Dermatolojik Lezyonu Taklit Eden Odontojenik Ekstraoral Fistül Olgularının Tanısı ve Endodontik Tedavisi: Üç Olgu Sunumu

Year 2021, , 304 - 308, 01.09.2021

Safa Kurnaz , Gülsen Kiraz , Burçak Emek

https://doi.org/10.19127/bshealthscience.899153

Abstract

Odontojenik ekstraoral fistüller pulpa nekrozu sonucu oluşan ve klinik olarak farklı hastalıklarla karıştırılabilen patolojik oluşumlardır. Ekstraoral fistüllerin etkili tedavisinin yapılmasında enfeksiyon kaynağının doğru tanısının yapılması gerekmektedir. Yüz ve boyun bölgesinde görülen ekstraoral fistül varlığında dental muayene çok önemlidir. Odontojenik ekstraoral fistülleri kök kanal tedavisi uygulayarak veya gerekli durumlarda dişin çekimi ile iyileştirmek mümkündür. Bu olgu sunumu da üç farklı dişten kaynaklanan üç ayrı ekstraoral fistül vakasının tedavisini içermektedir. Ekstraoral fistüle neden olan dişlere kök kanal tedavisi uygulanmıştır. Seans aralarında kanal içi medikament olarak kalsiyum hidroksit kullanılmıştır. Vakaların uzun dönem takiplerinde ekstraoral fistüllerin tamamen iyileştiği görülmüştür. Ayrıca takip seanslarında yapılan radyografik incelemelerde periapikal dokularda iyileşme izlenmiştir.

Keywords

Ekstraoral fistül, Kalsiyum hidroksit, Kök kanal tedavisi, Kutanöz fistül, Periapikal apse

Diagnosis and Endodontic Treatment of Odontogenic Extraoral Sinus Tracts Cases Mimicking Dermatological Lesion: Three Case Reports

Abstract

Odontogenic extraoral sinus tracts are pathological formations that occur as a result of pulp necrosis and can be clinically confused with different diseases. For the effective treatment of extraoral sinus tracts, the correct diagnosis of the source of infection should be performed. In the presence of extraoral sinus tracts in the face and neck, dental examination is very important. It is possible to heal odontogenic extraoral sinus tracts with root canal treatment or tooth extraction when necessary. This case report includes the treatment of three different cases of extraoral sinus tracts which originating from three different teeth. Root canal treatments were performed to the teeth that caused extraoral sinus tracts. Calcium hydroxide was used as an intracanal medication between appointments. In the long-term follow-up of the cases, it was observed that the extraoral sinus tracts were completely healed. In addition, healings were observed in the periapical tissues in the radiographic examinations performed during the follow-ups.

Keywords

Extraoral sinus tracts, Calcium hydroxide, Root canal treatment, Cutaneous fistula, Periapical abscess

References

• Assery M, Al Shamranit S. 2011. Cutaneous facial sinus tract of dental origin: a clinical case report. Saudi Dent J, 13: 37-39.
• Boffano P, Roccia F, Pittoni D, Di Dio D, Forni P, Gallesio C. 2012. Management of 112 hospitalized patients with spreading odontogenic infections: correlation with DMFT and oral health impact profile 14 indexes. Oral Surg Oral Med Oral Pathol Oral Radiol, 113: 207-213.
• Bose R, Nummikoski P, Hargreaves K. 2009. A retrospective evaluation of radiographic outcomes in immature teeth with necrotic root canal systems treated with regenerative endodontic procedures. J Endod, 35: 1343-1349.
• Brown R, Johnson C, Melissinos E, Smith B. 1995. A large necrotic defect secondary to a cutaneous sinus tract of odontogenic origin: a case report. Compend Contin Educ Dent, 16: 362-366
• Brown RS, Jones R, Feimster T, Sam FE. 2010. Cutaneous sinus tracts (or emerging sinus tracts) of odontogenic origin: a report of 3 cases. Clin Cosmet Investig Dent, 2: 63-67.
• Cantatore JL, Klein PA, Lieblich LM. 2002. Cutaneous dental sinus tract, a common misdiagnosis: a case report and review of the literature. Cutis-New York, 70: 264-275.
• Chan C, Jeng J, Chang S, Chen C, Lin C, Lin C. 1998. Cutaneous sinus tracts of dental origin: clinical review of 37 cases. J Formos Med Assoc, 97: 633-637.
• Cohenca N, Karni S, Rotstein I. 2003. Extraoral sinus tract misdiagnosed as an endodontic lesion. J Endod, 29: 841-843.
• Foster KH, Primack PD, Kulid JC. 1992. Odontogenic cutaneous sinus tract. J Endod, 18: 304-306.
• Goomer P, Jain R. 2013. Non-surgical endodontic treatment of extraoral sinus with triple antibiotic paste and mineral trioxide aggregate obturation. Indian J Oral Sci, 4: 95-95.
• Gupta R, Hasselgren G. 2003. Prevalence of odontogenic sinus tracts in patients referred for endodontic therapy. J Endod, 29: 798-800.
• Heling I, Rotstein I. 1989. A persistent oronasal sinus tract of endodontic origin. J Endod, 15: 132-134.
• Ines K, Walid L, Nabiha D. 2017. Treatment of odontogenic cutaneous sinus tract misdiagnosed for 6 years. Dent Oral Craniofac Res, 3: 1-4.
• Jeansonne MJ, White RR. 1994. A comparison of 2.0% chlorhexidine gluconate and 5.25% sodium hypochlorite as antimicrobial endodontic irrigants. J Endod, 20: 276-278.
• Jiménez Y, Bagán JV, Murillo J, Poveda R. 2004. Odontogenıc infections, complications. systemic manifestations. Med Oral Patol Oral Cir Bucal, 9: 139-147.
• Lubit FA, Senzer J, Rothenberg F. 1976. Extraoral fistulas of endodontic origin: report of two cases. J Endod, 2: 393-396.
• Mittal N, Gupta P. 2004. Management of extra oral sinus cases: a clinical dilemma. J Endod, 30: 541-547.
• Mortensen H, Winther J, Birn H. 1970. Periapical granulomas and cysts: An investigation of 1,600 cases. Eur J Oral Sci, 78: 241-250.
• Nakamura Y, Hirayama K, Hossain M, Matsumoto K. 1999. A case of an odontogenic cutaneous sinus tract. Int Endod J, 32: 328-331.
• Pasternak‐Júnior B, Teixeira C, Silva‐Sousa Y, Sousa‐Neto M. 2009. Diagnosis and treatment of odontogenic cutaneous sinus tracts of endodontic origin: three case studies. Int Endod J, 42: 271-276.
• Sammut S, Malden N, Lopes V. 2013. Facial cutaneous sinuses of dental origin–a diagnostic challenge. Br Dent J, 215: 555-558.
• Siqueira Jr JF, Batista MM, Fraga RC, de Uzeda M. 1998. Antibacterial effects of endodontic irrigants on black-pigmented gram-negative anaerobes and facultative bacteria. J Endod, 24: 414-416.
• Slutzky-Goldberg I, Tsesis I, Slutzky H, Heling I. 2009. Odontogenic sinus tracts: A cohort study. Quintessence Int, 40: 13-18.
• Spear KL, Sheridan PJ, Perry HO. 1983. Sinus tracts to the chin and jaw of dental origin. J Am Acad Dermatol, 8: 486-492.
• Unal GC, Kaya BU. 2011. Non-Surgical Endodontic Treatment of Large Periradicular Lesions with and without Cutaneous Sinus Tract: Report of Two Cases and Review. SDU J Health Sci, 2: 89-100.
• Varol A, Gülses A. 2009. An unusual odontogenic cutaneous sinus tract to the cervical region: a case report. OHDMBSC, 8: 43-45.