Traumatic Bone Cyst — ORE Part 1 MCQ

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ModerateOral PathologyTraumatic Bone CystORE Part 1

A 60-year-old man presents with a painless, slowly enlarging radiolucency in the anterior mandible. The OPG shows a well-defined unilocular radiolucency with scalloping between the roots of the lower incisors. All teeth in the area are vital. Aspiration reveals a thin blood-tinged fluid. What is the most likely diagnosis?

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Correct answer: E — Traumatic (simple/solitary) bone cyst

Explanation lettering: B = shown as A · E = shown as B · A = shown as E

The diagnosis is traumatic bone cyst (answer A). The key clinical and radiographic features are pathognomonic: a well-defined unilocular radiolucency with characteristic scalloping between tooth roots, vital teeth throughout, and blood-tinged (serous-bloody) aspirate. These findings are classic for traumatic bone cyst. Option B (radicular cyst) is excluded definitively because all teeth are vital—radicular cysts require a non-vital tooth. Options C, D, and E do not present with this combination of findings: lateral periodontal cysts typically occur in the anterior maxilla and lack blood-tinged aspirate; central giant cell granulomas have more aggressive biology and tooth mobility; ameloblastomas are usually larger and multilocular. Aspiration of blood-tinged fluid combined with scalloping margins and vital teeth confirms traumatic bone cyst, which is managed by surgical exploration and curettage to stimulate bone healing.

Reference: Xanthinaki A, Choupis KI, et al. Traumatic bone cyst of the mandible of possible iatrogenic origin: a case report and brief review of the literature. Head & Face Medicine. 2006;2:40. https://pubmed.ncbi.nlm.nih.gov/22499365/