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Two cases of an atypical presentation of necrotizing stomatitis

  • Magan-Fernandez, Antonio (Department of Periodontology, University of Granada School of Dentistry) ;
  • O'Valle, Francisco (Department of Pathology, University of Granada School of Medicine) ;
  • Pozo, Elena (Department of Periodontology, University of Granada School of Dentistry) ;
  • Liebana, Jose (Department of Microbiology, University of Granada School of Medicine) ;
  • Mesa, Francisco (Department of Periodontology, University of Granada School of Dentistry)
  • Received : 2015.10.21
  • Accepted : 2015.12.07
  • Published : 2015.12.31

Abstract

Purpose: The purpose of this report was to describe the clinical and microbiological characteristics of two rare cases of necrotizing stomatitis, and the outcomes of a non-invasive treatment protocol applied in both cases. Methods: We report two cases of necrotizing stomatitis in a rare location in the hard palate of a 40-year-old woman and a 28-year-old man. Neither had a relevant medical history and both presented with highly painful ulceration in the palate and gingival margin that was accompanied by suppuration and necrosis. 3% hydrogen peroxide was applied to the lesions using sterile swabs, and antibiotic and anti-inflammatory treatment was prescribed to both patients in addition to two daily oral rinses of 0.2% chlorhexidine. Results: In both cases, radiological examination ruled out bone involvement, and exfoliative cytology revealed a large inflammatory component and the presence of forms compatible with fusobacteria and spirochetes. There was a rapid response to treatment and a major improvement was observed after 48 hours, with almost complete resolution of the ulcerated lesions and detachment of necrotic areas with partial decapitation of gingival papillae. Conclusions: Necrotizing periodontal lesions can hinder periodontal probing and the mechanical removal of plaque in some cases due to the extreme pain suffered by the patients. We present a non-invasive treatment approach that can manage these situations effectively.

Keywords

References

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