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

Abstract

-The mandibular bifurcation cyst is an uncommon lesion that was first described by Stoneman and Worth in 1983. It is a site and age-specific lesion affecting the first or second permanent mandibular molar in children between 6 and 13 years old. Even if the clinical and radiological signs are well defined, this lesion can be misdiagnosed in particular with forms which would have a spontaneous resolution. The patient care is less well defined, the range of treatments being rather wide, from the simple follow-up to the extraction of the involved tooth. Both two clinical cases presented will illustrate the diagnostic criterias associated to the buccal bifurcation cyst. The etiopathogenesis and the therapeutic decision criterias will be discussed through a literature review.Résumé -Traitement du kyste de furcation vestibulaire : à propos de 2 cas et revue de la littérature. Le kyste de furcation vestibulaire est une lésion peu commune qui a été décrit pour la première fois par Stoneman et Worth en 1983. Elle a une topographie et un âge d'apparition spécifiques en touchant uniquement les premières et secondes molaires mandibulaires permanentes chez des enfants ayant entre 6 et 13 ans. Même si les signes cliniques et radiologiques sont bien définis, ces lésions peuvent passer inaperçues notamment à certaines formes qui auraient une résolution spontanée. En revanche, la prise en charge est moins bien codifiée il existe un large éventail de traitements allant de la simple surveillance à l'élimination de la dent impliquée. Les deux cas cliniques présentés illustreront les critères diagnostiques associés au kyste de furcation vestibulaire. L'étiopathogénie et les critères de décisions thérapeutiques seront discutés à travers la revue de littérature.

Current Perspectives on Paradental Cyst: A Literature Review

“…Many authors have proposed that in the process of tooth eruption, the epithelial attachment of connective tissue may appear inflammatory areas and stimulate epithelial proliferation when the mesiobuccal cusp first penetrates the oral epithelium (Figure 4). This theory may be supported by the fact that BBC often occurs on the buccal side, and the buccal tilting of the crown afterwards [2,29,33,38,51,66]. Only when a tooth is partially or fully erupted does the inflammation have a channel to get into the periodontal pocket, so clinically a BBC is often found during eruption.…”

“…If the lesion can be completely removed, it will rarely recur and bone healing is achieved; thus, the tooth can erupt further. Until now, cases that have applied enucleation of the BBC alone with preservation of the associated tooth were followed up for 0.5 to 3 years [25,[34][35][36][37][38][39][40][41][42], and there were no returns and no need for reoperation or tooth extraction. Additionally, Gallego et al [26] reported that an interactive 3D implant planning system can better assist enucleation, which showed clear and readily visualizable view of the cyst and its relation with the molar and the neighboring neurovascular features.…”

Common Odontogenic Cysts in Pediatric Patients: Traditional Review

“…Çoğu durumda periodontal ligament aralığı değişmez veya genişlemez. 25 Kemikte ekspansiyona ve rezorpsiyona neden olabilmektedirler. 24,25 Semptomlar lezyon büyüdükten veya sekonder olarak enfekte olduktan sonra ortaya çıkabilmektedir.…”

“…25 Kemikte ekspansiyona ve rezorpsiyona neden olabilmektedirler. 24,25 Semptomlar lezyon büyüdükten veya sekonder olarak enfekte olduktan sonra ortaya çıkabilmektedir. 24 Bukkal bifurkasyon kisti genelde 6-13 yaş arası çocuklarda görülen, 1 ve 2. mandibular molar dişleri etkileyen, bölgeye ve yaşa özgü lezyonlardır.…”

“…Molar dişlerin açılanmasını değiştirebilecek bukkal bir şişliğin neden olduğu lingual tüberküllerin artan belirginliği ile birlikte görülebilmektedirler. 25 İltihaplanmanın, epitel hücrelerinin çoğalmasına ve kist oluşumuna yol açabilecek diş sürmesi esnasındaki bir bozukluktan kaynaklanabileceği düşünülmektedir. İlgili dişin sürmesinde gecikmeye veya kısmen sürmesine neden olabilmektedirler.…”