Traumatic Bone Cyst Management — ORE Part 1 MCQ

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ModerateOral SurgeryTraumatic Bone Cyst ManagementORE Part 1

A 40-year-old man presents with a slowly growing painless radiolucent lesion in the anterior mandible on an OPG. The lesion is unilocular and well-corticated. All adjacent teeth test vital. Aspiration yields blood-tinged straw-coloured fluid. What is the most appropriate next step?

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Correct answer: A — Surgical exploration and curettage (both diagnostic and therapeutic)

The correct answer is A: surgical exploration and curettage. The clinical presentation—unilocular well-defined radiolucency, vital teeth, asymptomatic course, and blood-tinged straw-coloured fluid on aspiration—is classic for traumatic bone cyst (TBC). Definitive diagnosis of TBC is achieved only at surgery, when an empty bone cavity without epithelial lining is observed. Curettage is the standard curative treatment. Option E (root canal) is incorrect because all teeth are vital and there is no endodontic pathology. Option B (observation) delays diagnosis and is not appropriate after positive aspiration findings. Option D (marsupialization) is used for larger odontogenic cysts requiring decompression, not for TBC. Option C (antibiotics) is unnecessary as the lesion is sterile and non-infected.

Reference: Cortell-Ballester I, Figueiredo R, Berini-Aytés L, Gay-Escoda C (2009). Traumatic bone cyst: a retrospective study of 21 cases. Int J Oral Maxillofac Surg. 38(5):513-517. https://pubmed.ncbi.nlm.nih.gov/19218905/; also supported by PMC1660580 (2006) and PMC9733790 (2023).