Simple bone cyst: possible misdiagnosis in periapical pathology

Simple bone cysts are non-neoplastic bone lesions, classified as intraosseous pseudocysts without epithelial lining, that can be empty or filled by fluid and display uncommon clinical and radiographic features. This article presents an unusual case of a simple bone cyst with clinical and radiographic features similar to chronic apical periodontitis. A general dentist referred an 18-year-old man for endodontic treatment after the patient complained of pain in the mandibular right second molar, which displayed a significant bony radiolucency. Chronic periapical lesion was excluded after detailed clinical and radiographic examinations. During surgical exploration, an empty bone cavity was observed and curetted before wound closure. One year later, complete healing was observed.