Simultaneous Intraoral and Extraoral Sinus Tracts Associated with a Mandibular Second Molar: A Case Report

Abstract

Aim: The aim of this case report is to present the diagnostic process, nonsurgical endodontic treatment, and 12-month clinical and radiographic follow-up findings of a mandibular right second molar associated with simultaneous intraoral and extraoral sinus tracts. Case Report: A 21-year-old female patient with no known chronic systemic disease was referred to the endodontics clinic for evaluation of a possible odontogenic source of infection after being hospitalized for septic shock. Based on a detailed medical and dental history, clinical examination, pulp sensibility tests, periapical and panoramic radiographs, and cone-beam computed tomography findings, the pulpal diagnosis for tooth #47 was established as pulp necrosis, while the apical diagnosis was chronic apical abscess, accompanied by intraoral and extraoral sinus tract formation. Following chemomechanical preparation and intracanal medication with calcium hydroxide–chlorhexidine, root canal treatment was completed using gutta-percha and a resin-based root canal sealer. Clinical and radiographic follow-up examinations revealed marked healing of the intraoral and extraoral sinus tracts, a reduction in the size of the periapical lesion, and osseous healing. Conclusion: This case highlights the importance of considering a possible odontogenic source in the differential diagnosis of persistent cutaneous sinus tracts in the head and neck region and documents a favorable clinical and radiographic outcome following nonsurgical endodontic treatment.

Keywords

• Chronic Apical Abscess
• Endodontic Treatment
• Extraoral Sinus Tract
• Intraoral Sinus Tract
• Septic Shock

Supporting Institution

No financial support was received for this study.

Project Number

Not applicable

Ethical Statement

This case report was prepared in accordance with the principles of the Declaration of Helsinki. Institutional ethics committee approval was not required for a single-patient case report. Written informed consent was obtained from the patient for the publication of the clinical information and images.

Thanks

None.

Mandibular İkinci Molar Diş ile İlişkili Eş Zamanlı İntraoral ve Ekstraoral Sinüs Yolları: Bir Olgu Sunumu

Abstract

Amaç: Bu olgu sunumunun amacı, eş zamanlı intraoral ve ekstraoral sinüs yolları ile ilişkili mandibular sağ ikinci molar dişin tanı sürecini, cerrahi olmayan endodontik tedavisini ve 12 aylık klinik-radyografik takip bulgularını sunmaktır. Olgu Sunumu: Bilinen kronik sistemik hastalığı bulunmayan 21 yaşında kadın hasta, septik şok nedeniyle hastaneye yatırıldıktan sonra olası odontojenik enfeksiyon odağının değerlendirilmesi amacıyla endodonti kliniğine yönlendirilmiştir. Ayrıntılı tıbbi ve dental anamnez, klinik muayene, pulpa duyarlılık testleri, periapikal ve panoramik radyografi ile konik ışınlı bilgisayarlı tomografi değerlendirmesi sonucunda; pulpa nekrozu ile ilişkili kronik apikal apse ve eşlik eden intraoral ve ekstraoral sinüs yolu oluşumu tanısı konulmuştur. Kemomekanik preparasyon ve kalsiyum hidroksit–klorheksidin ile intrakanal medikasyonu sonrası; güta-perka ile rezin esaslı kanal patı kullanılarak kök kanal tedavisi tamamlanmıştır. Klinik ve radyografik takiplerde intraoral ve ekstraoral fistül yollarında belirgin iyileşme, periapikal lezyonda küçülme ve kemik iyileşmesi saptandı. Sonuç: Bu olgu, baş-boyun bölgesindeki persistan kutanöz sinüs yollarının ayırıcı tanısında olası bir odontojenik kaynağın değerlendirilmesinin önemini vurgulamakta ve cerrahi olmayan endodontik tedavi sonrasında elde edilen olumlu klinik ve radyografik sonucu belgelemektedir.

Keywords

• Ekstraoral Sinüs Yolu
• Endodontik Tedavi
• İntraoral Sinüs Yolu
• Kronik Apikal Apse
• Septik Şok

Supporting Institution

Bu çalışma için herhangi bir kurum veya kuruluştan mali destek alınmamıştır.

Project Number

Not applicable

Ethical Statement

Bu olgu sunumu, Helsinki Bildirgesi ilkelerine uygun olarak hazırlanmıştır. Tek hastaya ait olgu sunumları için kurum etik kurul onayı gerekmemektedir. Hastadan klinik bilgilerin ve görüntülerin yayımlanması için yazılı bilgilendirilmiş onam alınmıştır.

Thanks

Teşekkür edilecek kişi veya kurum bulunmamaktadır.

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