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(TC63) Mandibular Buccal Bifurcation Cyst Mimicking Periapical Pathology: A Case Report and Diagnostic Guide

Thursday, April 3, 2025
1:00 PM – 4:00 PM EST

    Co-Author(s)

  • Adrian A. Reyes, D.M.D.

    Endodontic Resident
    Nova Southeastern University College of Dental Medicine
    Davie, Florida, United States

    • Co-Presenter(s)

  • Michael Borshov, D.M.D.

    Resident in Endodontics
    Nova Southeastern University College of Dental Medicine
    Dania Beach, Florida, United States

This abstract seeks to review the literature and present an often-underdiagnosed phenomenon: the mandibular buccal bifurcation cyst (MBBC). MBBC is a rare odontogenic inflammatory cyst reported in the literature which typically comprises 5% of all odontogenic cysts1 . This entity may present bilaterally in a significant number of patients, up to 30% of reported cases in the literature1. Enucleation without tooth extraction is the preferred treatment for MBBC. Marsupialization or periodontal irrigation are alternative treatment options that have shown great success1. There is a near zero incidence reported in adults and is typically encountered in children 4-14 years of age2,1. The present case involves a 16-year-old female that presented to the Nova Southeastern University College of Dental Medicine Postgraduate Endodontic clinic for evaluation of a suspicious radiographic finding involving the buccal aspect of tooth #18. The patient was previously seen by a private practice general dentist, who referred her to the Universities Oral Surgery Department for further evaluation. Interdisciplinary evaluation of the tooth between Oral Surgeons and Endodontic residents, along with their respective faculty determined that tooth was responsive to pulp sensibility testing potentially ruling out a lesion of Endodontic origin.  The patient was recommended to undergo biopsy and enucleation. MBBCs can pose a diagnostic challenge and endodontists are uniquely positioned to help identify MBBCs ultimately leading to accurate, timely diagnosis and management, while reducing unnecessary root canal treatment or dental extraction.