Oral ulcers have long been a source of diagnostic difficulty. This has been attributed to the tremendous overlap in their clinical appearances. The problem is compounded by the fact that a number of oral ulcers may be superimposed by infections owing to their easy access to the oral cavity and thin nature of the oral mucous membrane which may get traumatized locally adding additional challenge to their diagnosis. While the diagnosis of some types of oral ulcers is facilitated by their association with constitutional signs and symptoms or lesions on the skin and/or mucous membranes in other areas, ulcers which are localized to the oral cavity may be more difficult to identify. Most of the oral ulcers are, therefore, biopsied because they are less readily recognizable on the basis of their clinical features. The similarity in histologic features by virtue of contamination by the oral liquids and microflora also on occasions makes differentiation difficult by masking the basic pathology. This review aims at a systematic approach toward the diagnosis of oral ulcers based on their clinical and histopathological features while ruling out unrelated causal factors.

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Chronic non-suppurative osteomyelitis, also known as Garre's osteomyelitis is a well-described pathologic entity in dental literature. We present here a case report of a unilateral hard bony swelling of the lower jaw associated with infection. Radiograph revealed the pathognomic feature of 'onion skin' appearance. Surgical recontouring of the lower jaw was performed since there was no evidence of bone remodelling after removal of the infected tooth.

The keratocystic odontogenic tumor (KCOT), earlier considered as the odontogenic keratocyst (OKC), is now classified as a benign neoplasm owing to its aggressive nature which includes a high recurrence rate. This case report describes a symptomatic large intraosseous odontogenic cystic neoplasm in the left mandible presenting radiographically as a large multilocular radiolucency and associated with an impacted tooth. The typical clinical and distinguishing histological features of KCOT morphed by the presence of inflammation are discussed here together with an intriguing clear cell component and epithelial theques and their clinical relevance. The newly acknowledged neoplastic potential serving significant role in treatment planning has also been addressed. Various lesions can present intraosseously as large multilocular radiolucencies in the jaws. Histopathological examination remains the mainstay for the diagnosis of such lesions.