Combined non-surgical and surgical management of misdiagnosed cutaneous sinus tract of endodontic origin – 15 months CBCT follow-up

Authors

  • Sameer Makkar Department of Conservative Dentistry and Endodontics, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh, India https://orcid.org/0000-0002-1184-5055
  • Smriti Rohilla Department of Conservative Dentistry and Endodontics, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh, India https://orcid.org/0000-0002-2746-9525
  • Sandeep Gupta Department of Conservative Dentistry and Endodontics, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh, India https://orcid.org/0000-0003-4905-9655
  • Shabnam Negi Department of Conservative Dentistry and Endodontics, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh, India
  • Monika Makkar Department of Prosthodontics, Crown and Bridge, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh, India

DOI:

https://doi.org/10.15584/ejcem.2024.2.20

Keywords:

CBCT, cutaneous sinus tracts, diagnostic errors, healing, root canal treatment, surgical management

Abstract

Introduction and aim. An extraoral cutaneous sinus tract of endodontic origin represents a skin condition that appears due to an infection that could be primary or secondary to trauma accompanied by alveolar bony changes. It may be easily misdiagnosed and inappropriately treated due to lack of inadequate expertise on part of medical professionals followed by faulty treatment which can complicate the case further.

Description of case. This case report intends to highlight a case of a sixteen-year-old male patient referred for an extraoral cutaneous sinus tract misdiagnosed and insufficiently treated by a general physician followed by general dentists for more than a month due to lack of proficiency in the field of endodontics. The clinical and radiographic examinations confirmed the pulpal origin due to trauma related to permanent mandibular incisors. A combination of non-surgical root canal therapy followed by periapical surgery was performed leading to a significant healing of the lesion.

Conclusion. Accurate diagnosis is the key to treat draining sinus tracts of endodontic origin. Root canal treatment and endodontic surgery should be used judiciously for effectively eliminating the pathogens thus providing healing and repair mechanisms a chance to achieve the desired result.

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References

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;10:05333. doi:10.1002/ccr3.5333

Cohenca N, Karni S, Rotstein I. Extraoral sinus tract misdiagnosed as an endodontic lesion. J Endod. 2003;29(12):841-843. doi: 10.1097/00004770-200312000-00015

Pasternak-Júnior B, Teixeira CS, Silva-Sousa YT, et al. Diagnosis and treatment of odontogenic cutaneous sinus tracts of endodontic origin: three case studies. Int Endod J. 2009;42:271-276. doi: 10.1111/j.1365-2591.2008.01519.x

Kreisler M, Gockel R, Aubell-Falkenberg S, et al. Clinical outcome in periradicular surgery: effect of patient- and tooth-related factors–a multicenter study. Quintessence Int. 2013;44(1):53-60. doi: 10.3290/j.qi.a28742

Bennani A, Jawad K. Cutaneous fistulas of dental origin. Afr J Dent Implant. 2018;13:8-18.

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(2):223. doi: 10.4103/jcd.jcd_56_21

Lewandowski B, Mac-Pietrasz I. Problems with diagnosis and treatment of an odontogenic fistula of facial skin. Pol Merkur Lekarski. 1997;2(8):120-121.

Gupta M, Das D, Kapur R, Sibal N. A clinical predicament–diagnosis and differential diagnosis of cutaneous facial sinus tracts of dental origin: a series of case reports. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112(6):132-136. doi: 10.1016/j.tripleo.2011.05.037

Torabinejad M, Chivian N. Clinical applications of mineral trioxide aggregate. J Endod. 1999;25(3):197-205. doi: 10.1016/S0099-2399(99)80142-3

Bogen G, Kuttler S. Mineral trioxide aggregate obturation: a review and case series. J Endod. 2009;35(6):777-790. doi: 10.1016/j.joen.2009.03.006

Torabinejad M, Corr R, Handysides R, Shabahang S. Outcomes of nonsurgical retreatment and endodontic surgery: a systematic review. J Endod. 2009;35(7):930-937.

Friedman S. The prognosis and expected outcome of apical surgery. Endodontic Topics. 2005;11:219-262.

Pavlovic V, Ciric M, Jovanovic V, Trandafilovic M, Stojanovic P. Platelet-rich fibrin: Basics of biological actions and protocol modifications. Open Medicine. 2021;16(1):446-454. doi: 10.1515/med-2021-0259

Patel S, Brown J, Pimentel T, Kelly RD, Abella F, Durack C. Cone beam computed tomography in Endodontics – a review of the literature. Int Endod J. 2019;52(8):1138-1152. doi: 10.1111/iej.13115

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Published

2024-06-30

How to Cite

Makkar, S., Rohilla, S., Gupta, S., Negi, S., & Makkar, M. (2024). Combined non-surgical and surgical management of misdiagnosed cutaneous sinus tract of endodontic origin – 15 months CBCT follow-up. European Journal of Clinical and Experimental Medicine, 22(2), 457–461. https://doi.org/10.15584/ejcem.2024.2.20

Issue

Vol. 22 No. 2 (2024)

Section

CASUISTIC PAPERS

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