Unusual surgical approach in a bilateral case of mandibular buccal infected cyst

In the new edition of WHO's "Histological typing of odontogenic tumors", the mandibular infected buccal cyst, that is associated with the lower first or second permanent molars, is considered a paradental cyst as well as the inflammatory collateral cyst, which is usually related to the lower third molar. The lesion occurs on the buccal and lateral aspects of the roots of mandibular molars with vital pulp, at the eruption time, in children aged between 6 and 10 years. The inflammation is always present in these cysts and may have an important role in their pathogenesis because it stimulates hyperplasia and cystic change of the reduced enamel epithelium or the epithelial cell rests of Malassez. The authors report the case of a 7-year-old girl, in whom both first mandibular molars were affected by an infected buccal cyst. A different surgical approach was performed with marsupialization on the left side and cystectomy on the right side. The case reported here seems to be interesting because it is the second well documented case of bilateral mandibular infected cyst associated with unerupted molars and because the adopted treatment differs from the therapeutical approach suggested in the literature. A 6-year follow-up demonstrates a correct dental and bone evolution on both mandibular molar sides.