Kang Kun-Hwa, Byun Jin-Seok, Jung Jae-Kwang, Kim Ji Rak
Department of Oral Medicine, Kyungpook National University Dental Hospital, 2175 Dalgubeol- daero, Jung-gu, Daegu, 41940, Korea.
Department of Oral Medicine, School of Dentistry, Kyungpook National University, 2177 Dalgubeol- daero, Jung-gu, Daegu, 41940, Korea.
BMC Oral Health. 2025 Apr 13;25(1):561. doi: 10.1186/s12903-025-05919-1.
Oral ulcers exhibit diverse symptoms and etiologies. The treatment approach varies depending on the size and characteristics of the ulcer, typically starting with topical therapies such as steroid or antifungal mouth rinses. While most ulcers respond well to these localized treatments, some cases necessitate systemic interventions, including oral medications or intralesional injections.
A 59-year-old man with a one-month history of a persistent oral ulcer in the maxillary vestibule was diagnosed with major aphthous ulcer and treated with intralesional triamcinolone injection and corticosteroid gargle. The ulcer healed completely within two weeks, but a triamcinolone deposit remained asymptomatic and resolved spontaneously within a month. The patient experienced no discomfort and required no further intervention.
While triamcinolone is a highly effective and rapid treatment for oral mucosal ulcers, caution is advised when treating ulcers above the alveolar bone. It is preferred to administer injections in the corresponding vestibular groove near the buccal mucosa, which has a rich blood supply, rather than above the alveolar bone. Otherwise, reducing the dosage or switching to a more easily absorbable corticosteroid, such as dexamethasone, may be carefully recommended.
口腔溃疡症状多样,病因各异。治疗方法因溃疡大小和特征而异,通常从局部治疗开始,如使用类固醇或抗真菌漱口水。虽然大多数溃疡对这些局部治疗反应良好,但有些病例需要全身干预,包括口服药物或病灶内注射。
一名59岁男性,上颌前庭持续性口腔溃疡1个月,被诊断为重型阿弗他溃疡,接受病灶内注射曲安奈德和皮质类固醇含漱液治疗。溃疡在两周内完全愈合,但曲安奈德沉积物无症状,在一个月内自行消退。患者无不适,无需进一步干预。
虽然曲安奈德是治疗口腔黏膜溃疡的高效快速药物,但在治疗牙槽骨上方的溃疡时需谨慎。建议在颊黏膜附近血供丰富的相应前庭沟进行注射,而不是在牙槽骨上方。否则,可谨慎建议减少剂量或改用更易吸收的皮质类固醇,如地塞米松。