A 7-year Follow up of a Solitary Cyst on the Mandibular First Premolar: A Case Report

Aims: The principal goal of the following case report is to shed light on the importance of thorough clinical, radiological and histological examinations in order to exhibit a final diagnosis of solitary bone cyst, as well as the importance of the surgical treatment for a better outcome.

Presentation of case: A case of solitary cyst was identified accidentally in the mandibular right premolars’ region of an asymptomatic 14-year-old male patient post orthodontic consultation. Panoramic radiograph revealed a well-circumscribed, unilocular, radiolucent area giving a typical scalloped appearance between the roots of the involved teeth, that is, 43–44 (Federation Dentaire Internationale). The lesion was asymptomatic and no cervical lymphadenopathy was detected.

Discussion: Solitary bone cysts are infrequent mandibular cavities lacking epithelial coating and that are most commonly found in the posterior region of the lower jaw. They exhibit multiple names such as traumatic bone cyst, hemorrhagic bone cyst, extravasation cyst, progressive bone cavity and single chamber bone cyst. Solitary bone cysts are usually asymptomatic but may cause bone deformities, teeth displacement as well as pathological fractures of the affected region. Solitary bone cyst, also found in other skeletal locations, is often suspected after epidemiologic and radiologic test results and confirmed at surgery.

Conclusion: In solitary bone cysts cases, undoubtedly, the determinant factor is surgical exploration of the lesion, although its clinical characteristics and scientific literature descriptions must be borne in mind as well as the fact that histological and radiographic characteristics are important to sustain accurate diagnosis. Since etiology of these cysts is unknown to the present date, it can only be intuited according to personal characteristics of each patient. The most accepted theory suggested a traumatic origin for these lesions. Nevertheless, when trauma is discarded as etiologic factor, the most accepted theory would be related to calcium metabolism alterations associated to the overall condition of our patient.