THE ETIOPATHOGENESTOMY OF INTRA-ORAL FISTULAS AND ENDODÀ”NTICO TREATMENT: CASE REPORT

Abstract

INTRODUCTION: A POSSIBLE EVOLUTION OF A PERIAPICAL INFECTIOUS PROCESS IS THE EMERGENCE OF THE OPENING OF A PATHOPATHIC CANAL BETWEEN THE ORAL CAVITY AND THE ALVEOLAR BONE THAT WILL DRAIN INTO THE ORAL MUCOSA (FISTULA). AN ETIOLOGICAL FACTOR IS FAILURE IN PRIMARY ENDODONTIC TREATMENT. ITS LOCATION IS ABLE TO INDUCE A WRONG DIAGNOSIS, SINCE IT IS NOT NECESSARY FOR THE DRAINAGE CHANNEL TO HAVE ITS OPENING IN THE TISSUE NEAR THE TOOTH INVOLVED. IT IS COMMON TO BE DISTANT, SO IT IS ESSENTIAL TO DETERMINE ITS ORIGIN THROUGH FISTULA SCREENING. OBJECTIVES: TO REPORT A CLINICAL CASE OF INTRAORAL FISTULA; UNDERSTAND THE ETIOLOGY, DIAGNOSIS AND POSSIBLE TREATMENTS FOR IT. METHODOLOGY: PATIENT A.P.P.S, 38 YEARS OLD, FEMALE, SOUGHT FACEG COE TO PERFORM PROPHYLAXIS. INTRA-ORAL PHYSICAL EXAMINATION SHOWED THE PRESENCE OF A FISTULA NEAR THE CERVICAL REGION OF ELEMENT 47, A FISTULOGRAPHY WAS PERFORMED AND AFTER RADIOGRAPHIC EXAMINATION, THE PROBABLE DIAGNOSIS WAS IATROGENIC PERFORATION OF THE FURCA. RESULTS AND DISCUSSION: THE DIAGNOSIS IN ENDODONTICS IS OF PARAMOUNT IMPORTANCE IN THE TREATMENT OF FISTULAS BEING THE MOST CONSERVATIVE AND EFFECTIVE, EVEN FISTULAS HAVING SEVERAL ORIGINS. ANAMNESIS, THOROUGH CLINICAL EXAMINATION, AND RADIOGRAPHIC EXAMINATION ARE FUNDAMENTAL FOR THE CORRECT DIAGNOSIS. TREATMENT OF FISTULAS WILL DEPEND ON THE CAUSE AND MAY INVOLVE CANAL TREATMENT IN THE TOOTH ASSOCIATED WITH INFECTION. FOR THE DISAPPEARANCE OF THE LESION TO OCCUR, THE ETIOLOGICAL AGENT SHOULD BE ELIMINATED, IN VIEW OF THIS POSSIBILITY, A CONVENTIONAL RETREATMENT WILL BE NECESSARY. CLINICAL AND RADIOGRAPHIC FOLLOW-UP AFTER TREATMENT IS INDISPENSABLE. THE USE OF ANTIBIOTICS AS AN ADJUNCT TO THE TREATMENT OF THESE ENDODONTIC INFECTIONS IS USUALLY PRESCRIBED, BUT THE VAST MAJORITY OF INFECTIONS ARE TREATED WITHOUT THE NEED FOR ANTIBIOTICS. HOWEVER, NARCOTICS ANALGESICS ARE USED TO CONTROL SEVERE PAIN KILLERS. FINAL CONSIDERATIONS: FAILURE OF ENDODONTIC TREATMENT MAY CAUSE INTRAORAL FISTULAS THAT THE PATIENT OFTEN DOES NOT COMPLAIN ABOUT BECAUSE HE DOES NOT NOTICE PAINFUL SIGNS, SINCE WHILE PURULENT SECRETION IS DRAINED, THERE WILL BE NO PRESSURE AND LOCAL PAIN. THUS, PERIODICITY TO THE DENTIST IS FUNDAMENTAL FOR DIAGNOSIS.

KEYWORDS: FISTULA. FISTULOGRAPHY. ENDODONTICS. ENDODONTIC TREATMENT.