Sinus tracts caused by endodontic infections can cause lot of pain and are difficult to treat. This case report presents a patient who was diagnosed with traumatic pulp necrosis and extensive inflammatory apical periodontitis in tooth #31. An endodontic treatment was initiated, and the working length was determined by using an apex locator. During irrigation of the root canal with saline, the irrigant was found to be squirting out of the extraoral lesion, confirming the diagnosis of a sinus tract. Chlorhexidine was preferred as an irrigant during the instrumentation procedure to avoid the risk of apical extrusion. The canal was then obturated using the lateral condensation method. The patient was followed up for 4 years, and cone beam computed tomography scans revealed no recurrence of the lesion. This case report highlights the importance of correct diagnosis and prompt management of endodontic infections to prevent the recurrence of sinus tracts and associated complications.
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