ORTHODONTIC: Pre-Orthodontic cyst- report of a traumatic bone cyst diagnosed prior to Orthodontic treatment

Traumatic bone cyst (TBC) is a non neoplastic bone lesion also referred by synonyms such as haemorrhagic bone cyst, simple bone cyst, solitary bone cyst, extravasation cyst, idiopathic bone cyst & primary bone cyst.

It was first described Lucas in the year 1929 since then it has evoked great deal of interest. The World Health Organization (WHO) recommends use of term Solitary bone cyst, although traumatic one cyst is most widely used term.

Read also: PDF: ORTHODONTIC: Analysis of Factors Associated with Orthodontic Microscrew Failure

Numerous theories have been linked to the formation traumatic bone cyst which includes medullary bone haemorrhage secondary to trauma, cystic degeneration of fibro-osseous lesions, intraosseous vascular anomalies, alteration of bony metabolism and low level of infection. It was suggested that trauma initiated a subperiostal hematoma that caused a compromised blood supply to the area, leading to osteoclastic bone resorption.

In an evaluation carried out on 26 cases of TBC, 30.77% had trauma history, 69.23% had some relation to orthodontic treatment, and 50% of all cases had been diagnosed during initial orthodontic documentation.TBC accounts for nearly 1% of cystic lesions occurring in the jaws. About 56-70% of the cases of TBC are diagnosed during the sex decade of life with no gender predilection. TBCs usually occur in the posterior region of mandibular body but instances of occurrence in the symphisis region have also been reported. TBC usually presents as a unilocular radiolucent area with a typical festooned pattern around the apices of the adjacent teeth. The typical festooned or scalloping appearance is also seen in edentulous areas.

Surgical exploration has been advised not just to confirm the diagnosis but also a treatment modality. Bone regeneration after surgical exploration is typical feature of TBCs. Spontaneous regression of the lesion has been observed in cases of TBC.