Chen Ke, Liang Yun, Xiong Huacui
From the Department of Stomatology of Guangzhou Women and Children's Medical Center (KC,YL,HX); and Medicine School of Jinan University (YL), Tianhe District, Guangzhou, Guangdong, China.
Medicine (Baltimore). 2016 May;95(20):e3662. doi: 10.1097/MD.0000000000003662.
Odontogenic cutaneous sinus tracts (OCSTs) are generally primarily misdiagnosed and inappropriately treated by virtue of their rarity and the absence of dental symptoms. Accurate diagnosis and treatment and the elimination of the source of infection can reduce the incidence of complications and relieve the pain of the patient.In this case report, we present the case of an 11-year-old patient with an apparent abscess but an unobvious draining sinus tract in his left cheek. Intraorally, a glass-ionomer-cement filling on the occlusal surface of the left mandibular first molar (tooth 36) was noted. Radiographic examination revealed a radiopaque mass inside the crown and pulp chamber and an irregular, radiolucent periapical lesion surrounding the distal root apex. He was diagnosed with an OCTS secondary to a periapical abscess of tooth 36. Precise root canal therapy (RCT) and chronic granuloma debridement was performed; 6 months later, the abscess and sinus had healed completely, and the periapical lesion had resolved.Odontogenic cutaneous sinus tracts are uncommon in the clinic. This case report reminds us of the significance of OCSTs and provides some implications for their diagnosis and treatment.
牙源性皮肤窦道（OCSTs）通常因其罕见性以及缺乏牙科症状而被误诊和不恰当地治疗。准确的诊断和治疗以及消除感染源可以降低并发症的发生率并减轻患者的痛苦。在本病例报告中，我们介绍了一名11岁患者的病例，该患者左侧脸颊有明显脓肿但引流窦道不明显。口腔内，发现左下颌第一磨牙（36号牙）咬合面有玻璃离子水门汀充填物。影像学检查显示牙冠和牙髓腔内有不透光团块，远中根尖周围有不规则的透光性根尖周病变。他被诊断为继发于36号牙根尖脓肿的OCSTs。进行了精确的根管治疗（RCT）和慢性肉芽肿清创术；6个月后，脓肿和窦道完全愈合，根尖周病变也已消退。牙源性皮肤窦道在临床上并不常见。本病例报告提醒我们OCSTs的重要性，并为其诊断和治疗提供了一些启示。
