BACKGROUND: 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. CASE PRESENTATION: 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. CONCLUSIONS: 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.
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