACT
Las fístulas odontogénicas son canalizaciones anormales originadas a partir de procesos infecciosos de los ápices radiculares, las cuales puede adoptar distintas morfologías en piel. Se presenta el caso de hombre de 40 años, con una lesión en mejilla derecha de 2 años de evolución. El estado de las piezas dentarias, a la inspección, era deficiente. Debido a la sospecha clínica, se solicitó una ecografía de partes blandas que fue compatible con una fístula odontogénica. Estas lesiones, muchas veces son subdiagnosticadas, lo cual limita y retrasa el tratamiento adecuado.
Odontogenic cutaneous sinus are abnormal tracts originated from infectious processes of the root canal, which can show different morphologies on the skin. We present a 40 year old man, who had a lesion on his right cheek of 2 years of duration. The tooth pieces were compromised. Due to the clinical suspicion, a soft tissue ultrasound was requested which result was consistent with odontogenic cutaneous sinus. These injuries are often underdiagnosed, limiting and delaying a proper treatment.
Subject(s)
Humans , Male , Adult , Dental Caries/complications , Cutaneous Fistula/diagnosis , Cutaneous Fistula/etiology , Diagnosis, DifferentialABSTRACT
La fístula cutánea dental es una patología de difícil diagnóstico. Se presenta como una lesión supurativa crónica e indolora, cuya localización no siempre guarda relación con la pieza dental afectada. Su diagnóstico requiere un alto índice de sospecha, que habitualmente se confirma con radiografía. Se presentan seis casos que se manifestaron con lesiones de larga evolución, con supuración intermitente y apariencia clínica variable. A todos se les realizó ecografía de partes blandas para demostrar el trayecto fistuloso. Para determinar la localización del foco osteomielítico, a dos pacientes se les solicitó además una tomografía axial computada y a otros dos una radiografía periapical. La mayoría de las fístulas tuvo su origen en la arcada dental inferior.
Odontogenic cutaneous sinus tract is a condition difficult to diagnose. It appears as a painless, chronic suppurative lesion, with a location not always related to the affected tooth. Its diagnosis requires a high index of suspicion, usually confirmed by radiography. We report six cases, all of them presenting with long lasting lesions, with intermittent drainage and variable clinical appearance. An ultrasonography was done in every patient, in order to demonstrate the sinus tract. To determine the location of the osteomyelitic focus, in two patients a computed tomography was done, and in other two a periapical radiography. Most sinus tracts were originated in the lower dental arch.
Subject(s)
Humans , Male , Adult , Female , Aged , Aged, 80 and over , Periapical Abscess/complications , Cutaneous Fistula/diagnosis , Cutaneous Fistula/etiologyABSTRACT
PURPOSE: The odontogenic sinus and fistulous tracts is the most common draining sinus and fistulous tract of the head and neck region. These are often misdiagnoses by clinicions who are not familiar with cutaneous sinus, since most of patients do not have dental symptoms. Here we present two cases of odontogenic cutaneous sinus tract which have been diagnosed after excision of epidermal cyst. METHODS: Two patients who presented with an odontogenic sinus tract draining to the skin at our institusion during the two years were enrolled in this study. We reviewed all the medical records of the patients and literature about odontogenic cutaneous sinus tract. RESULTS: Odontogenic cutaneous sinus tracts of our cases were healed after treatment of periapical odontitis and extraction of the carious tooth. CONCLUSION: The cutaneous sinus tract of dental origin is well documented condition. But its diagnosis is not always easy unless the clinicians consider the possibility of its dental origin. An understanding of the pathogenesis of odontogenic cutaneous sinus tract will lead to early correct diagnosis and proper treatment without unnecessary surgery.
Subject(s)
Humans , Diagnostic Errors , Epidermal Cyst , Head , Medical Records , Neck , Skin , Unnecessary ProceduresABSTRACT
Cutaneous sinus tract of dental origin usually arises from chronic dental infection. Because many patients with these lesions do not have any complaints of oral symptoms, the lesions are often diagnosed incorrectly and overlooked. We report two cases of cutaneous sinus tract of dental origin. One case on nasolabial fold originated from the maxillary canine periapical abscess. Another case on the mandible originated from the mandibular 2nd premolar periapical abscess. Endodontic root canal therapy resulted in complete healing of the lesions in both cases. Early correct diagnosis and treatment of the lesions can prevent unnecessary and ineffective antibiotic therapy or surgical treatment.
Subject(s)
Humans , Bicuspid , Mandible , Nasolabial Fold , Periapical Abscess , Root Canal TherapyABSTRACT
The most common cause of chronic cutaneous sinus tract in the face and neck is chronically draining dental infection. The diagnosis is easily confirmed by dental examination and dental roentgenogram of the involved area, but this disease is frequently misdiagnosed and incorrectly treated in dermatologic department. We report four cases of cutaneous sinus tract of dental origin. First patient had a painful nodule with chronically draining pus and a dimple on the left cheek. Second patient had a dimple with draining bloody fluid on the right chin. Third patient had a pea-sized papule with draining serous fluid on the left chin. Fourth patient had a fluctuant erythematous plaque with draining pus and a dimple on the left buccal area. In all four patients radiologic examination of the maxillary and mandibular regions demonstrated radioluency at the apex of tooth consistent with periapical abscess.