Diagnosis of an External Dental Fistula Using Computed Tomography: A Case Report

Abstract

An external dental fistula involves formation of a fistula or granulation as an excretion pathway in the jaws or face, due to chronic purulent odontogenic inflammation. We describe a case involving a 30-year-old male patient who had an external dental fistula-like scar in the right buccal region. A diagnosis of an external dental fistula, caused by an infected right mandibular first molar, was made; endodontic therapy was performed without symptomatic improvement, and the patient was referred to our university. Tenderness in the masseter region and scarring in the right buccal region were found upon examination. Diagnostic imaging revealed a cylindrical structure suggestive of an external dental fistula in the soft tissues. Removal of the external dental fistula was performed under general anesthesia and the course was good. Patients with an external dental fistula may show symptoms for a prolonged period before a definitive diagnosis is made; however, diagnosis can be facilitated by early, accurate imaging examination.