Abstract
Oral ulceration associated with bony exposure and sequestration is uncommon and often
related to well-recognised conditions. In a small group of patients no obvious aetiological
factors can be elucidated, and various terminologies have been utilised to describe
these lesions. We report six cases of spontaneous oral ulceration with bone sequestration
as a specific entity and review the pertinent literature. We retrospectively reviewed
patients presenting in the period 2013-2018. Data collected included demographic details,
relevant medical, drug, and radiotherapy history; presentation, investigations, management,
and outcome. Six patients with an age range of 49-65 years were identified with spontaneous
oral ulceration with bone sequestration in the study period. All were males, and none
had any relevant history. Five lesions occurred over the mylohyoid ridge and one was
related to a lingual mandibular torus. The most common presentation was a painful
ulcer with exposed bone, which had been present for 6 - 12 weeks. Occlusal radiographs
demonstrated focal rarefaction in two patients. All were managed conservatively and
by removal of the loose sequestrum. Healing occurred successfully in all cases, and
this was earlier when the loose sequestrum was removed. Spontaneous oral ulceration
with bone sequestration is a distinct lesion that most often presents over the prominence
of the mylohyoid ridge. It is currently an uncommon entity (0.02%), but this could
well be due to a lack of recognition and under-reporting. It should be considered
as a diagnosis only when other causes have been excluded. Lesions heal successfully
with conservative management and surgical intervention, and this occurs earlier following
removal of the loose sequestrum.
Keywords
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Article info
Publication history
Published online: July 07, 2020
Accepted:
June 16,
2020
Identification
Copyright
© 2020 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
