Oral ulceration with bone sequestration: Retrospective study of eight cases and literature review

Oral Dis. 2019 Mar;25(2):515-522. doi: 10.1111/odi.13000. Epub 2018 Dec 10.

Abstract

Objective: Oral ulceration with bone sequestration (OUBS) describes a site-specific intraoral ulcer that covers exposed, non-vital bone in patients lacking any etiological factor known to induce osteonecrosis. We aimed to conduct a retrospective study of eight new cases of OUBS and review the literature.

Subjects and methods: This is a retrospective study of OUBS cases, diagnosed and managed during 2007-2017. Inclusion criteria were the presence of oral ulcer with exposed non-vital bone at sites of bone prominence and the absence of any factor known to cause osteonecrosis. The English literature was reviewed on original OUBS cases.

Results: Eight patients (5 males and 3 females, aged 27-75 years) were diagnosed with OUBS during years 2007-2017. Four cases involved the mandibular mylohyoid ridge, one a mandibular anterior exostosis and three the maxillary buccal/palatal exostoses. Exposed bone was removed under local anesthesia, resulting in complete healing in all cases. The literature review yielded 32 OUBS cases in the mandible.

Conclusion: Oral ulceration with bone sequestration is a distinct, probably under-reported rather than rare clinical entity that should be regarded the provisional diagnosis in case of an oral ulcer covering exposed, non-vital bone at sites of bone prominence in patients lacking any etiological factor known to induce osteonecrosis.

Keywords: bone necrosis; bone sequestration; osteonecrosis; sequestrum; ulceration.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Male
  • Mandibular Diseases / surgery
  • Maxillary Diseases / surgery
  • Middle Aged
  • Oral Ulcer / complications*
  • Oral Ulcer / etiology
  • Oral Ulcer / surgery
  • Osteonecrosis / complications*
  • Osteonecrosis / etiology
  • Osteonecrosis / surgery
  • Retrospective Studies