Post extraction lingual mucosal ulceration with bone necrosis

This report describes a case of a 49 year old male patient presenting with lingual mucosa ulceration with cortical bone necrosis, above mylohyoid ridge in the right side of mandible. The patient had extraction a few days before development of the ulcer. The patient’s medical history was clear and not on any drugs. Clinically, he presented with moderate pain and discomfort. Intraoral examination revealed a discrete ulcer of about 1 cm in diameter and exposure of the underlying bone, which was necrotic. Extra-oral examination showed no abnormalities. Radiographs revealed no pathology, apart from extraction socket. The case was treated in two phases; initial control of acute signs and symptoms by antibiotic cover and analgesic for 5 days, and smoothening of the exposed bone. This was followed by surgical removal of the necrotic bone and dressing of the vital bone with iodoform gauze. The lesion healed completely in 3 weeks.

Although the cause of this lesion is not clear, minor trauma from suture may be initiated the process. These ulcers are basically uncommon; however, general dental practitioners are invited to understand the potential systemic and local etiological factors and the management to avoid any unwanted complications.