Limits...
Migratory and misleading abscess of oro-facial region.

ArunKumar KV, Deepa D - J Indian Soc Periodontol (2015 Jul-Aug)

Bottom Line: Acute pericoronitis usually presents with severe localized pain, swelling and sometimes trismus.However, chronic pericoronitis and periodontal abscess produce a dull pain, moderate swelling and are occasionally seen migrating into distant sites producing fistulae intra-orally and/or extra-orally.Here, we present three such cases and their management.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Subharti Dental College and Hospital, Meerut, Uttar Pradesh, India.

ABSTRACT
Acute pericoronitis usually presents with severe localized pain, swelling and sometimes trismus. However, chronic pericoronitis and periodontal abscess produce a dull pain, moderate swelling and are occasionally seen migrating into distant sites producing fistulae intra-orally and/or extra-orally. This may quite often cause diagnostic dilemmas necessitating thorough medical and dental history, careful clinical examination and sometimes special investigations to confirm the etiology and or origin of infection. Here, we present three such cases and their management.

No MeSH data available.


Related in: MedlinePlus

(a) Preoperative extra-oral photograph showing the scar of the previous stab incision attempted by the surgeon (b) Intra-oral photograph showing the infection around the right mandibular third molar region (a and d) Computer tomograph revealing the course of the sinus tract (e-g) Intra-operative showing excision of fistula and Limberg's flap, postoperative photographs
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Figure 3: (a) Preoperative extra-oral photograph showing the scar of the previous stab incision attempted by the surgeon (b) Intra-oral photograph showing the infection around the right mandibular third molar region (a and d) Computer tomograph revealing the course of the sinus tract (e-g) Intra-operative showing excision of fistula and Limberg's flap, postoperative photographs

Mentions: A 30-year-old male patient complained of recurrent swelling and discharge from right cheek. On two occasions, patient had experienced bad breath and reduced mouth opening. Once, a stab incision and drainage was attempted extra orally by a dermatologist. Clinical features included linear depressions evident in right cheek, discharge positive on palpation. Intra oral examination revealed nothing significant except an impacted third molar with mild pericoronitis. Computed tomography revealed the entire course of the sinus tract from its site of origin to its exit on extra-oral region. Management included antibiotic therapy; extra oral fistula was traced till mandibular third molar. Surgical extraction of third molar was done, and fistula excised. Extra-oral surgical wound was treated with Limberg's flap. Healing was uneventful. Patient is under follow-up [Figure 3a–g].


Migratory and misleading abscess of oro-facial region.

ArunKumar KV, Deepa D - J Indian Soc Periodontol (2015 Jul-Aug)

(a) Preoperative extra-oral photograph showing the scar of the previous stab incision attempted by the surgeon (b) Intra-oral photograph showing the infection around the right mandibular third molar region (a and d) Computer tomograph revealing the course of the sinus tract (e-g) Intra-operative showing excision of fistula and Limberg's flap, postoperative photographs
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4555811&req=5

Figure 3: (a) Preoperative extra-oral photograph showing the scar of the previous stab incision attempted by the surgeon (b) Intra-oral photograph showing the infection around the right mandibular third molar region (a and d) Computer tomograph revealing the course of the sinus tract (e-g) Intra-operative showing excision of fistula and Limberg's flap, postoperative photographs
Mentions: A 30-year-old male patient complained of recurrent swelling and discharge from right cheek. On two occasions, patient had experienced bad breath and reduced mouth opening. Once, a stab incision and drainage was attempted extra orally by a dermatologist. Clinical features included linear depressions evident in right cheek, discharge positive on palpation. Intra oral examination revealed nothing significant except an impacted third molar with mild pericoronitis. Computed tomography revealed the entire course of the sinus tract from its site of origin to its exit on extra-oral region. Management included antibiotic therapy; extra oral fistula was traced till mandibular third molar. Surgical extraction of third molar was done, and fistula excised. Extra-oral surgical wound was treated with Limberg's flap. Healing was uneventful. Patient is under follow-up [Figure 3a–g].

Bottom Line: Acute pericoronitis usually presents with severe localized pain, swelling and sometimes trismus.However, chronic pericoronitis and periodontal abscess produce a dull pain, moderate swelling and are occasionally seen migrating into distant sites producing fistulae intra-orally and/or extra-orally.Here, we present three such cases and their management.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Subharti Dental College and Hospital, Meerut, Uttar Pradesh, India.

ABSTRACT
Acute pericoronitis usually presents with severe localized pain, swelling and sometimes trismus. However, chronic pericoronitis and periodontal abscess produce a dull pain, moderate swelling and are occasionally seen migrating into distant sites producing fistulae intra-orally and/or extra-orally. This may quite often cause diagnostic dilemmas necessitating thorough medical and dental history, careful clinical examination and sometimes special investigations to confirm the etiology and or origin of infection. Here, we present three such cases and their management.

No MeSH data available.


Related in: MedlinePlus