ABSTRACT
No abstract available.
Subject(s)
Humans , Cutaneous Fistula , Glomerulonephritis, Membranous , Sarcoma, KaposiABSTRACT
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
Cutaneous odontogenic sinuses are the most common cause of chronic draining sinus tracts on the face and neck. These lesions present as erythematous nodules with surrounding dimples, which intermittently drain purulent fluid. Although most patients do not have dental symptoms, careful questioning of a patient's past symptoms may help the clinician identify a dental etiology. A history of toothache in the affected area that resolves without dental intervention is useful information. Clinical and radiographic examination may reveal carious teeth with radiolucent areas. Elimination of the source of infection by endodontic treatment or tooth removal results in resolution of the sinus tract, typically within 2 weeks. Early precise diagnosis and appropriate dental treatment can circumvent unnecessary and ineffective antibiotic therapy or surgical treatment. We report a case of a cutaneous odontogenic sinus in the right cheek area.
Subject(s)
Humans , Cheek , Neck , Periapical Abscess , Tooth , ToothacheABSTRACT
BACKGROUND: An odontogenic sinus tract draining to the skin is the most common type of cutaneous fistula that occurs on the face. This lesion can be a diagnostic challenge to clinicians who are not familiar with cutaneous fistula since many patients with an odontogenic sinus tract draining to the skin do not have any symptom such as toothache. OBJECTIVE: Our purpose was to determine the characteristic features of an odontogenic sinus tract draining to the skin. METHODS: Eleven patients who presented with an odontogenic sinus tract draining to the skin at the Dermatologic Department of Pusan National University Hospital during the last ten years were enrolled in this study. We reviewed all the medical records of the patients. RESULTS: The mean age was 51.8 years. The male to female ratio was 1.2:1. Nine patients (82%) had lesions on their chins or the mandibular region. The most common tooth with endodontic infection was the lower first premolar tooth (36%), and the most common clinical feature was pyogenic granuloma-like solitary papule (64%). The panoramic view showed radiolucent periapical abscesses in all the patients. Skin biopsy showed chronic granulomatous inflammation, and fistular tracts were present in three patients. Only 1 of 11 patients (9%) had toothache, and two patients had prior therapies for prosthetic dentures or caries, respectively. Nine patients (82%) were treated ineffectively, and their first visit was to adermatologic clinic (91%) or an otolaryngologic clinic (9%). After the diagnosis of odontogenic sinus tract draining to the skin, eight patients (73%) were treated completely by root canal therapy or extraction of teeth. CONCLUSION: In this study, most patients had no toothache or history of dental disease, and they were treated inappropriately, even in dermatologic clinics. The results of this study will help reduce the incidence of inappropriate management for odontogenic sinus tract draining to the skin at dermatologic departments.