title: Cutaneous Sinus Tracts of Odontogenic Origin: Two Case Reports.
abstract: BACKGROUND
  Cutaneous odontogenic fistulas or sinus tracts are frequently misdiagnosed and incorrectly treated, leading to unnecessary procedures and patient suffering. An understanding of the draining of cutaneous sinus tracts will lead to more appropriate treatment. Most cases respond to conservative, nonsurgical root canal therapy. Our objective is to report 2 cases of cutaneous sinus tract secondary to chronic periapical dental infection that were recently observed at our hospital.
  
  
  METHODS
  We present 2 cases of recurrent suppurative facial lesions that were initially misdiagnosed and treated with oral antibiotics without response.
  
  
  RESULTS
  Clinical findings included palpable facial nodules with drainage, palpable intraoral cords, and poor dentition with gingivitis; radiologic examination showed a periapical disease process consistent with dental sinus tracts. Both of the cases were referred to the maxillofacial department, where the cyst and nonrestorable teeth were extracted.
  
  
  CONCLUSIONS
  Because patients with cutaneous facial sinus tracts of dental origin often do not have obvious dental symptoms, a possible dental etiology may be overlooked. If dental origin is suspected, the diagnosis is easily confirmed by dental examination and dental roentgenograms of the involved area. Early correct diagnosis, based on radiologic evidence of a periapical root infection and treatment of these lesions can help prevent unnecessary and ineffective antibiotic therapy or surgical treatment, reducing the possibility of further complications such as sepsis and osteomyelitis.
authors.affiliation: From the Department of Dermatology, Hospital Rio Hortega, Valladolid, Spain. rosagim@hotmail.com.
authors.forename: Rosa
authors.initials: R
authors.lastname: Giménez-García
authors.affiliation: From the Department of Dermatology, Hospital Rio Hortega, Valladolid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Martinez-Vera
authors.affiliation: From the Department of Dermatology, Hospital Rio Hortega, Valladolid, Spain.
authors.forename: Leticia
authors.initials: L
authors.lastname: Fuentes-Vera
mesh_terms: D017577:Cutaneous Fistula / Q000175:diagnosis* / Q000628:therapy; D003751:Dental Fistula / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: Cutaneous Fistula; Dental; Focal Infection; Odontogenic Cysts