Primary molar with chronic periapical abscess showing atypical presentation of simultaneous extraoral and intraoral sinus tract with multiple stomata

• Published in: BMJ case reports Vol. 12; no. 9; p. e229039
• Main Authors: Bashar, Abul Khair Mohammad, Akter, Khaleda, Chaudhary, Govind Kumar, Rahman, Asifur
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.09.2019; BMJ Publishing Group
• Series: Case report
• Subjects: Abscesses; Anti-Bacterial Agents - therapeutic use; Antibiotics; Case reports; Child; Chronic Disease; Cutaneous Fistula - etiology; Cutaneous Fistula - therapy; Dental Fistula - etiology; Dental Fistula - therapy; Dentistry; Female; Humans; Infections; Molar; Ostomy; Periapical Abscess - complications; Periapical Abscess - therapy; Pulpectomy; Rare Disease; Sinuses; Skin; Teeth; Tooth, Deciduous; infections; dentistry and oral medicine
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2018-229039

Chronic periapical abscess drains through a sinus tract either intraorally or extraorally. However, intraoral drainage is more common than extraoral in both dentitions. Nevertheless, the simultaneous presentation of extraoral and intraoral sinus tract is very rarely reported in primary dentition. This case report discussed the management of a girl aged 7 years with a chronic periapical abscess of tooth no. 85 with both non-healing extraoral and intraoral sinus tract having multiple stomata. Non-vital pulpectomy using calcium hydroxide paste intracanal dressing was performed initially until 2 weeks without remarkable healing; then antibiotic dressing consisting of a mixture of ciprofloxacin, metronidazole and clindamycin was placed as an intracanal medicament for 1 week, which shows uneventful healing of both intraoral and extraoral sinus tract. This case report clearly indicates about how history, correct diagnosis and appropriate treatment of endodontic infection associated with sinus tract can be conservatively healed with endodontic treatment alone.