skip to main content

Palatal Injection Necrosis — NDEB AFK MCQ

Instant feedback + full explanation. One question, done properly.

HardPain & Anxiety ControlPalatal Injection NecrosisNDEB AFK

A patient presents with a painless oral ulcer on the hard palate that has a crater-like appearance with surrounding areas of ischaemic (yellow-white) tissue. History reveals that the patient had a dental injection in this area 3 days ago. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Ischaemic necrosis from palatal injection (intrapalatal anaesthesia)

Ischaemic necrosis of the palatal mucosa following a palatal injection of local anaesthetic (with vasoconstrictor) is a recognised complication. The hard palate has tightly bound mucoperiosteum with limited blood supply, and vasoconstriction from epinephrine can cause localised tissue ischaemia and necrosis. The resulting painless crater ulcer with yellowish-white (ischaemic) borders heals spontaneously over 1-3 weeks by secondary intention. It must be distinguished from necrotising sialometaplasia (which has similar clinical and histological features but is spontaneous).

Reference: Malamed – Handbook of Local Anesthesia, 7th ed., 2020