Management of Odontogenic Cutaneous Fistula Secondary to Dental Abscess: Report on Two Cases

Authors

  • Ni Putu Natasha Ayu Rupayasa Oral and Maxillofacial Department, Faculty of Medicine, Udayana University
  • Nyoman Ayu Anggayanti Oral and Maxillofacial Department, Faculty of Medicine. Udayana University
  • Ni Made Ista Prestiyanti Oral and Maxillofacial Department, Faculty of Medicine. Udayana University

DOI:

https://doi.org/10.46862/interdental.v22i1.13462

Keywords:

Fistulectomy, odontogenic cutaneous fistula, dental abscess

Abstract

Introduction: Odontogenic cutaneous fistula is an abnormal pathway that causes pathologic communication between the cutaneous surface of the face skin and the oral cavity that occurs due to a chronic dental infection.

Case:  A 37-year-old male presented with frequent throbbing pain in all four wisdom teeth and a sunken scar on the lower left cheek, resulting from a carious lesion in the lower left molar. A 56-year-old female presented with a sunken scar on her cheek following the extraction of an infected upper molar.

Case Management: Both odontogenic cutaneous fistulas were treated by addressing causative tooth infection, when present, in combination with fistulectomy. On follow-up, the first patient exhibited delayed wound closure, whereas the second achieved complete closure through a combined subcutaneous and cutaneous suturing technique. The extraoral fistula may present in various forms, with dimpling or retraction resulting from adherence to underlying tissues. Accurate diagnosis of odontogenic cutaneous fistulas that are often misdiagnosed require careful history taking, clinical evaluation, and radiographic examination. Definitive management typically involves fistulectomy to resolve the extraoral lesion.

Conclusion: Odontogenic cutaneous fistulas are managed by eliminating dental infection and performing fistulectomy, with combined closure optimizing healing and aesthetic outcomes.

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References

1. Hupp, J.R., Elliss, E., and Tucker, M.R. Contemporary Oral and Maxillofacial Surgery. 7th edn. Philadelphia: Elsevier, Inc., 2019. p. 318-322.

2. Figaro, N., & Juman, S. Odontogenic cutaneous fistula: A cause of persistent cervical discharge. Case Reports in Medicine, 2018(1), 3710857. DOI : https://doi.org/10.1155/2018/3710857

3. Bruneau A, Lehner J, Bertolus C, et al. Odontogenic Cutaneous Fistula Following Wisdom Tooth Extraction: A Rare Case Report. Cureus. 2025; 17(6): e86256. DOI: 10.7759/cureus.86256

4. Taylor, R. R., Mirsky, N., Jabori, S., Verling, S., Coelho, P. G., & Thaller, S. R. Odontogenic cutaneous fistula: a zombie diagnosis. Journal of Craniofacial Surgery, 2024; 35(4), 1197-1200. DOI: 10.1097/SCS.0000000000010144

5. Srikanth, G., T Kamath, A. B. H. A. Y., Kudva, A., Singh, A., Smriti, K., & Carnelio, S. A linguoverted impacted tooth with orocutaneous fistula–a rare case report. Clujul Medical, 2018; 91(4), 479. DOI : https://doi.org/10.15386/cjmed-945

6. Xia, J., Tang, H., & Jiang, G. . A retrospective study of the clinical and imaging features of 60 cases of odontogenic cutaneous fistula. Indian Journal of Dermatology, Venereology and Leprology, 2024; 90(6), 777-781. DOI : 10.25259/IJDVL_1059_2023

7. Lee, E. Y., Kang, J. Y., Kim, K. W., Choi, K. H., Yoon, T. Y., & Lee, J. Y. Clinical characteristics of odontogenic cutaneous fistulas. Annals of Dermatology, 2016; 28(4), 417-421. DOI: https://doi.org/10.5021/ad.2016.28.4.417

8. Tsuda, T., Gonda, K., Tachi, K., & Takami, J. A Case of an External Dental Fistula Originating from a Retained Tooth Fragment in the Edentulous Maxilla. Journal of Plastic and Reconstructive Surgery. 2025; p 1-6 DOI : https://doi.org/10.53045/jprs.2025-0010

9. Bilginaylar, K. Uncommon Odontogenic Orocutaneous Fistula of the Jaw Treated with Platelet‐Rich Fibrin. Case reports in dentistry, 2017(1), 7174217. DOI : https://doi.org/10.1155/2017/7174217

10. Latifa, H., Dorsaf, T., Amira, K., Karim, J., & Nabiha, D. Surgical management of an odontogenic cutaneous sinus tract misdiagnosed for 4 years. Clinical Case Reports, 2022;10(2), e05333. DOI : https://doi.org/10.1002/ccr3.5333

11. Carvalho, M., Castro-Lopes, F., & Miroux-Catarino, A. Odontogenic cutaneous fistula. BMJ Case Reports, 2025; 18(1), e263314. DOI : 10.1136/bcr-2024-263314.

12. Chang, L. S. . Common pitfall of plastic surgeon for diagnosing cutaneous odontogenic sinus. Archives of Craniofacial Surgery, 2018; 19(4), 291.

13. Kim, N. G., Kim, J. O., Park, Y. J., Kim, J. S., Lee, Y. J., & Lee, K. S. . Cutaneous basal cell carcinoma arising in odontogenic cutaneous fistula. Archives of Craniofacial Surgery, 2017; 18(2), 141. DOI : https://doi.org/10.7181/acfs.2017.18.2.141

14. Martínez-Ortega, J. I., & Quiroga, A. N. M. Odontogenic Cutaneous Fistula: First Dermoscopic Description and a Practical Management Framework. Cureus, 2025; 17(9), e92791. DOI : 10.7759/cureus.92791

15. Chhabra, A., & Chhabra, N. Dental infection mimicking dermatological lesion: three case reports of cutaneous fistulae and sinus tracts on face. Indian Dermatology Online Journal, 2018; 9(6), 441-444.DOI : 10.4103/idoj.IDOJ_317_17

16. Mashyakhy, M. (2024). Diagnosis, treatment and recall of a poorly managed submandibular cutaneous fistula of odontogenic origin: a case report utilizing CBCT. Kuwait Medical Journal, 56(2), 161-166.D

17. Kim, Y. S., Kim, B. S., Kim, H. S., In, S. K., Yi, H. S., Kim, H. I., ... & Kim, H. Y. (2020). A Case of Odontogenic Fistula Misdiagnosed as Cutaneous Ulcer on the Alar-Facial Angle. Journal of Wound Management and Research, 16(3), 177-181. DOI : https://doi.org/10.22467/jwmr.2020.01249

18. Luo, W., Tao, Y., Wang, Y., Ouyang, Z., Huang, J., & Long, X. (2023). Comparing running vs interrupted sutures for skin closure: A systematic review and meta‐analysis. International wound journal, 20(1), 210-220. DOI : https://doi.org/10.1111/iwj.13863

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Published

2026-04-30

How to Cite

1.
Rupayasa NPNA, Anggayanti NA, Prestiyanti NMI. Management of Odontogenic Cutaneous Fistula Secondary to Dental Abscess: Report on Two Cases. interdental [Internet]. 2026 Apr. 30 [cited 2026 May 1];22(1):165-72. Available from: https://e-journal.unmas.ac.id/index.php/interdental/article/view/13462