Case of the Week: Buccal Bifurcation Cyst on CBCT

Continuing with slowly updating the interpretation pages I thought I’d go with a case that’s not nearly as common but still a fun find.  Buccal bifurcation cyst is more uncommon and but has some very characteristic findings to help you identify it.

This case is fun as it has bilateral buccal bifurcation cysts. These are found in the bifurcation area of mandibular molars (most commonly the first molars) on the buccal side of the tooth. The associated tooth will be vital with its roots tipped to the lingual which is best visualized on coronal and cross-sectional views.  Clinically this will present with the lingual cusps projecting higher than the buccal cusps.

Reconstructed pantomograph showing well-defined radiolucent area in furcation area of mandibular left second molar.
Coronal view showing bilateral well-defined radiolucent areas centered near the furcation area of the mandibular second molars.
Cross-sectional views of right mandible with thinning of the buccal cortical plate.
Cross-sectional views of left mandible with thinning of the buccal cortical plate and note the roots at the lingual cortical plate.

Don’t forget to check out the updated page on buccal bifurcation cyst to see 2D examples and radiographic descriptions for both 2D and CBCT. Thanks and enjoy! 😀