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.

According to the American Association of Endodontists, “a ‘true' vertical root fracture is defined as a complete or incomplete fracture initiated from the root at any level, usually directed buccolingually.” Vertical root fracture (VRF) usually starts from an internal dentinal crack and develops over time, due to masticatory forces and occlusal loads. When they occur in teeth, those types of fractures can present difficulties in diagnosis, and there are however many clinic and radiographical signs which can guide clinicians to the existence of the fracture. Prognosis, most often, is hopeless, and differential diagnosis from other etiologies may be difficult sometimes. In this paper, we present a case of VRF diagnosed after surgical exploration; the enlarged fracture line was filled with a fluid resin. A 36-month clinical and radiological follow-up showed an asymptomatic tooth, reduction of the periodontal probing depth from 7 mm prior to treatment to 4 mm with no signs of ankylosis. In this work, the diagnosis and treatment alternatives of vertical root fracture were discussed through the presented clinical case.

Résumé -Les dysplasies osseuses florides (DOF) sont des lésions ostéo-fibreuses bénignes, rares des maxillaires, qui ne sont pas de nature néoplasique. Les DOF sont habituellement asymptomatiques, leur découverte se fait donc le plus souvent fortuitement lors d'un examen radiologique de routine. Une infection peut survenir à partir d'un foyer infectieux dentaire, la DOF devient alors symptomatique et se manifeste par une douleur, une fistule, un écoulement purulent, voire la formation d'un séquestre. À travers trois cas cliniques de DOF chez des femmes tunisiennes, les auteurs essayent de faire le point sur les caractéristiques cliniques, radiologiques et histopathologiques de cette affection, ainsi que sur le diagnostic différentiel, le traitement et les éventuelles complications. Les caractéristiques cliniques, radiologiques et histopathologiques de ces 3 cas sont comparables à celles retrouvées dans la littérature. Cependant, l'attitude thérapeutique bien qu'elle réponde aux modalités conventionnelles, reste souvent soumise à l'appréciation subjective du praticien et aux exigences du patient.Abstract -Florid osseous dysplasias: from diagnosis to treatment. Three cases report. Florid osseous dysplasias (FOD) are rare benign osteofibrous lesions of the maxillae, of a non-neoplastic nature. FOD are usually asymptomatic; they are often discovered fortuitously during a routine radiological examination. However, a focal infection could occur and FOD therefore becomes symptomatic, manifesting through pain, fistula, pus, or even sequestration. The authors report three clinical cases of FOD in Tunisian women. They tried, through the three cases, to highlight the clinical and radiological characteristics, the histopathology of FOD as well as the differential diagnosis and the treatment of the possible complications. The clinical, radiological and histological characteristics are without particularities and in relation to the literature. However, although the therapeutic attitude responds to the conventional modalities, they often remain subject to the personal judgement of the practitioner and the patient's requirements.Les dysplasies osseuses (DO) sont des lésions ostéo-fibreuses bénignes, qui ne sont pas de nature néoplasique. Elles ont été décrites sous différents termes : énostoses multiples, dysplasie osseuse cémentifiante, dysplasie cémento-osseuse, cémentome. Comme la présence de cément dans ces

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Drug reaction with eosinophilia and systemic symptoms (DRESS) is a distinct part of severe cutaneous adverse reactions (SCARs). It is characterized by fever, rash, hematologic abnormalities, lymphadenopathy, or/and different degrees of visceral organ involvement. Its diagnosis is particularly challenging due to the variability of its clinical presentations and its long latency period (2–6 weeks). Allopurinol, an uric acid‐lowering drug, has been incriminated in several cases of allopurinol‐induced DRESS syndrome. Through this paper, we present a case of allopurinol‐induced DRESS syndrome with initial oral mucosal involvement. A 69‐year‐old female patient presented with an erosive cheilitis that started 1 week prior to his presentation. The cheilitis was associated with maculopapular rash and fever. She started taking allopurinol, as treatment of Gout, 6 weeks before hospitalization. The histologic findings obtained from skin biopsy were consistent with a toxic drug reaction. A complete blood count (CBC) showed a moderate eosinophilia. Alteration of renal function was also noted, and the diagnosis of allopurinol‐induced DRESS syndrome was made. Systemic corticosteroid therapy was therefore started. The patient completely recovered and had been healthy for 3 years before developing a recurrence after re‐challenge with allopurinol.

Objective: the objective of this paper is to show through a clinical case that an adequate clinical and radiographic examination should be performed before third molar removal to avoid complications especially the displaced tooth. Methods: the authors present a case report of a submandibular displacement of a mandibular third molar during extraction. Results: after standard radiological examination and a computed tomography (CT-scan) surgery for retrieving the displaced tooth was performed under general anesthesia without difficulty. Conclusion: localization with CT-scan and proper surgical methods are the keys to retrieving the displaced tooth but we must to remind dentists on ways to prevent and manage this complication.

No abstract

Periostitis ossificans is a chronic disease characterized by an ossifying periostitis, occurring in children and young adults, commonly as a reaction to a mild infection or irritation. It is also characterized by the presence of lamellae of newly formed periosteal bone outside the cortex, giving the characteristic radiographic appearance of “onion skin.” Aim. The aim of this paper was to present the clinical and radiographic findings, as well as the postoperative follow-up of two cases diagnosed with periostitis ossificans of dental origin, and to discuss the differential diagnosis and treatment modalities. Case Reports. In the first case, a 16-year-old adolescent was referred for a persistent mandibular swelling. Intraoral examination showed two sinus tracts in relation to the carious necrotic left mandibular first molar. The periapical radiograph showed a periapical lesion in relation to the two root canals of the left mandibular first molar. Occlusal radiographs revealed the “onion skin” bone formation aspect. In the second case, a 10-year-old girl presented to our department with a slightly painful mandibular swelling. The periapical radiograph showed a periapical lesion in relation to both the mesial and distal roots of the carious necrotic right mandibular first molar. Cone beam computed tomography (CBCT) showed a subperiosteal bone formation with an “onion skin” aspect. Diagnosis of periostitis ossificans in the two cases was confirmed and the lesion was resolved by simply an endodontic treatment. Conclusion. Specific attention should be given to clinical and radiographic exploration in case of children with mandibular swelling. As osteosarcoma can be misdiagnosed, additional examinations, such as computed tomography, can be useful in differential diagnosis and in searching malignancy signs.