Odontogenic Cutaneous Sinus Tracts: A Clinician's Dilemma.
Facial sinus
investigations
odontogenic sinus
pulp necrosis
root canal
Journal
Indian dermatology online journal
ISSN: 2229-5178
Titre abrégé: Indian Dermatol Online J
Pays: India
ID NLM: 101586880
Informations de publication
Date de publication:
Historique:
received:
28
05
2019
accepted:
22
08
2019
entrez:
23
7
2020
pubmed:
23
7
2020
medline:
23
7
2020
Statut:
epublish
Résumé
Odontogenic cutaneous sinus tract (OCST) is one of the rare manifestations of chronic dental infections. Although well reported in literature, it is often misdiagnosed or under diagnosed. Apart from isolated case reports especially in dental literature there is a paucity of comprehensive case series on OCST. We undertook this study to observe the prevalence, clinico epidemiological features and management issues in these patients from a dermatological perspective. A retrospective study was undertaken analyzing the clinical records of patients registered at our outpatient department (OPD) from 2011 to 2018. Cases with a clinical and radiological diagnosis of odontogenic cutaneous sinus were included in the study. We studied the following variables: frequency, gender, age, localization, morphology, mean time of evolution and treatment response. 21 patients with OCST were identified from our records. Females outnumbered males; patients in the age group between 31-40 years were more commonly affected. Three morphological presentations were noted in the form of flesh-colored dry nodules with sinus, adherent plaques with mucopurulent discharge and ulcer. Posterior set of teeth were commonly affected and mandible was the commonest site for location of sinus. The time taken for appropriate diagnosis in these cases ranged from 7-16 months. Almost all the patients responded to endodontal or root canal treatment and there were no recurrences. A CST of dental origin is often a diagnostic challenge, especially in cases with minimal or no dental symptoms. A thorough skin and dental examination is required for sinuses on the head and neck area with a high index of suspicion for OCST. Most cases respond to conservative, root canal therapy. An early diagnosis can save the patient from unnecessary and ineffective therapies and sometimes surgeries.
Sections du résumé
BACKGROUND
BACKGROUND
Odontogenic cutaneous sinus tract (OCST) is one of the rare manifestations of chronic dental infections. Although well reported in literature, it is often misdiagnosed or under diagnosed. Apart from isolated case reports especially in dental literature there is a paucity of comprehensive case series on OCST.
AIMS AND OBJECTIVES
OBJECTIVE
We undertook this study to observe the prevalence, clinico epidemiological features and management issues in these patients from a dermatological perspective.
METHODS
METHODS
A retrospective study was undertaken analyzing the clinical records of patients registered at our outpatient department (OPD) from 2011 to 2018. Cases with a clinical and radiological diagnosis of odontogenic cutaneous sinus were included in the study. We studied the following variables: frequency, gender, age, localization, morphology, mean time of evolution and treatment response.
RESULTS
RESULTS
21 patients with OCST were identified from our records. Females outnumbered males; patients in the age group between 31-40 years were more commonly affected. Three morphological presentations were noted in the form of flesh-colored dry nodules with sinus, adherent plaques with mucopurulent discharge and ulcer. Posterior set of teeth were commonly affected and mandible was the commonest site for location of sinus. The time taken for appropriate diagnosis in these cases ranged from 7-16 months. Almost all the patients responded to endodontal or root canal treatment and there were no recurrences.
CONCLUSION
CONCLUSIONS
A CST of dental origin is often a diagnostic challenge, especially in cases with minimal or no dental symptoms. A thorough skin and dental examination is required for sinuses on the head and neck area with a high index of suspicion for OCST. Most cases respond to conservative, root canal therapy. An early diagnosis can save the patient from unnecessary and ineffective therapies and sometimes surgeries.
Identifiants
pubmed: 32695714
doi: 10.4103/idoj.IDOJ_261_19
pii: IDOJ-11-440
pmc: PMC7367566
doi:
Types de publication
Journal Article
Langues
eng
Pagination
440-443Informations de copyright
Copyright: © 2020 Indian Dermatology Online Journal.
Déclaration de conflit d'intérêts
There are no conflicts of interest.
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