Diagnosis and treatment of cutaneous facial sinus tracts of dental origin

Background. Cutaneous draining sinus tracts of dental origin often area dia gnostic challenge. A delay in correctly diagnosing these types of lesions c an result in ineffective and inappropriate treatment. Case Description. The authors present five cases of facial lesions that wer e initially misdiagnosed as lesions of nonodontogenic origin. The correct d iagnosis in each case was cutaneous sinus tract secondary to pulpal necrosi s and suppurative apical periodontitis. All facial sinus tracts resolved af ter the patients received nonsurgical root canal therapy. Cilnical implications. As patients with cutaneous facial sinus tracts of de ntal origin often do not have obvious dental symptoms, possible dental etio logy may be overlooked. Early correct diagnosis and treatment of these lesi ons can help prevent unnecessary and ineffective antibiotic therapy or surg ical treatment.