Midline odontogenic infections: a continuing diagnostic problem.

Cutaneous sinus tracts and facial swellings of odontogenic origin have been well documented in the literature. These lesions however continue to be incorrectly diagnosed resulting in inadequate and unnecessary treatment. This paper reports two cases of midline odontogenic infections presenting as skin lesions. Neither patient complained of dental problems, and intraoral examination failed to reveal pathology. Both had been treated over an 18-month period, undergoing multiple surgical procedures before the correct diagnosis was made. Lesions on the face can be the result of occult chronic odontogenic infection. Awareness of a possible dental cause, especially with facial lesions that recur after excision is essential. The use of vitality testing of the teeth and appropriate radiographs ensures the correct diagnosis should not be missed.