The cutaneous sinus tract is an uncommon disease. Occasionally dental problem cause the pathologic breaking out from intrabony lesion of maxilla or mandible directly to skin drainage, swelling, or abscess. It is difficult to diagnose exactly of odontogenic cutaneous sinus tract for dentists or dermatologists except experienced clinicians or previously known clinicians. It is often misdiagnosed as warts, acne, dermatitis, or even malignant. Once patients were misdiagnosed, many patients may be treated with repeated surgical excisions, biopsies, and antibiotic medications, but most of them could be frustrated with the recurrence of disease. There are several methods for differential diagnosis of odontogenic cutaneous sinus tract - such as GP cone tracing, conventional computed tomography(CT), periapical x-ray imaging, and cone beam computed tomography(CBCT). If proper dental diagnosis and treatment is provided, cutaneous sinus tract can be healed without complications and recurrences. This case report describes the diagnosis and treatment of odontogenic cutaneous sinus tract that referred from medical doctors.
Dr. Berkay Tolga Suer has completed his graduate degree at the age of 22 years from Aegean University and pHD degree from Gulhane Military Medical Academy (GATA) at Ankara. He is a clinical associate professor of the oral and maxillofacial surgery department at GATA Haydarpasa Teaching Hospital in Istanbul. He has published more than 30 papers in reputed journals.
The term of odontogenic keratocyst was first coined by Philipsen in 1956. Lately World Health Organisation (WHO) is designated this lesion as a keratocystic odontogenic tumour (KOT) due to its aggressive and infiltrative behavior. Historically, this lesion is treated by the way of enucleation, marsupialization, peripheral ostectomy, resection or combination of these modalities. Because of its high recurrence rate, clinitians has been tried different modalities alternative to aggressive resection. Technique. 31-year-old otherwise healthy male patient was referred to our department from the department of corrections with incidental findinds of a big radiolusent lesion on his mandible after a altercations between inmates. Patient’s medical history revealed that the patient was treated for KOT in the same location 4 years ago in our facility. Patient file showed that the intial treatment modality for KOT was marsupialization only and it took about 12 months and resulted with full resolution of the lesion. Afterwards, the patient haven’t showed up any follow-up examination due to his incarceration. The radiographic examination showed a big radiolusent lesion on the patients left mandibular angulus and corpus region. The patient was admitted to our clinic. due to recurrence of the first KOT, treatment modality for this lesion was changed. Enucleation, aggressive curettage and Carnoy solution application was adopted as the treatment modality. This case once proven that the utilization of the marsupialization for KOT treatment is the least acceptable definitive treatment due to high recurrence rate of this lesion.