The traumatic bone cyst is an exception to the rule that jaw cysts have an epithelial lining. Not only does it lack an epithelial lining, but also it may be almost devoid of tissue of any type. Surgical entry into this lesion reveals an empty cavity whose only contents are a few shards of fibrous connective tissue, a small amount of fluid, or hemorrhagic debris. The absence of a history of injury in many who have a traumatic bone cyst is reason to doubt the relationship to trauma. The increased incidence in males, supposedly accounted for by their robust lifestyle, has not been supported by large series that show no sex preference. The traumatic bone cyst is a lesion of youth, fully 75% occur before the age of 30. Mandibular lesions account for more than 95% of all cases; they are rare in the maxilla. In the mandible, it is more common in the premolar-molar region. Multiple cysts in a single patient have been reported but are rare. The increased incidence of multiple cysts in black females may reflect a relationship to florid osseous dysplasia, a bone disease in which traumatic bone cyst-like cavities are known to occur. Most traumatic bone cysts are asymptomatic but occasionally there is swelling, pain, or paresthesia. Because the radiographs are not diagnostic, biopsy is required. Upon entry into the lesion, if the surgeon finds an empty cavity, then the diagnosis is established, and no further procedure is required. Even large lesions will fill with bone in 6-12 months.
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