ABORDAGEM TERAPÊUTICA DE LESÃO BUCAL COM POSSÍVEL ASSOCIAÇÃO DE FÍSTULA NASAL: RELATO DE CASO

Abstract

Orofacial fistulas with extraoral manifestation often have an odontogenic etiology, requiring a precise diagnostic protocol for effective treatment. This case report describes the management of a patient who presented with edema in the infraorbital region associated with a fistulous tract. Diagnosis was established through anamnesis, clinical examination, and imaging tests, including periapical radiography and cone beam computed tomography (CBCT), which identified a periapical lesion of endodontic origin in tooth 13. The initial therapeutic approach consisted of intraoral drainage of the purulent collection, followed by systemic antibiotic therapy with Amoxicillin (500mg, every 8 hours, for 7 days) to control the acute infectious process. Definitive endodontic treatment was performed using nickel-titanium rotary files under irrigation with 2.5% sodium hypochlorite and 17% EDTA, followed by obturation using the Tagger's hybrid technique. Clinical evolution showed complete regression of the extraoral edema and spontaneous closure of the fistulous tract, confirming case resolution. It is concluded that the combined management of intraoral drainage, adjunctive antibiotic therapy, and modern endodontic treatment with rotary instrumentation and hybrid obturation proved effective for resolving this clinical condition, reinforcing the importance of an evidence-based approach.