Bilateral Mandibular Infected Buccal Cyst: A New Image

Abstract

The mandibular infected buccal cyst is an uncommon lesion associated with the permanent mandibular first or second molar in children just prior to tooth eruption. The World Health Organization includes this lesion under the category of paradental cyst and suggests the term "mandibular infected buccal cyst" (MIBC) for lesions that occur on the buccal surface of the permanent mandibular first molar in children approximately 6 to 8 years of age. We present the case of a patient with bilateral mandibular cyst affecting the second molars of an 8-year-old boy. To the best of our knowledge, this is the first case of bilateral MIBC published with a three-dimensional model made using an interactive three-dimensional (3D) implant planning system. An 8-year-old boy presented with swelling over the buccal gingiva of his lower left first molar. He complained of pain on chewing. Clinical examination revealed a 10-mm, firm, round swelling buccal to the lower left first molar. Computed tomography with multiplanar reconstruction of the jaws showed well-defined bilateral ovoid radiolucencies at the apices of the lower left first molar and the lower right first molar. A three-dimensional study was made using the interactive 3D implant planning system showing the presence of the cyst and its relation with the molar and the dental nerve. The treatment was to enucleate the left cyst and maintain the involved tooth. The histopathologic diagnosis of the lesion was an MIBC. The objective of the present study is to 1) familiarize dentists and oral surgeons with the entity of the MIBC; 2) show new image techniques for the diagnosis; and 3) emphasize the appropriate treatment approach.