Dental Fistula: case reports with images

Jul 11th, 2010 | Filed under Endodontics

Dental Fistula/ Cutaneous Fistula of Dental Origin/ Suppurative Apical Periodontitis/ Apical Periodontitis With Fistula.

  • Dental fistula is a communication between the oral cavity and cutaneous surface of face
  • It is a squeal of infection from dental pulp that spread beyond the apex
  • Generally it is a painless condition because when drainage occurs, pressure relieves and symptoms disappear.
  • Chronic inflammation involves apical portion of tooth’s root.
  • Drainage mostly occur within oral cavity on facial or buccal side of alveolar ridge
  • Rarely occurs on cutaneous surface of face
  • Intraoral sinus tracts are common but extra oral fistula is not common.
  • Treatment involves complete debridement and obturation of root canal or Extraction.

Case 1:

This is the case of 10 year old patient with the chief complain of draining pustule from one month. Clinical examination reveals extraorally cutaneous draining fistula, intraorally grossly carious left mandibular 1st molar. Vitality test was negative. Radiographic findings are radiolucency associated with distal root of 1st molar and open apices. gutta percha point was used to trace the fistulas tract and was confirmed from radiograph it was associated with mandibular 1st molar. Diagnosis was chronic apical abscess or suppurative periodontitis with fistula.

Cutaneous draining fistula due to dental infection from mandibular 1st molar

Infection originated from mandibular 1st molar

Periapical radiograph: Arrow indicates radiolucency associated with distal root of madibular 1st molar. Red line showing immature root apex.

Case 2:

Cutaneous fistula healed with scarring

Infection from mandibuler 2nd molar causes cutaneous fistula

Additional resources

Treatment of Oroantral Fistula: Experience With 27 Cases

Cutaneous sinus tracts (or emerging sinus tracts) of odontogenic origin: a report of 3 cases

Nonsurgical therapy of mucosal and cutaneous fistulae

Diagnosis of cutaneous sinus tract in association with traumatic injuries to the teeth 2011

Rhinolithisasis as cause of oronasal fistula

A Note On Etiology, Clinical Features And Management Of Oroantral Fistula

Diagnosis and treatment of odontogenic cutaneous sinus tracts of endodontic origin: A case report  International Journal of Dental Research, 2 (1) (2014) 8-10


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