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Fistula, odontogenicK09.0

Author:Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

dental sinus; Fistula; Odontogenic facial fistula; Odontogenic fistula

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HistoryThis section has been translated automatically.

Brown, 1839

DefinitionThis section has been translated automatically.

Fistula originating from periodontal infections and root tip granulomas, mostly localized in the lower jaw area (80%), especially in children and adolescents.

EtiopathogenesisThis section has been translated automatically.

Periapical abscesses of the root tip (mostly of teeth with deep carious lesions, extensive fillings) or chronic granular inflammation in caries, with pulpitis and infestation of the root tip area. Jaw growth that has not yet been completed and tooth roots that are very deep in the bone base favour the breakthrough to the outside.

ManifestationThis section has been translated automatically.

Almost exclusively occurring in children and adolescents up to the age of 20.

LocalizationThis section has been translated automatically.

Especially lower jaw: areas distal and medial to the muscle loop of the masseter muscle, chin, floor of the mouth; more rarely upper jaw (nasolabial fold).

Clinical featuresThis section has been translated automatically.

Initially diffuse, later described redness and swelling, fluctuation, pressure and spontaneous pain. Finally perforation with diminishing or disappearing symptoms. Persistence of a small opening surrounded by reddish granulation tissue.

DiagnosisThis section has been translated automatically.

Display of the fistula tract (X-ray contrast).

Differential diagnosisThis section has been translated automatically.

Boils, folliculitis, actinomycosis of the skin, lymphadenitis tuberculosa.

TherapyThis section has been translated automatically.

Restoration of the tooth (if necessary extraction) usually with root tip extraction by the dentist. Excision or curettage of the fistula and the tissue scarred by the chronic inflammation. Resulting scarred retractions on the facial skin can be corrected plastically and surgically after healing.

Progression/forecastThis section has been translated automatically.

Adequate therapy almost always leads to rapid healing without complications.

LiteratureThis section has been translated automatically.

  1. Brown AM (1839) Review of Burdell and Burdell's Observations on the structure, physiology, anatomy and diseases of the teeth. On J Dent Sc 1: 19-24
  2. Chan CP et al (1998) Cutaneous sinus tracts of dental origin: clinical review of 37 cases. J Formos Med Assoc 97: 633-637
  3. Ferrera PC et al (1996) Uncommon complications of odontogenic infections. On J Emerg Med 14: 317-322
  4. Nakamura Y (1999) A case of an odontogenic cutaneous sinus tract. Int Endod J 32: 328-331
  5. Sack U et al (1992) Skin symptoms of chronic inflammation of a tooth root apex. dermatologist 43:230-232
  6. Urbani CE et al (1996) Patent odontogenic sinus tract draining to the midline of the submental region: report of a case. J Dermatol 23: 284-286
  7. Witherow H et al (2003) Midline odontogenic infections: a continuing diagnostic problem. Br J Plast Surgery 56: 173-175

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Last updated on: 29.10.2020

Author: Prof. Dr. med. Peter Altmeyer