Quiste óseo simple de resolución espontánea: reporte de caso y revisión de la literatura / Simple bone cyst of spontaneous resolution: case report and literature review

Introducción: El quiste óseo simple (QOS) es un pseudoquiste intraóseo, de etiología desconocida que representa el 1% de los quistes maxilares. Radiográficamente se observa una imagen radiolúcida de bordes bien definidos, irregulares o festoneados. Su tratamiento consiste en la exploración quirúrgica y curetaje de paredes óseas. En pocas ocasiones se ha descrito resolución espontánea. El propósito de este documento es presentar un caso de QOS de resolución espontánea y realizar una revisión de literatura.Reporte de caso:Mujer de 12 años consulta para evaluación odontológica de rutina. En radiografía panorámica se observa lesión radiolúcida entre raíces de dientes 4.4 y 4.5, de límites bien definidos corticalizados. Se complementó con tomografía computarizada de haz cónico, donde se observó adelgazamiento de tablas óseas. Se realizó un diagnóstico presuntivo de QOS. Se controló a los 3 y 3,5 años observándose hueso de leve mayor densidad que el hueso circundante.Materiales y métodos:Se realizó una revisión de literatura sobre QOS de resolución espontánea en PubMed, Scopus y Web of Science, relacionando los términos libres “simple bone cyst” “spontaneous resolution” “jaws” y sus variantes.Resultados:Se encontraron 13 casos de QOS de resolución espontánea. Las características clínicas y radiográficas de los casos coinciden con la literatura. El 54% de los casos tuvo resolución espontánea en un periodo menor o igual a 5 años.Conclusión:En el presente caso se realizó el seguimiento radiográfico del paciente, demostrando que controlar en el tiempo puede considerarse como tratamiento, ya que la lesión podría resolverse espontáneamente.(AU)

Introduction: Simple bone cyst (SBC) is an intraosseous pseudocyst, of unknown etiology, which represents 1% of maxillary cysts. Radiographically, a radiolucent image with well-defined, irregular or scalloped edges is observed. Treatment consists of surgical exploration and curettage of bone walls. Spontaneous resolution has rarely been described. The purpose of this paper is to present a case of spontaneous resolution of SBC and perform a literature review.Case Report:A 12-year-old woman attends to a routine dental evaluation. Panoramic radiography shows a radiolucent image between roots of teeth 4.4 and 4.5, of well-defined corticated borders. It was complemented with cone-beam computed tomography examination, where thinning of cortical bone was observed. A presumptive diagnosis of SBC was performed. Controls at 3 and 3,5 years were performed and bone of slightly higher density than the surrounding bone was observed.Materials and methods:A literature review on SBC of spontaneous resolution was performed in PubMed, Scopus and Web of Science, relating the free terms “simple bone cyst” “spontaneous resolution” “jaws” and their variants.Results:13 cases of spontaneous resolution of SBC were found. The clinical and radiographic characteristics of the cases coincide with the literature. 54% of cases had spontaneous resolution in a period of 5 years or less.Conclusion:In the case presented, radiographic follow-up of the patient was performed, demonstrating that following-up can be considered as treatment, since the lesion could resolve spontaneously.(AU)

Traumatic Bone Cyst of the Anterior Mandibular Region: A Case Report.

A traumatic bone cyst (TBC) is an unusual non-neoplastic pseudocystic cavity in the bone that is often asymptomatic and slow-growing. It is unexpectedly detected by regular radiography imaging. These lesions are more common in the mandible than they are in the maxilla, and they are often seen in patients older than 40 years of age. A radiolucent unilocular lesion with scalloped margins is the most common radiographic appearance. If the hollow is found to contain blood or straw-colored fluid, surgical exploration is the only way to make a conclusive diagnosis of this uncommon condition. We present a case of an asymptomatic, incidentally diagnosed (on radiograph) traumatic bone cyst in a young patient involving the mandibular anterior region with periapical radiolucency. The case was diagnosed by radiographs and histopathological evaluation.

Idiopathic Bone Cavity: Clinicopathologic Features from a Case Series with Emphasis on Differential Diagnosis of Chronic Apical Periodontitis.

INTRODUCTION: Idiopathic bone cavity (IBC) is an uncommon bone lesion that usually affects youngsters as an unilocular radiolucency with predilection for the posterior mandible. Because the lesion is frequently located in proximity to the adjacent teeth, chronic apical periodontitis is commonly included as a differential diagnosis. The aim of the present study was to analyze the clinical and radiologic features of a series of IBCs diagnosed in a single service. METHODS: All cases diagnosed as IBC were retrieved from the files of an oral pathology laboratory, and the clinical and radiologic characteristics were described with a focus on the differential diagnosis with chronic apical periodontitis. RESULTS: Thirty cases composed the final sample. The mean age of the affected patients was 22 years old; there was no sex predilection, and most lesions were located on the posterior (47%) and anterior (43%) mandible. Most lesions presented as unilocular radiolucencies (87%), and 90% were located in close association with the adjacent teeth. The associated teeth presented no endodontic involvement, and all proved to be vital. CONCLUSIONS: IBC usually affects young patients as an unilocular radiolucency in close association with the adjacent teeth. Careful radiologic analysis and vitality tests of the adjacent teeth are essential to rule out chronic apical periodontitis, thus avoiding any unnecessary endodontic treatment.

Traumatic bone cyst of mandible: a case series.

BACKGROUND: A traumatic bone cyst is an uncommon nonneoplastic lesion of the jaws that is considered as a "pseudocyst" because of the lack of an epithelial lining. This lesion is particularly asymptomatic and therefore is diagnosed by routine dental radiographic examination as a unilocular radiolucency with scalloped borders, mainly in the posterior mandibular region. The exact etiopathogenesis of the lesion remains uncertain, though it is often associated with trauma. CASE PRESENTATION: We report three Persian cases of traumatic bone cyst with different clinical and radiographic features, and we present a review of the literature to further discuss diagnostic and treatment challenges. Only one of the three patients reported a history of trauma, and despite the usual signs and symptoms of the lesion, extension of the defect to the ramus, swelling of the lingual cortex, and their unusual presence in the anterior mandible were noted in these patients. CONCLUSIONS: Because features of this cyst can be varied, careful history taking and radiographic evaluation alongside the clinical signs and symptoms have a very significant role in definitive diagnosis, appropriate treatment, and accurate assessment of prognosis.

Idiopathic bone cavity of the jaws: an updated analysis of the cases reported in the literature.

The aim of this systematic review was to compare the clinical and radiological features of solitary and multiple idiopathic bone cavities (IBCs) reported in the jaws, as well as to identify possible features that may have some influence on the frequency of persistence of IBC following treatment. An electronic search was undertaken in August 2018. Eligibility criteria included publications with sufficient clinical, radiological, and histological information to confirm the diagnosis. A total of 284 publications reporting 1253 IBCs were included. Multiple IBCs affected older patients and female patients more frequently in comparison to solitary IBCs. While trauma was more commonly found in cases of solitary IBC, scalloping around teeth, bone expansion, and persistence of the cavity following treatment were more significantly associated with multiple lesions. The most relevant factors that are suggested to influence the persistence of the cavity are 'surgical access only' in comparison to 'curettage', presence of scalloping around teeth, patients with multiple IBCs, and a larger lesion size. Solitary and multiple IBCs differ in some clinical and radiological aspects and show distinct rates of persistence following treatment. Curettage is the treatment of choice for IBCs compared to surgical access only.

Traumatic Bone Cyst of Mandible: A Case Report of Rare Entity and Review of Literature.

The traumatic bone cyst was first described by Lucas in 1929 and later by Rushton. A solitary bone cyst (SBC) is a nonneoplastic osseous lesion affecting ≥95% of the metaphyses of long bones such as the proximal humerus and femur. The incidence of cyst affecting the jaws is 1% of all the cyst. About 89% of the lesion occurs in the mandible and 11% in the maxilla. Majority of the lesions occur in the posterior mandible, especially in the premolar-molar region. In this case report, we are presenting one such case of multiple lesions of SBC in mandible with systematic review of the literature.

Cisto ósseo solitário em mandíbula: relato de caso clínico / Solitary bone cyst of the mandible: clinical case report

Objetivo: apresentar um caso clínico de paciente com cisto ósseo solitário em mandíbula e sua evolução após o tratamento de exploração e curetagem cirúrgica por meio de achados radiográficos. Caso clínico: paciente do sexo masculino, 45 anos, compareceu à clínica da Faculdade de Estudos Administrativos ­ Fead. Ao exame clínico, os tecidos se apresentavam dentro dos padrões de normalidade e ao exame radiográfico observou-se área radiolúcida unilocular, limites regulares e bem definidos em região anterior de mandíbula entre ápices dos dentes 33, 32, 31, 41 e 42, sem deslocamento desses. Para confirmação do diagnóstico, além do exame clínico, foi necessário realizar a tomografia de feixe cônico e exploração cirúrgica. Após a exploração cirúrgica foi realizada a curetagem das paredes ósseas e a proservação do caso para acompanhar a sua evolução. Considerações finais: por ser uma lesão de comportamento não agressivo, responde bem a este tipo de tratamento, sendo notável sua melhora durante o período de acompanhamento.(AU)

Objective: To present a clinical case report of a patient with solitary bone cyst of the mandible and its evolution after exploration and surgical curettage treatment through radiographic findings. Case report: A 45-year-old male patient attended the clinic of the School of Administrative Studies - FEAD. The clinical examination showed normal tissues and the radiographic examination showed unilocular radiolucent area and regular and well-defined boundaries in the anterior mandible between the apexes of teeth 33, 32, 31, 41, and 42, without displacement. To confirm the diagnosis, in addition to the clinical examination, cone beam tomography and surgical exploration were required. After the surgical exploration, bone wall curettage and case proservation were performed to monitor the evolution. Final considerations: Considering it is a non-aggressive lesion, it responds well to this type of treatment, with considerable improvement during follow-up.(AU)

Expansile radiolucent lesion of the Temporomandibular Joint-A diagnostic enigma.

Radiolucent lesions of Temporomandibular Joint (TMJ) represent a diagnostic challenge and a treatment conundrum. Biopsy of the lesions is technically difficult owing to their complex anatomy. The Differential Diagnosis (DD) includes a wide array of lesions including Simple Bone Cyst, Ameloblastoma, Central Giant Cell Granuloma, Hemangioma, Osteoblastoma, Osteochondroma, Chondroblastoma, Chondrosarcoma, Neurofibroma and metastatic malignant lesions though none has a specific predilection for TMJ. Here we present a case report of a large expansile radiolucent lesion of right TMJ in a 22 year old male patient with difficulties involved in diagnosis and management. Though cystic lesion of TMJ is uncommon it is incumbent on the Maxillofacial Surgeon for an early diagnosis and prompt management.

Traumatic bone cyst of an anterior mandible with previous symphyseal fracture in a pediatric patient: a rare finding and etiopathologic correlation.

Traumatic bone cysts (TBCs) are uncommon intraosseous lesions, classified as pseudocysts because they lack an epithelial membrane lining. The etiology of a pseudocyst has not been determined. Various hypotheses have been put forward to explain its pathogenesis, of which the traumatic-hemorrhagic theory is the most commonly accepted. Minor trauma, insufficient to cause fracture or iatrogenic injury, is commonly implicated as the stimulus initiating cyst formation. A TBC presenting after jaw fracture has been rarely reported in the literature. This article presents a case of a TBC of the anterior mandible in a child with a previous history of trauma and fracture of the symphysis. The article also reviews the literature to corroborate the possible role of major trauma in the pathogenesis of TBC.

Bony window approach for a traumatic bone cyst on the mandibular condyle: a case report with long-term follow-up.

Traumatic bone cyst (TBC) occurs preferentially on the mandibular symphysis and body, but rarely on the mandibular condyle. When TBC occurs in the condylar area, it can usually be related with or misdiagnosed as a temporomandibular joint disorder. A 15-year-old female patient visited the Temporomandibular Joint Clinic with a 5-year history of pain and noise localized in the left temporomandibular joint. On imaging, a well demarked oval-shaped radiolucent lesion was observed on the left condyle head. The patient underwent cyst enucleation and repositioning of the bony window on the lateral cortex of the affected condyle head under the impression of subchondral cyst or TBC; however, no cystic membrane was found. The bone defect resolved and showed no recurrence on the serial radiographic postoperative follow-up for 43 months after surgery.

Quiste óseo solitario mandibular. Reporte de un caso y revisión de la literatura / Solitary mandibular bone cyst. Case report and literature review

El quiste óseo solitario de la mandíbula es una cavidad intraósea sin recubrimiento epitelial, considerado un pseudoquiste, ha recibido diversas denominaciones debido a su etiología y patogenia inciertas como quiste óseo traumático, quiste óseo solitario y quiste óseo idiopático. Clínicamente suele ser una lesión asintomática, muestra bordes festoneados cuando está localizado entre las raíces dentales, es una cavidad vacía pero puede contener sangre, fluido seroso o serohemático y es descubierta en exámenes radiológicos de rutina. En este artículo se presenta un caso de quiste óseo solitario localizado en el cuerpo mandibular que acomete a un paciente femenino de 17 años de edad con tetralogía de Fallot, revelando aspectos clínicos, diagnósticos e imagenológicos y tratamiento.

Solitary bone cyst of the mandible is an intra-osseous cavity lacking epithelial lining considered a pseudocyst. Due to its uncertain etiology and pathogenesis, it has received several names such as traumatic bone cyst or idiopathic bone cyst. From a clinical perspective, it is oftentimes an asymptomatic lesion, with festooned borders when located between dental roots. It is an empty cavity but might contain blood, serous or serous-hematic fluid and can be perceived in routine X-ray examinations. The present article describes the case of a solitary bone cyst located in the body of the mandible of a 17-year old female patient. Afflicted with Fallot's tetralogy. Clinical, diagnostic and radiologic aspects as well as treatment are described.

Bony window approach for a traumatic bone cyst on the mandibular condyle: a case report with long-term follow-up

Traumatic bone cyst (TBC) occurs preferentially on the mandibular symphysis and body, but rarely on the mandibular condyle. When TBC occurs in the condylar area, it can usually be related with or misdiagnosed as a temporomandibular joint disorder. A 15-year-old female patient visited the Temporomandibular Joint Clinic with a 5-year history of pain and noise localized in the left temporomandibular joint. On imaging, a well demarked oval-shaped radiolucent lesion was observed on the left condyle head. The patient underwent cyst enucleation and repositioning of the bony window on the lateral cortex of the affected condyle head under the impression of subchondral cyst or TBC; however, no cystic membrane was found. The bone defect resolved and showed no recurrence on the serial radiographic postoperative follow-up for 43 months after surgery.

Cisto ósseo simples: relatos de casos / Simple bone cyst: case reports

Geralmente diagnosticado em radiografias de rotina, o cisto ósseo simples ocorre com pouca freqüência. A etiologia é desconhecida e o diagnóstico diferencial pode estar associado com cisto dentígero, tumor odontogênico ceratocístico, tumor odontogênico adenomatóide, ameloblastoma e granuloma central de células gigantes. O tratamento é cirúrgico, através de perfuração do osso cortical. Na maioria dos casos, de uma cavidade vazia, sem qualquer cápsula ou revestimento epitelial, são encontrados, mas pode ter conteúdo líquido. A perfuração do osso cortical mandibular provoca uma resposta que resulta com a reparação óssea da cavidade vazia. Este artigo analisa o assunto e apresenta dois casos desta entidade e discute os possíveis fatores interferentes no processo de cura da lesão... (AU)

Usually diagnosed in routine radiographs, the simple bone cyst occurs infrequently. Etiology is unknown and differential diagnosis has to be made with dentigerous cyst, keratocystic odontogenic tumor, adenomatoid odontogenic tumor, ameloblastoma and central giant cell granuloma. Treatment is surgical, by perforating the cortical bone. In most cases an empty cavity, without any capsule or epithelial covering, is encountered, but it may have a liquid content. Perforation of the mandibular cortical bone elicits a response that results in bone repair of the empty cavity. This article reviews the subject and presents two cases of this entity and discusses the possible factors that could interfere in healing course... (AU)

Traumatic bone cyst of idiopathic origin? A report of two cases.

BACKGROUND: Traumatic bone cyst (TBC) is an uncommon non-epithelial lined cavity of the jaws. Traumatic bone cysts have been reported in the literature under a variety of names: solitary bone cyst, haemorrhagic bone cyst, extravasation cyst and simple bone cyst. The multitude of names applied to this lesion implies the lack of understanding of the true aetiology and pathogenesis. However, the term "traumatic bone cyst" is the most widely used name today (1). CASE DETAILS: A 15 years old male patient presented with a complaint of swelling with mild, intermittent and non-radiating pain in the lower left back teeth region. There was expansion of the buccal cortical plate. Radiograph showed a multilocular lesion straddling between the roots of the teeth. In addition, 21 years old male patient came with a complaint of swelling with mild, continuous pain in the lower left jaw region. OPG showed well defined radiolucency with scalloped borders extending from the periapical region of the 1(st) premolar until the 2(nd) molar. The radiolucency was seen extending between the roots of the involved teeth. CONCLUSION: The majority of TBCs are located in the mandibular body between the canine and the third molar. Clinically, the lesion is asymptomatic in the majority of cases and is often accidentally discovered on routine radiological examination, usually as a unilocular radiolucent area with a "scalloping effect". Since material for histologic examination may be scanty or non-available it is very often difficult for a definite histologic diagnosis to be achieved (1).

Solitary bone cysts-A rare occurrence with bilaterally symmetrical presentation.

Solitary bone cysts (SBCs) are bone cavities that lack a true epithelial lining. They are more commonly seen during the first 2decades of age.Very few cases have been reported over 40 years of age.SBCs are usually discovered as an accidental coexisting finding during a routine radiologic examination or during another unrelated dental complaint. They present as a unilocular or multilocular radiolucent lesion associated with vital teeth with mild or no cortical expansion. Bilateral presentation is however very rare. We present a case of 52-year-old female patient with bilateral presentation of SBCs.

Pathologic fracture of the mandible secondary to traumatic bone cyst.

The traumatic bone cyst (TBC) is an uncommon and poorly understood lesion. First described in 1929, TBCs lack an epithelial lining, typically occur during the second decade of life, and are most frequently located in the jaw. Although the majority of TBCs are asymptomatic, rarely a TBC can cause a pathologic fracture of the mandible. We present a case of an adolescent suffering a sports-related pathologic mandible fracture secondary to a traumatic bone cyst.

Cisto ósseo traumático em pacientes submetidos ao tratamento ortodôntico / Traumatic bone cyst in patients undergoing orthodontic treatment

Este artigo objetivou avaliar a prevalência do cisto ósseo traumático (COT) por meio da coincidência entre o diagnóstico do COT e o paciente que se apresenta para tratamento ortodôntico. A amostra constou de 12.805 pacientes oriundos de clínicas privadas, cursos de graduação e pós-graduação recrutados no período de 1990 e 2009. Inicialmente, cada profissional foi calibrado com radiografias panorâmicas que não fizeram parte da pesquisa, sobre as características e o diagnóstico de COT. O método consistiu na aplicação de um questionário objetivo, respondido por ortodontistas, com o objetivo de avaliar a prevalência de cisto ósseo traumático no contingente total de pacientes de cada profissional. O questionário de avaliação interrogou cada profissional sobre o número total de pacientes, bem como a quantidade de pacientes com diagnóstico de COT, após a criteriosa avaliação dos exames radiográficos panorâmicos. Evidenciou-se uma prevalência de 0,02% de cisto ósseo traumático na população estudada. A prevalência de COT foi muito baixa (1 em cada 4268 pacientes ortodônticos examinados), entretanto, por ser uma lesão assintomática, é de fundamental importância a realização de exames imaginológicos a partir dos 10 anos de idade para o seu diagnóstico.

His article aimed to assess the prevalence of traumatic bone cyst (TBC) in patients undergoing orthodontic treatment based on the evaluation of panoramic x-rays. The sample was composed of 12.805 patients from private practices, graduation and post-graduation programs recruited between 1990 and 2009. At first, each professional was calibrated with panoramic radiographs that were not part of the research on the characteristics and diagnosis of TBC. The method consisted on a objective questionnaire answered by orthodontists with the aim of evaluating the prevalence of traumatic cyst bone on the patients from each professional. The evaluation questionnaire asked each professional about the total number of patients as well as the number of patients diagnosed with TBC, after careful evaluation of panoramic radiographs. A prevalence of 0.02% of traumatic bone cyst (TBC) was found in the investigated population. The prevalence of TBC was very low (1 out of 4268 orthodontic patients examined). However, since TBC is an asymptomatic lesion it is of paramount importance to establish its diagnosis by having imaging examinations performed starting at age 10.

Management of traumatic bone cyst in a 3-year-old child: a rare case report.

The following case report describes a case of traumatic bone cyst (TBC) with classical clinical features occurring as a rare combination in a very young female patient with a traumatic etiology and its management using acrylic splint postsurgery. How to cite this article: Banda NR, Nayak UA, Vishwanath KH, Sharma DS, Khandelwal V. Management of Traumatic Bone Cyst in a 3-Year-Old Child: A Rare Case Report. Int J Clin Pediatr Dent 2012;5(3):213-216.

Traumatic bone cyst?: report of a case diagnosed after orthodontic treatment / Cisto ósseo traumático?: relato de caso diagnosticado após tratamento ortodôntico

Traumatic bone cyst is an uncommon lesion that may be incidentally diagnosed in routine dental treatment. Clinical features may comprehend asymptomatic lesion, with no bone expansion, most commonly located on the posterior mandible area. The lesion affects most often patients on second decade of life. Radiographically traumatic bone cyst it is manifested as a well-defined radiolucent area with a festooned pattern around the apexes of the adjacent teeth. Routine radiographies play an important role in diagnosing this lesion. In most of the cases the diagnosis is confirmed by the finding of an empty cavity during surgical management. Simple exploration of the cyst may be the curative procedure for this lesion. The present study reports a clinic case in which traumatic bone cyst had been diagnosed during final documentation at the end of the orthodontic treatment.

O cisto ósseo traumático é uma condição incomum que pode ser diagnosticada ao acaso em tratamento odontológico de rotina. Os aspectos clínicos envolvem lesão assintomática, sem expansão óssea, mais comumente localizada na região posterior da mandíbula, afetando preferencialmente indivíduos na segunda década de vida. Radiograficamente, o cisto ósseo traumático apresenta uma área radiolúcida bem definida, com padrão festonado ao redor dos ápices dos dentes adjacentes. As radiografias de rotina cumprem papel importante na identificação da lesão. A confirmação do diagnóstico é geralmente confirmada no ato cirúrgico, quando uma cavidade vazia é encontrada. Este relato de caso envolve uma situação clínica em que o cisto ósseo traumático foi diagnosticado a partir da documentação radiográfica ao final de um tratamento ortodôntico.