Idiopathic lingual mandibular sequestration and its relationship to medication-related osteonecrosis of the jaws (MRONJ): mini review

Quintessence Int. 2022 Oct 21;53(10):868-873. doi: 10.3290/j.qi.b3418171.

Abstract

Objective: Idiopathic lingual mandibular sequestration is an uncommon condition that affects the lingual aspect of the mandible and may result in a necrosis of the jaw that is clinically indistinguishable from medication-related osteonecrosis of the jaw. This condition, however, is not associated with the intake of antiresorptive medication and may not require the same safeguards for extended periods of time. The etiology of idiopathic lingual mandibular sequestration is still unknown although trauma has been shown to play an important role.

Method and materials: PubMed and the Cochrane Library were used to retrieve papers written in English through the years 1970 to 2021 using the key words "idiopathic osteonecrosis," "lingual sequestration," and "idiopathic jaw sequestration." In addition, clinical presentation of the lesion was included.

Results: Idiopathic lingual mandibular sequestration is a benign, mostly self-limiting condition distinct from medication- related osteonecrosis of the jaw.

Conclusion: The dental clinician should be familiar with this condition and include it in their differential diagnosis when exposed bone is present with no history of radiation to the area or intake of antiresorptive medication. The course of the condition is usually very mild and may be self-limiting and usually does not require surgical intervention.

Keywords: bone; medication; oral lesions; osteonecrosis of the jaw; sequestration.

Publication types

  • Review

MeSH terms

  • Bisphosphonate-Associated Osteonecrosis of the Jaw* / diagnosis
  • Bone Density Conservation Agents* / adverse effects
  • Diagnosis, Differential
  • Diphosphonates
  • Humans
  • Mandible
  • Osteonecrosis* / chemically induced
  • Osteonecrosis* / diagnosis
  • Tongue

Substances

  • Bone Density Conservation Agents
  • Diphosphonates