The role of ischaemia in necrotising sialometaplasia

Aim To establish the role of ischaemia in necrotising sialometaplasia. Background Necrotising sialometaplasia is a rare, benign inflammatory lesion primarily involving the minor salivary glands of the hard palate. Presentation of the lesion is that of a deep seated ulcer. It represents a diagnostic challenge to the clinician because of its clinical and histopathologic features that simulate malignancy. It is commonly believed that the lesion is a result of vascular ischaemia initiated by trauma. Materials and methods Cases of necrotising sialometaplasia described in the literature have been reviewed. Relations between oral manifestations, aetiology, pathogenesis and management have been critically analysed. Results Different factors have been described as the source of trauma responsible for necrotising sialometaplasia, such as local anaesthetic, ill‐fitting dentures, smoking, alcohol, cocaine snorting, vomiting and fellatio. Conclusions The literature supports the causal role of trauma and ischaemia in the development of necrotising sialometaplasia. However not all cases of trauma inevitably lead to necrotising sialometaplasia.