Surgical Management of an Anterior Mandibular Botryoid Odontogenic Cyst With GBR: A Case Report

The botryoid odontogenic cyst (BOC) is a rare multilocular variant of the lateral periodontal cyst (LPC), characterized by a more expansile growth pattern despite its benign nature. Whereas the LPC exhibits a very low recurrence rate, the botryoid variant is associated with a higher risk of recurrence, mainly due to its multilocular architecture. Since its first description in 1973, fewer than 100 cases have been reported in the literature.

A 40-year-old male patient, a smoker, with no significant systemic medical history, was referred for evaluation of a radiolucent lesion located between Teeth 43 and 44, incidentally detected on panoramic radiography. Complete surgical enucleation of the lesion was performed with preservation of the involved teeth, which underwent endodontic treatment and apicectomy. Given the CBCT and intraoperative evidence of buccal cortical plate loss and reduced defect containment, a selective guided bone regeneration (GBR) approach was used as an adjunct to support defect healing and soft tissue stability. Clinical and radiographic follow-up at 6, 12, and 24 months reported complete healing and no evidence of recurrence.

Complete surgical enucleation represents the treatment of choice for BOCs. Early diagnosis and long-term radiographic follow-up are essential to minimize the risk of recurrence and to ensure a favorable clinical outcome. The adjunctive GBR should not be considered routine but may be considered on an individual basis in selected defects with cortical plate loss or reduced bony containment.