Odontogenic cutaneous fistula in area of the patient's chin: a case report

Aim: An odontogenic, extraoral/cutaneous fistula located in the facial or neck area is a rare symptom of a long-term, chronic infection caused by a complication of caries, dental trauma or periodontal inflammation. This article presents a case of a patient with a cutaneous fistula on the chin that healed after root canal treatment. Materials and methods: To apply an appropriate treatment that would ensure therapeutic success, a thorough examination of the patient was conducted and the correct diagnosis was made. An extraoral and intraoral examination was performed, including inspection of the soft and hard tissues, beginning with visual analysis and palpation, followed by status of pulp and periapical tissues testing, and finishing with radiological examinations. A panoramic and a periapical radiograph were taken of the mandibular incisors. In the clinical case discussed in this report, despite the prior long-term, improper medical management, a satisfactory treatment effect was finally achieved by performing an antiseptic root canal treatment of the mandibular left incisors. Results: The elimination of inflammation of the causal teeth through endodontic treatments performed led to healing of the skin lesion without surgical excision or systemic antibiotic therapy. Conclusion: In the differential diagnosis of cutaneous fistulae occurring in the facial or neck area, an odontogenic aetiology should always be taken into consideration. Keywords: aetiology, calcium hydroxide, cutaneous fistula, endodontic treatment, extraoral fistula, periapical inflammation