ODONTOJENİK KUTANÖZ FİSTÜLDE TEK SEANSTA KÖK KANAL TEDAVİSİ

Giriş: Fistül, kapalı bir alandaki enfeksiyonun epitelyal bir yüzeye açılma yolu olarak tanımlanmaktadır. Apikal periodontitisli dişler intraoral veya ekstraoral bölgeye bir fistül ile drene olabilir. Yüz derisinde drene olan bir lezyon ile karşılaşıldığında ayırıcı tanıda odontojenik köken her zaman göz önünde bulundurulmalıdır. Günümüzde odontojenik kutanöz fistüle neden olan dişlerde kök kanal tedavisinin çok seansta yapılması tercih edilmekte olup, kök kanal tedavisinin tek seansta tamamlandığı yeterli çalışma bulunmamaktadır. Olgu: 31 yaşında kadın hasta submental bölgede 8 aydır iyileşmeyen ve pürülan drenajı olan yumuşak doku lezyonu nedeniyle kliniğimize sevk edildi. Yapılan oral muayene ve radyolojik değerlendirme sonucunda ekstraoral fistül sebebinin sol alt lateral diş kökündeki lezyon olduğu tespit edildi. Sol alt lateral dişe tek seansta kök kanal tedavisi uygulandı ve 6 aylık iyileşme takibi yapıldı. Sonuç: Endodontik tedavi sonrası 2 hafta içinde ekstraoral fistül spontan olarak kapandı. 6. ay kontrolünde radyolojik olarak apikal lezyonda küçülme olduğu görüldü. Diş, hasta ağzında fonkiyonel ve asemptomatiktir. Odontojenik kutanöz fistül saptanan olgularda kök kanal tedavisinin tek seansta yapılması düşünülebilir.

SINGLE VISIT ROOT CANAL TREATMENT OF ODONTOGENIC CUTANEOUS FISTULA

Introduction: Fistula is defined as the opening way of infection in a closed area to an epithelial surface. Teeth with apical periodontitis can drain with a fistula to intraoral or extraoral area. When a draining lesion is encountered on the facial skin, odontogenic origin should always be considered in the differential diagnosis. Today, multi-session root canal treatment is preferred in teeth that cause odontogenic cutaneous fistula, and there are not enough studies in which root canal treatment is completed in a single visit. Case: A 31-year-old female patient was referred to our clinic because of a soft tissue lesion in the submental region that had not healed for 8 months and had purulent drainage. As a result of oral examination and radiological evaluation, it was determined that the cause of the extraoral fistula was a lesion in the left lower lateral tooth root. Root canal treatment was applied to the left lower lateral tooth in a single visit and a 6-month healing follow-up was performed. Result: Extraoral fistula closed spontaneously within 2 weeks after endodontic treatment. At the 6th month followup, a reduction in the apical lesion was observed radiologically. The tooth is functional and asymptomatic in the patient's mouth. Root canal treatment in a single visit can be considered in cases with odontogenic cutaneous fistula.

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