Journal of Periodontal & Implant Science  2015;45(6):252-256

doi:10.5051/jpis.2015.45.6.252

Two cases of an atypical presentation of necrotizing stomatitis.

Antonio MAGAN-FERNANDEZ 1 ; Francisco O'VALLE ; Elena POZO ; Jose LIEBANA ; Francisco MESA

Affiliations

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Keywords

Histology; Microbiology; Necrotizing stomatitis; Necrotizing ulcerative gingivitis

Country

Republic of Korea

Language

English

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.