Cutaneous sinus tract of endodontic origin: a case report

Aim: To report an uncommon case of an extraoral sinus tract of the submandibular region caused by a molar in the mandible (tooth 47). Case report: Tooth 47 presented with an insufficient coronal restoration and an absence of pain and discomfort to pressure and palpation in the periapical region. Based on oral inspection and radiographic examination, a pulp necrosis of tooth 47 was diagnosed, which had resulted in a cutaneous sinus tract. The persistent purulent drainage of the sinus tract in the submandibular region ceased during the successful root canal treatment of tooth 47. The root canal was irrigated with copious rrigant (3% sodium hypochlorite, 0.9% sodium chloride, 2% chlorhexidine) and several intracanal calcium hydroxide dressings. Conclusion: In the presented case it was observed that it is challenging to diagnose a cutaneous draining sinus tract of endodontic origin. Thus, treatment of skin lesions of the face, and neck odontogenic infections should always be considered. Clinical and radiographic dental examinations can identify the tooth involved and may avoid unnecessary antibiotic or surgical therapies. Proper disinfection of the root canal system by chemo-mechanical instrumentation resulted in resolution of the sinus tract and promoted periapical healing of the tooth involved. This should therefore be considered as the treatment of choice when dealing with an odontogenic extraoral sinus tract. Keywords: apical periodontitis, cutaneous sinus tract, root canal treatment