The origine of a fistula can be found by putting a gutta percha point in the fistula as far as possible. With a radiograph you can see where the guttapercha point ends. Not always the origin and the place of the fistula in the oral cavity are completely corresponding.
Sometimes a fistula can be mixed up with a periodontal abscess. A sensitivity test of the pulp can help to diffrentiate.
When there is a fistula, the situation is more or less chronic. The patient does not have many complaints. Sometimes a sinus tract fistulates through the periodontal ligament. Again, sensitivity tests are needed. Careful probing is very important.
After a good endodontic treatment the fistula has to disappear within some weeks.
When there are more sinus tracts it is possible that the tooth has a (vertical) fracture.
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