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Oral ulceration with bony sequestration

British Dental Journal volume 228, pages 397–398 (2020)Cite this article

Oral ulceration with bone sequestration has been used to characterise oral ulceration and bone sequestration without an aetiologic cause.2 It is a rare condition which contains cases previously recognised by the term 'lingual mandibular sequestration and ulceration'.3 More recently OUBS has been defined as, 'spontaneous sequestration of the lingual mandibular bone, usually in the area of the mylohyoid ridge, in patients with no significant underlying systemic condition.'4 Anatomically, the mylohyoid ridge of the lingual mandible, mandibular tori and exostoses are the most common areas associated with OUBS.5The identified sites are more susceptible to this form of trauma because of the bony prominences and thin lining mucosa. It is most likely that a traumatic irritant such as food trauma or tooth brushing cause disruption to the local blood supply with subsequent breakdown in the soft tissues and periosteum.3

In this case, food trauma and the patient's difficulty swallowing are more likely to be causative. During the neurosurgery apparently the vagus nerve was damaged and the patient has had difficulty swallowing since. Clinicians should be aware of OUBS in the differential diagnosis of mouth ulcers with appropriate management.

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Reference

  1. Palla B, Burian E, Klecker J R, Fliefel R, Otto S. Systematic review of oral ulceration with bone sequestration. J Craniomaxillofac Surg 2016; 44: 257-264.

  2. Khan A A, Morrison A, Hanley D A et al. International Task Force on Osteonecrosis of the Jaw. Diagnosis and management of osteonecrosis of the jaw: a systematic review and international consensus. J Bone Miner Res 2015; 30: 3-23.

  3. Peters E, Lovas G L, Wysocki G P. Lingual mandibular sequestration and ulceration. Oral Surg Oral Med Oral Pathol 1993; 75: 739-743.

  4. Almazrooa S A, Woo S B. Bisphosphonate and non-bisphosphonate-associated osteonecrosis of the jaw: a review. J Am Dent Assoc 2009; 140: 864-875.

  5. Farah C S, Savage N W. Oral ulceration with bone sequestration. Aust Dent J 2003; 48: 61-64.

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  1. St Helen’s, UK

    R. S. Burrows

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Burrows, R. Oral ulceration with bony sequestration. Br Dent J 228, 397–398 (2020). https://doi.org/10.1038/s41415-020-1442-9

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