Sinus on the chin can be the result of a chronic apical abscess due to pulp necrosis of a mandibular anterior tooth. The tooth is usually asymptomatic, and a dental cause is therefore not apparent to the patient or the unsuspecting clinician. Not infrequently, the patient may seek treatment from a dermatologist or general surgeon instead of a dentist. Excision and repair of the fistula may be carried out with subsequent breakdown because the dental pathology is not removed. This paper reports the presence of median mental sinus of dental origin in twins. One case healed following root canal therapy while the other required both root canal therapy and surgery to eliminate the infection.
This case report describes the management of a mandibular first molar with an additional distolingual root (radix entomolaris) and grade III cervical enamel projection through a multidisciplinary approach. Diagnosis for the case was endodontic-periodontal lesion due to non-vitality and associated advanced periodontal destruction. The patient was treated with drainage of the periodontal abscess with adjunct antibiotics, phase I periodontal therapy, endodontic therapy, radiculoplasty, regenerative periodontal therapy, replacement of the missing right mandibular second molar, and long-term maintenance. Follow-up of the patient up to 9 months has been uneventful. Cases of advanced periodontal destruction typically show some degree of tooth mobility, which was absent in this case. The article discusses the tripod effect as well as the increased surface area for periodontal attachment provided by the additional root contributing to the non-mobility of the involved tooth.