Sir, I read with interest the letter from Kharazmi and colleagues regarding mandibular osteonecrosis following general anaesthesia.1

I am a foundation dentist and during my first nine months in practice I have seen two similar cases, which were, however, not related to general anaesthesia.

I was unsure how to manage these cases but my trainer had fortunately heard of a condition named 'lingual mandibular sequestration and ulceration' and was able to point me in the right direction.

The condition is of uncertain aetiology, but is thought to be caused by a combination of poor blood supply to the lingual mandible and the tendency of this area to respond to trauma by forming bony exostoses. This results in necrosis and sequestration of the bone fragment. Healing follows spontaneous exfoliation of the fragment or surgical removal.2

I would like to share this reference with your readers as I hope they will find it interesting; in five years of dental school this condition was never mentioned.