Bilateral Buccal Bifurcation Cyst: Case Report and Literature Review

Abstract

Buccal bifurcation cyst (BBC) is a rare inflammatory odontogenic cyst that typically occurs at the buccal region of the first or second mandibular molars of children. In the current case, a 9-year-old boy complained of an extraoral soft tissue painful swelling. Intraoral examination revealed a partial eruption of the right permanent mandibular first molar with drainage of purulent material and clinical absence of the left mandibular first molar. Panoramic radiographic and computed tomography showed two well-defined areas surrounding the mandibular first molars consistent with cystic lesions. Surgical enucleations were performed and histopathologic analysis revealed inflammatory cysts. Based on the clinical, microscopic, radiographic, and CT images, the diagnosis of bilateral BBC was established. Patient has been under follow-up for about 1 year showing normal bone repair and eruption of the involved teeth. Although BBC is uncommon, it is important to recognize this entity.

Mandibular buccal bifurcation cyst treatment: report of two cases and literature review

“…A more conservative non surgical approach (daily irrigation of the pocket with saline) has also been reported [5,7]. Marsupialization can be useful to reduce the volume of a big cyst to facilitate its enucleation later on.…”

The use of localised CBCT to image inflammatory collateral cysts: a retrospective case series demonstrating clinical and radiographic features

“…Inflammatory collateral cysts have been previously referred to as buccal bifurcation and paradental cysts in literature, along with many other synonyms (Table 2) (Wright and Vered 2017). The term buccal bifurcation cyst describes cysts situated buccal to first or second permanent molars, often during eruption in children of respective dental age (David et al 1998;Friedrich et al 2014;Ramos et al 2012). Cysts in the same position situated on third permanent molars have been described as paradental cysts; however, these terms have been used interchangeably (Thikkurissy et al 2010).…”

“…Those affecting third molars tend to present in the third decade of life due to late eruption and high tendency for impaction (Jones et al 2006;Thikkurissy et al 2010). Bilateral inflammatory collateral cysts have also been reported in literature, with the patient reported in 'case 2' an example of bilateral cyst presentation (Corona-Rodriguez et al 2011;Ramos et al 2012).…”

“…Factors that predispose to plaque accumulation such as enamel pearls at the bifurcation are likely to be contributing factors. It is rare for inflammatory collateral cysts to affect tooth vitality; hence, they can progress asymptomatically until an infectious process initiates swelling and pain, or until they are detected as incidental findings (Oenning et al 2018;Ramos et al 2012). The symptoms of pain, discomfort and trismus are mainly due to inflammation of the pericoronal tissue, especially on mandibular third molars (Chrcanovic et al 2011;El-Naggar et al 2017;Lo Muzio et al 2017).…”

“…Clinical presentation is usually of a progressively expanding swelling buccal to a developing permanent molar causing bone resorption and altering the crown's angulation. Symptoms are normally evident once the lesion has sufficiently advanced and has become acutely inflamed through an infectious process (Ramos et al 2012).…”