Extraoral cutaneous sinus tracts of dental origin: A report of two pedodontic cases

Abstract

Odontogenic extraoral, cutaneous sinus is described as a path leading from an enclosed area of inflammation to an epithelial surface. The patients visit a physician first for evaluation, diagnosis, and treatment and both do not give consideration most of the times to the dental etiology. The misdiagnosis and mismanagement leading to persistence of infection can cause frustration to the patient. Successful management of the odontogenic cutaneous sinus tracts of pulpal pathology depends on proper diagnosis. However, these lesions continue to be a diagnostic quandary. Two cases of 11-year-old and 13-year-old female patients with cutaneous extraoral sinus tract have been discussed in this article. These patients were not taken seriously by the physicians, and due to their negligence, these pediatric patients had to undergo a lot of trauma. The case report describes how after proper history, diagnosis, and correct treatment by a pedodontist, the infection healed in these two different patients. Proper diagnosis is the basic requirement for the successful management of the odontogenic cutaneous sinus tracts of pulpal origin. Several case reports reveal that the appropriate diagnosis could not be made leading the incorrect treatment offered to the patients. It causes the cutaneous sinus tract to reoccur as the dental etiology is not addressed. The cutaneous sinus tracts are a rare entity in the pedodontic patients. Proper management can lead to treatment at a much earlier stage thus curbing the progression of the disease and also saving of time and expenses of the patient.

Primary molar with chronic periapical abscess showing atypical presentation of simultaneous extraoral and intraoral sinus tract with multiple stomata

“…Chronic periapical abscess in primary dentition commonly drains via the intraoral sinus tract. However, occasionally a necrosed primary tooth can drain via extraoral cutaneous sinus tract 12 13. Chronic periapical abscess in primary dentition draining simultaneously through intraoral and extraoral sinus tract is a very rare condition which is until now not reported by any study.…”