Buccal Bifurcation Cyst Associated with Mandibular Second Molars: Report of Two Pediatric Cases

Bruno Teixeira Gonçalves Rodrigues; Pedro Cardoso Silva; Esther Engiel de Lima Alves Foly; Fábio Ramoa Pires; Henrique Martins da Silveira; Mônica Simões Israel; Danilo Passeado Branco Ribeiro

doi:10.5327/2525-5711.463

Autores/as

Bruno Teixeira Gonçalves Rodrigues Oral & Maxillofacial Surgery, Pedro Ernesto University Hospital, State University of Rio de Janeiro, Rio de Janeiro, Brazil. Oral Medicine, São Leopoldo Mandic School, Rio de Janeiro, Brazil. https://orcid.org/0000-0001-7678-2588
Pedro Cardoso Silva Oral & Maxillofacial Surgery, Pedro Ernesto University Hospital, State University of Rio de Janeiro, Rio de Janeiro, Brazil. https://orcid.org/0000-0002-6576-6694
Esther Engiel de Lima Alves Foly Oral Medicine, São Leopoldo Mandic School, Rio de Janeiro, Brazil. https://orcid.org/0009-0009-1067-0247
Fábio Ramoa Pires Oral Pathology, Department of Diagnosis and Therapeutics, School of Dentistry, State University of Rio de Janeiro, Rio de Janeiro, Brazil. https://orcid.org/0000-0003-0317-8878
Henrique Martins da Silveira Oral & Maxillofacial Surgery, Pedro Ernesto University Hospital, State University of Rio de Janeiro, Rio de Janeiro, Brazil. https://orcid.org/0009-0009-0882-9909
Mônica Simões Israel Oral Medicine, Department of Diagnosis and Therapeutics, School of Dentistry, State University of Rio de Janeiro, Rio de Janeiro, Brazil. Oral Medicine, São Leopoldo Mandic School, Rio de Janeiro, Brazil. https://orcid.org/0000-0002-9234-7903
Danilo Passeado Branco Ribeiro Oral & Maxillofacial Surgery, Pedro Ernesto University Hospital, State University of Rio de Janeiro, Rio de Janeiro, Brazil. https://orcid.org/0000-0001-7629-0698

DOI:

https://doi.org/10.5327/2525-5711.463

Palabras clave:

Odontogenic cyst, Jaws, Mandible

Resumen

Buccal bifurcation cyst (BBC) is an uncommon inflammatory odontogenic cyst that predominantly affects the buccal aspect of partially erupted mandibular molars in children. Because its histopathological features are nonspecific, diagnosis relies on careful clinicopathological correlation.This report describes two pediatric cases of BBC associated with mandibular second molars, including a rare bilateral presentation. Both patients presented with buccal swelling, and imaging revealed well-defined radiolucent lesions associated with vital mandibular molars. Conservative surgical enucleation with preservation of the involved teeth was performed in both cases. Histopathological examination demonstrated cystic lesions lined by non-keratinized stratified squamous epithelium with chronic inflammatory infiltrate, confirming the diagnosis when correlated with the clinical and radiographic findings. No recurrence was observed during follow-up, and spontaneous eruption of the affected teeth occurred. These cases emphasize the importance of considering BBC in the differential diagnosis of radiolucent lesions associated with vital, fully or partially erupted mandibular molars in children and adolescents. Early recognition and conservative management allow preservation of the involved teeth and result in favorable clinical outcomes.

Citas

1. Corona-Rodriguez J, Torres-Labardini R, Velasco-Tizcareño M, Mora-Rincones O. Bilateral buccal bifurcation cyst: case report and literature review. J Oral Maxillofac Surg. 2011;69(6):1694-6. doi: 10.1016/j.joms.2010.07.030.

2. Ramos LM, Vargas PA, Coletta RD, de Almeida OP, Lopes MA. Bilateral buccal bifurcation cyst: case report and literature review. Head Neck Pathol. 2012;6(4):455-9. doi: 10.1007/s12105-012-0342-y.

3. Philipsen HP, Reichart PA, Ogawa I, Suei Y, Takata T. The inflammatory paradental cyst: a critical review of 342 cases from a literature survey, including 17 new cases from the author’s files. J Oral Pathol Med. 2004;33(3):147-55. https://doi.org/10.1111/j.0904-2512.2004.00139.x

4. WHO Classification of Tumours Editorial Board. Head and neck tumours. Lyon (France): International Agency for Research on Cancer; 2022. (WHO classification of tumours series, 5th ed.; vol. 9).

5. Jajam M, Niklander S, Faúndez F, Córdova P, Martínez-Flores R. Different presentations of the Buccal Bifurcation Cyst: A case series. J Stomatol Oral Maxillofac Surg. 2023;124(3):101371. doi: 10.1016/j.jormas.2022.101371.

6. Ruddocks LA, Fitzpatrick SG, Bhattacharyya I, Islam MN, Cohen DM. Buccal bifurcation cyst: A case series and review of the literature. J Am Dent Assoc. 2022;153(5):421-428. doi: 10.1016/j.adaj.2021.10.002.

7. Stoneman DW, Worth HM. The mandibular infected buccal cyst--molar area. Dent Radiogr Photogr. 1983;56(1):1-14.

8. de Souza LL, Correia-Neto IJ, Pontes HAR, Pontes FSC, Nikitakis NG, Delli K, Pires FR, Miranda ÁMMA, Santos-Silva AR, Vargas PA, Lopes MA. Exploring mandibular buccal bifurcation cysts: a case series and a comprehensive literature review. Oral Surg Oral Med Oral Pathol Oral Radiol. 2025;139(6):e151-e159. doi: 10.1016/j.oooo.2025.01.738.

9. Aloyouny A, Albagieh H, Mansour S, Mobarak F. Case Report: Bilateral mandibular buccal bifurcation cysts. F1000Res. 2020;23;9:1502. doi: 10.12688/f1000research.28000.3.

10. Levarek RE, Wiltz MJ, Kelsch RD, Kraut RA. Surgical management of the buccal bifurcation cyst: bone grafting as a treatment adjunct to enucleation and curettage. J Oral Maxillofac Surg. 2014;72(10):1966-73. doi: 10.1016/j.joms.2014.04.028.

11. Trask GM, Sheller BL, Morton TH., Jr Mandibular buccal infected cyst in a six-year-old girl: report of case. ASDC J Dent Child. 1985;52:377–379.

12. Martinez-Conde R, Aguirre JM, Pindborg JJ. Paradental cyst of the second molar: report of a bilateral case. J Oral Maxillofac Surg. 1995;53:1212–1214. doi: 10.1016/0278-2391(95)90638-X.

13. Shohat I, Buchner A, Taicher S. Mandibular buccal bifurcation cyst: enucleation without extraction. Int J Oral Maxillofac Surg. 2003;32:610–613. doi: 10.1054/ijom.2002.0431.

14. Stanback JS., III The management of bilateral cysts of the mandible. Oral Surg Oral Med Oral Pathol. 1970;30:587–591. doi: 10.1016/0030-4220(70)90378-6.

15. Gallego L, Baladron J, Junquera L. Bilateral mandibular infected buccal cyst: a new image. J Periodontol. 2007;78:1650–1654. doi: 10.1902/jop.2007.060500.