Nasal Fistula Associated With Dental Infection Following Severe Tooth Injury: A Case Study

Dental pulp infection is predominantly initiated by anaerobic, gram-negative bacterial flora introduced through dental caries, operative dental procedures, or severe tooth injury, which can lead to pulp necrosis. A 39-year-old man developed an extra-nasal sinus tract on the right side of the nostril following trauma to the right maxillary central incisor. He presented with a chief complaint of a painful mass inside the right nostril after the right maxillary central incisor was traumatized in a fall down the stairs. A diagnosis of a periapical abscess with a sinus tract on the right side of the nostril was made. The patient was managed with endodontic treatment of the non-vital maxillary central incisor followed by debridement of the periapical lesion, resulting in complete resolution of the lesion and nasal swelling. Clinicians should be aware of both odontogenic and non-odontogenic causes of lesions associated with sinus pathologies and should carefully evaluate the pathways of infection through thorough clinical and radiographic examination.