Osteonecrosis of the jaw unrelated to medication or radiotherapy

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

“…The cases described herein presented with an oral ulcer covering a bone sequestrum at sites of bone prominence, in the absence of any known cause of osteonecrosis, features consistent with OUBS (Gadiwalla & Patel, ; Khan, Morrison, Ruggiero, et al, ; Palla et al, ). Although OUBS has no pathognomonic microscopic characteristics (Farah & Savage, ), histopathological examination confirmed the presence of necrotic bone.…”

“…The differential diagnosis of an intraoral ulcer above exposed bone includes various entities, such as MRONJ, osteoradionecrosis, congenital or acquired disorders, infectious diseases, or malignancies (Gabric et al, ; Gadiwalla & Patel, ; Villa & Gohel, ). In case of OUBS, the absence of any systemic factor known to induce osteonecrosis (Gadiwalla & Patel, ; Khan, Morrison, Hanley, et al, ; Palla et al, ) and the presence of a well‐demarcated, localized lesion (Fisher, ) in specific sites of bone prominences that heals soon after the sequestrum removal (Palla et al, ) are pathognomonic. OUBS may share few clinical similarities with “mild,” that is, early stage, MRONJ (Khan et al, ), such as the predilection for the posterior lingual mandible (Khan et al, ; Woo, Hellstein, & Kalmar, ).…”

“…Inclusion criteria were (a) presence of oral mucosa ulceration with exposed non‐vital bone at sites of bone prominence that are tori, exostoses, or the lingual mandibular surface covering the mylohyoid ridge; and (b) absence of any known osteonecrosis inducing factor (Gadiwalla & Patel, ; Khan, Morrison, Hanley, et al, ; Palla et al, ). For each patient, the following information was collected as follows: age; gender; intraoral location and duration of the lesion; symptoms, management, and follow‐up; medical history; smoking habits; history of trauma in the area; and a history of similar lesions in the past.…”

“…and (b) absence of any known osteonecrosis inducing factor (Gadiwalla & Patel, 2018;Khan, Morrison, Hanley, et al, 2015b;Palla et al, 2016).…”

“…Oral ulceration with bone sequestration (OUBS) designates a site‐specific oral ulcer that covers exposed, non‐vital bone in patients lacking any etiological factor known to induce osteonecrosis (Gadiwalla & Patel, ; Khan, Morrison, Ruggiero, et al, ; Palla, Burian, Klecker, Fliefel, & Otto, ). It has been reported in the literature under various descriptive names (Otto et al, ; Palla et al, ), including lingual mucosal ulceration with mandibular sequestration (Dhanrajani, ; Jackson & Malden, ), lingual mucosal ulceration with bone necrosis (Alkabouli, Kokovic, & Emad, ), lingual mandibular bone sequestration (Gündüz, Özden, Kurt, Bulut, & Günhan, ), lingual mandibular sequestration and ulceration (Peters, Lovas, & Wysocki, ), lingual mandibular sequestration with ulceration (Kessler, ), lingual mandibular osteonecrosis (Cerruto, Ugolini, & Cozzani, ), oral ulceration with mandibular necrosis (Villa & Gohel, ), oral ulceration with bone sequestration (Carrard, Sieck, Chaves, Filho, & Rados, ; Farah & Savage, ; Palla et al, ), mandibular bone exposure and osteonecrosis (Kharazmi et al, ), bone sequestration (Friel & Macintyre, ), bony necrosis and sequestration in the mandible (Fisher, ), spontaneous alveolar bone sequestration (Danesh‐Meyer, ), idiopathic exposure and sequestration of alveolar bone (Sonnier & Horning, ), oral ulceration (Scully, ), or osteonecrosis (Almazrooa, Chen, Nascimben, Woo, & Treister, ; Gabric, Seiwerth, Baraba, Vucicevic & Boras, 2017; Kharazmi, Nilsson, & Hallberg, ).…”