Learning Center

Buccal Bifurcation Cyst

Author :

Sindhura Anamali B.D.S., M.S.
Diplomate Of ABOMR , Clinical Assistant Professor, The University of Iowa

Buccal Bifurcation Cyst

  • Is an inflammatory odontogenic cyst
  • Usually associated with the permanent mandibular first molars
    1. Occasionally second molars are involved
    2. Third molars may also be involved but are rare
  • The exact etiology is unknown, said to arise from the epithelial cell rests of the periodontal ligament in the furcation area
  • Seen mostly in first and second decades of life
  • The cyst presents on the buccal aspect of the involved tooth
  • Majority of the cases are detected as a result of lack or delayed in eruption of the molars
  • The involved teeth are vital
  • Some cases present with a palpable bony hard swelling on the buccal aspect
  • Symptomatic in some cases
    1. If secondarily infected – pain and swelling can be present (referred to as the infected buccal cyst)
    2. If secondarily infected – pain and swelling can be present (referred to as the infected buccal cyst)

Best imaging modality :

  • Partial volume - cone beam computed tomography
  • True occlusal radiograph

Radiographic Features :

  • Well-defined radiolucent entity with corticated borders, on the buccal aspect of the permanent mandibular first molar
  • Usually unilocular, around 1 cm but can get very large up to 2.5 cm in diameter

Effect on surrounding structures:

  • The classic presentation would be the roots tipped towards the lingual cortex and the crown tilted toward the buccal aspect of the mandible
  • BBC cause lingual cusp tips of the involved tooth to protrude higher when compared to the buccal cusps
  • If secondarily infected can cause
    1. Discontinuity of the cortex
    2. Periosteal reaction may be seen
  • Large cysts can displace and resorb adjacent teeth

Differential diagnosis

  • Paradental cyst


  • Surgical enucleation of the cyst
  • The associated tooth will erupt normally and the area will be filled in with normal bone

Buccal Bifurcation Cyst
Example 1

Buccal Bifurcation Cyst
Example 2

Buccal Bifurcation Cyst
Example 3

Buccal Bifurcation Cyst
Example 4

Buccal Bifurcation Cyst
Example 5


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