Biopsy For Oral Cysts, Masses, and Lesions

If you have a new lesion see your dentist or oral surgeon for immediate evaluation. For some lesions, observation and re-evaluation in 10 to 14 days may be recommended. In others, immediate biopsy may be indicated to establish early diagnosis and treatment.

Types of biopsy procedures:



  • Enucleation biopsy is performed for jaw cysts where the lining and content of the cyst are removed. It may be a partial enucleation in large cysts (to establish biopsy) or a complete enucleation in relatively smaller cysts.

  • Excisional biopsy is performed on any lesion, lump, ulcer, or other abnormalities. The lesion is completely removed, therefore providing biopsy and definitive treatment in one stage.

  • Incisional biopsy is performed when the lesion/mass is large and it is important to establish diagnosis before the definitive treatment. A section is removed as a sample and sent to the laboratory for histology reading.

  • Brush biopsy is performed by swapping a cotton over the mucosa surface and obtaining sample cells and sent to a lab for reading. Some dentists recommend it because it is non-invasive and easy but, it is not very reliable. it is associated wit many false negatives or positives and does not provide sufficient diagnosis.  If it is positive, then a regular biopsy is required.

  • Fine needle biopsy is performed by placing a fine needle into a mass to obtain sample tissue. Although not conclusive, it is a useful adjunctive tool in diagnosis. It may be beneficial for some cysts or masses in the jaw bone.


Where and how biopsy is best performed:



  • Most biopsy procedures are performed in office.

  • Biopsy procedures may be done with local anesthesia, nitrous oxide, or IV sedation. For minor biopsies, local anesthesia may be adequate, but for larger procedures or cysts, IV sedation is highly recommended.


Biopsy results:



  • We submit all biopsies to Johns Hopkins, department of dermatology and oral pathology for processing and diagnosis.

  • Results are usually ready in 5-7 days.

  • Based on biopsy results, further treatment may be indicated. This may include additional excision of the lesion or more aggressive treatment.

  • We will make appropriate referrals to head & neck cancer specialists for malignant lesions.