Haematemesis related to orthodontic treatment with Nance palatal arch: a case report. (3rd April 2018)

• Record Type: Journal Article
• Authors: Patini, Romeo; Bonetti, Anna Alessandri; Camodeca, Andrea; Staderini, Edoardo; Gallenzi, Patrizia
• Is Part Of: Journal of orthodontics. Volume 45:Number 2(2018)
• Page Start: 125
• Page End: 128
• Publication Date: 2018-04-03
• Subjects: Haematemesis -- palatal necrosis -- orthodontics -- orthodontic appliances -- Nance palatal arch; Orthodontics -- Periodicals; 617.643005
• DOI: 10.1080/14653125.2018.1445505
• Languages: English
• ISSNs: 1465-3125

Abstract

ABSTRACT: Haematemesis is a worrying sign, generally related to acute upper gastrointestinal bleeding and potentially life-threatening condition. We present a case of a 15-year-old Caucasian girl who was belatedly diagnosed with oral bleeding because it was not related to the most common aetiologic factors. In fact, she was undergoing orthodontic treatment with a Nance palatal arch, an appliance used to reinforce anchorage during teeth movements. In her case haematemesis was a sign of inflammation and necrosis occurring in the palatal mucosa, under the acrylic button of palatal arch. The appliance was removed; antibiotic and Chlorhexidine 0.12% were recommended. After a 6-week follow-up, no pathological signs were present and the orthodontic treatment was resumed. Both physicians and dentists should be aware of the possible side effect of the Nance palatal arch use; this could help in achieving a diagnosis and providing a correct treatment. Orthodontists should avoid excessive compression over the palatal mucosa and check the appliance condition during every follow-up in order to avoid necrosis of the palatal mucosa.