Extraosseous and intraosseous oral traumatic neuromas and their association with tooth extraction

Tooth extraction has been suggested as the most common etiologic factor in the development of oral traumatic neuroma, but intraosseous lesions are stated to be rare. The clinicopathologic features of 45 oral traumatic neuromas are reviewed. Fifteen cases were painful. Inflammatory infiltrate was present in 53% of the painful cases in contrast to only 17% of asymptomatic neuromas, and was the only light microscopic feature significantly related to the incidence of pain. Eleven of 45 cases were found in an intraosseous location. Four of 45 reviewed neuromas were associated with extractions. All 4 cases were painful and 2 of them were in an intraosseous location. Only 3 of the 15 painful cases and 2 of the remaining asymptomatic 30 cases had a tentative clinical diagnosis of traumatic neuroma before removal.