Oral and Maxillofacial Surgery Expert Forum
Traumatic bone cyst - risks vs benefits of jawbone biopsy
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Questions in the Oral and Maxillofacial Surgery forum are answered by Dr. Michael H Kirsch and Dr. Mario Tuchman. Topics covered include teeth extractions, wisdom teeth, dental implants, bone grafting, orthognathic surgery, facial bones realignment, facial trauma repair, jaw alignment, anesthesia , jaw cyst or tumor diagnosis, reconstructive jaw surgery, temporomandibular joint syndrome (TMJ) and TMJ surgery.

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Traumatic bone cyst - risks vs benefits of jawbone biopsy

Hello,

I'm a 44 year old male. About two years ago (Jan. 2007) I had a gumboil (first one ever) below #44-45 that popped and then disappeared after about two weeks worth of antibiotics and Peridex. At that time, the dentist did a regular cleaning, but no scaling and root planing (S and RP) nor incision.

I had my very first Panorex last month (Oct. 2008), that show a 2-3 inch radiolucency that scallops under the roots of #42-45.

Today, I went to the Oral Surgeon who thought it was a traumatic or simple bone cyst, but would have to biopsy to make sure. He said it was near the mandibular nerve so there is a possibility of losing feeling in my chin (permanent or temporary) if he took the bone sample.

I currently have no pain, discomfort, or other symptoms in the area, and the percussion tests on #44-45 were negative. He said the teeth and gums all look good, with no signs of gingivitis or periodontal disease.

Do the benefits outweigh the risks in having this bone biopsy done?

Did the first dentist make the correct call by not doing any S and RP or incision where I had the infection?

Is the radiolucency a sign the infection is still present?

Thanks.




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The forum rule allow for only one response per post.  It is very important to have the biopsy!  There is no way to know if the lesion is in fact a simple bone cyst by clinical and radiographic exam alone.

It is possible the lesion is something more serious and may continue to destroy your jaw.    A biopsy is the Standard of Care, and I highly recommend you get it done as soon as possible.

Speak to your surgeon about a needle biopsy vs. open biopsy.  A pre-operative CT scan may be helpful by allowing the surgeon a way to access the lesion and minimizing the risk of nerve injury.

Information contained within this reply is intended solely for general educational purposes and is not intended nor implied to be a medical diagnosis or treatment recommendation.  This is not a substitute for professional medical advice relative to your specific medical condition or question. Always seek the advice of your own doctor for medical condition. Only your doctor can provide specific diagnoses and therapies.
2 Comments
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Hello Michael,

Thank you for the prompt response! I will be speaking to the OS regarding the needle biopsy and CT scan option.

Regarding the first part of my post above, do you feel I received an adequate "Standard of Care" when I first went to my dentist with the gumboil in January 2007?

Thank you,

CK
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Dr. Michael H. Kirsch
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