Combined non-surgical and surgical management of misdiagnosed cutaneous sinus tract of endodontic origin – 15 months CBCT follow-up

Introduction and aim. An extraoral cutaneous sinus tract of endodontic origin represents a skin condition that appears due to an infection that could be primary or secondary to trauma accompanied by alveolar bony changes. It may be easily misdiagnosed and inappropriately treated due to lack of inadequate expertise on part of medical professionals followed by faulty treatment which can complicate the case further. Description of case. This case report intends to highlight a case of a sixteen-year-old male patient referred for an extraoral cutaneous sinus tract misdiagnosed and insufficiently treated by a general physician followed by general dentists for more than a month due to lack of proficiency in the field of endodontics. The clinical and radiographic examinations confirmed the pulpal origin due to trauma related to permanent mandibular incisors. A combination of non-surgical root canal therapy followed by periapical surgery was performed leading to a significant healing of the lesion. Conclusion. Accurate diagnosis is the key to treat draining sinus tracts of endodontic origin. Root canal treatment and endodontic surgery should be used judiciously for effectively eliminating the pathogens thus providing healing and repair mechanisms a chance to achieve the desired result.