Abstract Background: The presence of sinus tract has been related to chronic apical abscess that happens due to the perforation of the buccal plate of bone that affects the healing of periapical lesions. Aim: This retrospective study aimed to investigate the incidence of persistent sinus tract through clinical cases of anterior teeth indicated for apical surgery and to correlate them with the histological findings and healing rates. Materials and Methods: Eighty-four anterior teeth with persistent periapical lesions with and without sinus tract received endodontic microsurgery. The biopsies of these lesions were examined histologically to determine each lesion type. A follow-up examination was done over 2 years and healing was assessed by digital radiography. An independent-t test and a paired-t test were used for the data analysis. A 5% level of significance was recognized as a statistical difference. Results: The incidence of sinus tract occurred in 21.4% (18 cases) of the total cases. The results of the histopathological examinations of the cases with sinus tract revealed that 33% (6 cases) of the total cases were granuloma, 28% (5 cases) were chronically infected apical cysts, 22% (4 cases) were chronically inflamed tissues, 11% (2 cases) were fibrous tissue, and 1 case was ameloblastoma. The 66 cases without persistent sinus tract were classified in histopathological examination as 62.1% (41 cases) apical cysts or cystic transformations, 22.7% (15 cases) granulomas, and 15.1% (10 cases) fibrous tissues. After a 2-year follow-up for all cases, 88.09% (74 cases) were classified as successful, 7.14% (6 cases) were incomplete healing, 3.57% (3 cases) were uncertain, and 1 case was a failure. The healing state was affected by the preoperative lesion size. Conclusions: Not all cases with persistent sinus tract are associated with chronic apical abscess when examined histologically. The size of the lesion affects the success and healing rates. Over the follow-up periods, the lesions decreased in area. Finally, the presence of sinus tract adversely affects the outcome of endodontic surgery.
Khalil et al. (Wed,) studied this question.