Cutaneous dental sinus tract - Oral Mucosal Lesion
These sinus tracts occur more commonly in adults but may also be seen in children and adolescents.
Involvement of the mandibular first molars is most common in children. In contrast, the mandibular incisors are most commonly involved in adults, likely due to higher likelihood of physical activities that may result in trauma. The location of cutaneous sinus tracts will differ depending on the teeth involved.
These lesions are usually painless and without edema because continuous drainage prevents fluid accumulation and pressure. However, there may be a history of fever, pain, swelling, and intraoral drainage prior to the development of the sinus tract to the cutaneous surface.
Culturing of exudate has revealed a mix of obligate and facultative anaerobic bacteria, including Staphylococcus epidermidis, Bacteroides melaninogenicus, and Fusobacterium, Peptostreptococcus, and Veillonella species.
K04.6 – Periapical abscess with sinus
472978005 – Orocutaneous fistula
Differential Diagnosis & Pitfalls