Patent odontogenic sinus tract draining to the midline of the submental region: report of a case.

We report a case of a 65-year-old woman with a cutaneous sinus tract located on the midline of the submental region secondary to a periapical abscess of the right lateral mandibular incisor. The lesion was nodulocystic and chronically drained purulent fluid. Previous topical and systemic treatments were uneffective. Radiologic examination of the mandible demonstrated diffuse radiolucency involving the apices of four affected incisors. A further radiologic sinogram revealed both the exact origin and the high grade patency of the fistolous tract. Appropriate conservative endodontic therapy led to quick resolution of the sinus tract within sixteen days. In the presence of a single chronic suppurative or nodulocystic lesion of the face, it is always useful to perform a radiologic evaluation of the maxillary and mandibular regions to promptly exclude a possible odontogenic background.