Traumatic bone cyst with a rare anatomical record of inferior alveolar nerve branching: a case report

Resumo

Introduction: Traumatic bone cyst is a benign intraosseous lesion, often asymptomatic, characterized radiographically by a radiolucent area with defined contours, which may exhibit a classic "glove fingers" appearance, due to its rounded invasion of the interdental spaces. Case Report: A 12-year-old female patient presented with an asymptomatic lesion in the posterior region of the right mandible, identified radiographically. Imaging tests, such as periapical radiography and Cone Beam computed tomography, revealed a well-defined radiolucent and hypodense area close to the mandibular canal, without involvement of the bone cortex. Surgical exploration confirmed the absence of membrane or content, characterizing the traumatic bone cyst. During the procedure, a rare anatomical finding was recommended: a branching of the inferior alveolar nerve towards the root of the second right lower molar. Discussion: Confirmation of the diagnosis of traumatic bone cyst requires surgical intervention due to pseudocystic nature, without epithelial lining. The rare anatomical finding in this case was only possible due to the specific characteristic of the lesion in promoting selective subtraction of the bone marrow, preserving the local neurovascular bundles. The conservative approach proved to be effective in stimulating the bone regeneration process in a non-invasive manner. Conclusion: Knowledge in identifying the specific imaging characteristics of traumatic bone cysts guaranteed the early diagnosis that motivated the conservative approach. Appropriate management of the traumatic bone cyst promoted complete bone repair after 6 months. The documentation of rare anatomical findings appears to be specific for this type of lesion.