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Sinus Tract From a Dental Abscess

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The history and lesional morphology are virtually pathognomonic for a dental sinus. Radiographic examination revealed an apical dental abscess that communicated with the skin via a sinus tract.

A 17-year-old boy complained about a painful “hole” in his cheek along the jawline and an associated spontaneous purulent discharge. He was in good health and denied a history of trauma to the affected area.

Key point: This history and lesional morphology are virtually pathognomonic for a dental sinus. Radiographic examination revealed an apical dental abscess that communicated with the skin via a sinus tract, which confirmed the suspected diagnosis.


Treatment: The affected tooth was extracted and the patient given a course of oral penicillin. The sinus tract closed.

Note: The differential diagnosis includes “lump jaw” caused by Actinomycosis infection. In the former instance, examination of the purulent discharge should reveal opaque, gritty-feeling granules, and culture would likely identify the etiologic organism.

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