— 23 Oncology and Radiotherapy © 1 (46) 2019: • CASE REPORT Buccal bifurcation cyst-mimicking a periodontal abscess Shalini Kapoor Department of Periodontics, SGT Dental College, Gurgaon, India INTRODUCTION Background Te Buccal Bifurcation Cyst (BBC) is a rare entity associated with the permanent mandibular frst or second molar in children just prior to tooth eruption [1]. Stone and Worth in 1983 frst documented its radiographic and clinical features [2]. Te BBC has been described with several names, such as mandibular infected buccal cyst-molar area [1], circumferential dentigerous cyst [3] buccal bifurcation cyst [4] and juvenile paradental cyst. In 1992, it was included by the World Health Organization (WHO) in their histologic typing of odontogenic tumors listed in the category of ‘‘paradental cyst’’ and named ‘‘mandibular infected buccal cyst’’ by Pompura et al. [5]. Buccal bifurcation cyst may produce few or no clinical symptoms and minimal signs, but there may be discomfort, pain, tenderness, painful occlusion and, rarely suppuration. A common sign is the lack of delayed eruption of the associated tooth; however swelling is the most likely clinical presentation. Te diagnostic features are the young age of the patients, the mandibular molar site, the buccal periostitis, the usually vital pulp and the radiographic preservation of the continuity of the apical lamina dura [5]. Te radiographic presentation of the BBC may be subtle and easily overlooked unless the lesion is large or symptomatic [6]. Te diagnosis of a BBC relies entirely on clinical and radiographic information because the histology of BBC is nonspecifc and reveals non-keratinized stratifed squamous epithelium [7]. Treatment of MBBC has been controversial: tooth extraction and curettage of the lesion, or enucleation and curettage without extraction of the involved tooth [1]. Clinical presentation A 13-year-old otherwise healthy girl reported with the chief complaint of pus discharge from lower right back tooth region. On intraoral examination, there was localized swelling on the buccal aspect of permanent mandibular frst molar (Figure 1) with frank pus discharge from the region. Hard tissue examination revealed a deep periodontal pocket (7 mm) on disto buccal surface of the tooth with a catch in furcation area using a naber’s probe (Figure 2). Root canal treatment was done in relation to the same tooth 1 month back. An Intraoral periapical radiograph revealed horizontal bone loss with Buccal Bifurcation Cyst (BBC) is a rare inflammatory odontogenic cyst that typically occurs at the buccal region of the first or second mandibular molars in younger patients. We report a rare case, of buccal bifurcation cyst mimicking a periodontal abscess in a 13-year-old female who complained of pus discharge from the right mandibular first molar region and was irresponsive to periodontal therapy. Treatment was done by simple enucleation without extraction of teeth. The patient has been under follow-up for about 2 years showing the normal bone repair. Although the BBC is uncommon, it is important for clinicians to recognize this entity, which will aid in early diagnosis and proper patient management. Key words: abscess, buccal, cyst, mandibular, young SUMMARY Address for correspondence: Dr. Shalini kapoor, Department of Periodontics, SGT Dental College, Haryana, email: dr_shalinibasur@yahoo.co.in Word count: 1919 Tables: 1 Figures: 11 References: 17 Received: - 07 May, 2019 Accepted: - 25 May, 2019 Published: - 30 May, 2019 023-0026