Mucosal dental sinus tract - Oral Mucosal Lesion
This is usually a condition of adults. However, some developmental tooth malformations (such as dentinal dysplasia) predispose to necrosis of the pulp, apical abscesses and subsequent sinus tracts.
The condition is usually painless since pressure from the abscess within bone is released by drainage of pus through the tract.
Patients who are at risk for recurrent infections (e.g., patients with diabetes mellitus) are prone to develop this because of recurrent odontogenic infections. After a periapical lesion has developed from devitalization of the pulp and depending on host immune factors, the apical infection may erode through bone and break through onto the mucosal surface. Generally, the thinnest portion of the jawbone is involved and therefore the presentation is usually on the buccal aspect/facial aspect of the gingival. The same process is true for periodontal abscesses.
K04.6 – Periapical abscess with sinus
196341005 – Periapical abscess
Differential Diagnosis & Pitfalls
- The gingival "tumors" such as lobular capillary hemangioma (pyogenic granuloma), peripheral giant cell granuloma, peripheral ossifying fibroma, peripheral odontogenic fibroma and gingival fibroma are usually located on the marginal gingival.
- Gingival abscesses tend to be larger and are almost always fluctuant and tender.