Mandibular Buccal Bifurcation Cyst (MBBC): A New Microsurgical and Guided Tissue Regeneration Approach-A Case Report

Mandibular buccal bifurcation cyst (MBBC) is an inflammatory cyst that typically manifests during early childhood and is positioned buccal to the furcation area of the mandibular first molars. Clinically, it manifests as a buccal inclination of the crown without associated symptoms or dental vitality loss. The diagnosis is confirmed through a combination of clinical, radiological, surgical, and histological findings.

A case of a 9-year-old boy with MBBC is presented. Molar 4.6 exhibits a buccal inclination of the crown and a palpable, nonpainful hard swelling on the vestibular side of the tooth. Radiographic and cone-beam computed tomography (CBCT) imaging revealed a lack of bone structure. A minimally invasive surgical procedure involving a micro-osteotomy was performed, which enabled the en bloc excision of the cyst. A collagen membrane was used to reconstruct the tissues through complete regeneration, in accordance with the principles of guided tissue regeneration (GTR). After a 1-year follow-up period, complete restoration of the cortical bone and the lesion area is observed on a CBCT, with a completely asymptomatic tooth.

A precise diagnosis of MBBC lesions is paramount for effective treatment, and this diagnosis must be made through clinical signs, radiographic imaging, and histology. Furthermore, it is imperative to ensure that surgical interventions are performed in a meticulous manner. A case is presented in which the lesion was treated by generating a bony microwindow to access the cyst and enucleate it in a single piece. Additionally, a collagen membrane was used to achieve complete regeneration of the lesion without interference from the soft tissues. The subsequent year of observation revealed a favorable evolution of the case, with complete regeneration of all lost tissues, including the buccal cortical.