Cases reported "Dental Fistula"

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11/44. Persistent cutaneous fistula in the neck.

    A cutaneous fistula may develop from an infected tooth. The lesion usually arises without dental symptoms and for this reason is often incorrectly diagnosed. For correct diagnosis intraoral radiographs and essential. Elimination of the infectious process and curettage of the periapical lesion are indicated. Usually no further treatment is warranted.
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keywords = dental
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12/44. Periapical lesions accidentally filled with calcium hydroxide.

    AIM: To evaluate the effect of accidental and voluminous calcium hydroxide overextensions into periradicular lesions and tissues on the prognosis of periapical healing. SUMMARY: Eleven cases with periapical lesions and voluminous calcium hydroxide overextension are presented. Despite literature reports on the deleterious effects of calcium hydroxide extension in the periapical area, none of the endodontic treatments failed and surgical intervention was not indicated. KEY learning POINTS: Extensive extrusion of calcium hydroxide into the periapical tissues does not appear to comprise periapical healing. Despite this finding, the deliberate extrusion of dental materials into the apical tissues is not advocated.
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keywords = dental
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13/44. The healing potential of periodontal-endodontic lesions.

    Osseous lesions involving the periodontium, and which are sometimes associated with discomfort and pathologic changes such as swelling or the development of a sinus tract, are not always due to periodontal disease. Thus, it is not uncommon to find a dentition with generally good periodontal health but with one tooth having a severe isolated bony periodontal defect. In other cases, periodontal treatment may result in a general improvement, except in relation to one tooth which does not respond to the therapy. Very often these cases are instances of combined periodontal-endodontic lesions, but which are solely of pulpal origin. This paper serves to help the dental practitioner recognise the disease process underlying the condition and appreciate its effective management with non-surgical root canal treatment.
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keywords = dental
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14/44. Management of extra oral sinus cases: a clinical dilemma.

    The cutaneous sinus tract of dental origin is an uncommon but well documented condition. Its diagnosis is not always easy unless the treating clinician considers the possibility of its dental origin. Such patients may undergo multiple surgical excisions, biopsies, and antibiotic regimens, but all of them fail with the recurrence of the sinus tract. This is because the primary etiology is incorrectly diagnosed. This case report describes the treatment of four patients presenting with variable complaints of pain and purulent or hemorrhagic discharge from lesions of the face. Clinical and radiographic examination revealed carious teeth with radiolucent areas indicating chronic periradicular abscess. The teeth were restorable, so nonsurgical endodontic therapy was performed in all of them. No systemic antibiotic therapy was provided. The patients responded well, and the cutaneous lesions healed uneventfully. Improper diagnosis can lead to needless loss of teeth that can be otherwise maintained through timely and proper management.
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ranking = 2
keywords = dental
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15/44. Dentocutaneous fistula.

    Chronic dental infection is the most common cause of draining sinus tracts of the face and neck. These lesions can be a diagnostic challenge to the clinician who is not familiar with dentocutaneous fistula. diagnostic errors can result in multiple excisions, biopsies, and ineffective long-term antibiotic therapy. patients may require excision of the fistula once the dental abscess has been successfully treated by root-canal therapy or extraction. Nine patients are reported.
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ranking = 2
keywords = dental
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16/44. Management and prevention of retrograde peri-implant infection from retained root tips: two case reports.

    Fracture of root tips in the maxillary premolar region is not an uncommon finding because of the high incidence of bifid and root dilacerations. Therefore, a retained root tip may serve as a nidus of infection when a dental implant is placed. The likely result is the development of an implant periapical lesion. This case report shows the successful management of a rapidly developing implant periapical lesion caused by an undetected retained root tip. Initially, systemic antibiotics failed to subdue the infection. A retained root fragment was retrieved surgically, together with the implant, and a new wide-body implant was engaged with DFDBA mixed with tetracycline. A 5-month follow-up showed increased radiographic density, and clinical reentry revealed the formation of bone with a hard consistency. The second case demonstrates the management of a retained root tip via a guided bone regeneration technique when it is detected prior to or during implant placement. Finally, a systematic therapeutic approach is proposed based on 17 case reports on implant periapical lesion management.
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keywords = dental
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17/44. Odontogenic sinus tract to the neck skin: a case report.

    We describe a 22-year-old woman with neck skin sinus tract that developed as a consequence of dental infection. The patient was treated twice in an inappropriate way with recurrence of the sinus tract. We opted for an extraction of the tooth. This case illustrates the need for cooperative diagnostic referrals between physicians and dentists.
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keywords = dental
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18/44. Cutaneous draining sinus tract of odontogenic origin: unusual presentation of a challenging diagnosis.

    A 44-year-old woman presented with a chronically draining lesion on her cheek just lateral to the nasofacial sulcus. The lesion was refractory to treatment with oral antibiotics. physical examination revealed poor dentition, and a panoramic radiograph demonstrated periapical abscesses in the maxillary right lateral incisor and canine. A diagnosis of cutaneous fistula of odontogenic origin was made, and the patient was treated with tooth extraction. The cutaneous fistula subsequently resolved. Intraoral examinations and radiographs are critical for making the diagnosis of cutaneous draining sinus tract of odontogenic origin. Many patients undergo unnecessary surgical therapies before having the correct diagnosis made, but root canal therapy or surgical extraction is the treatment of choice. A dental origin must be considered for any chronically draining sinus of the face or neck.
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keywords = dental
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19/44. A case of cutaneous odontogenic sinus.

    Despite the fact that cutaneous sinus tracts of odontogenic origin are well documented, the condition is still commonly misdiagnosed, because chronic periapical periodontitis may be asymptomatic and is rarely open to the skin. A 75-year-old Japanese woman presented to our clinic with the chief complaint of a left cheek skin lesion with mild pain. physical examination revealed a subcutaneous nodule covered with erythematous skin on her left buccal region. Cultures from the subcutaneous nodule grew bacteroides species and peptostreptococcus micros but did not yield acid-fast bacilli, fungi, or actinomyces. Stains of smeared pus showed a considerable number of Gram-negative rods. The histopathological examination revealed a focal abscess formation in the lower dermis and subcutaneous tissue. Dental evaluation, including an orthopantogram, showed a radiolucent alveolar area at the left lower first molar apex, suggesting a periapical abscess. Antibiotic therapy for three weeks associated with surgical root canal therapy eliminated the subcutaneous nodule. A high degree of suspicion is required to correctly diagnose a lower facial lesion as being of odontogenic origin, and prompt dental evaluation should be considered.
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20/44. Intraoral examination in pyogenic facial lesions.

    Pyogenic cutaneous lesions of the cervicofacial region may be due to a variety of causes. One possibility that should be considered is an odontogenic infection secondary to untreated dental caries, periodontal disease or previous maxillofacial trauma. An intraoral examination is mandatory to evaluate the oral cavity for signs of pathology that may be manifested as a purulent cutaneous lesion. patients with odontogenic infection should be referred to a dentist for definitive treatment, which may consist of either endodontic therapy or extraction of the involved tooth and curettage of any abscesses or fistulous tracts.
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keywords = dental
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