Haematemesis related to orthodontic treatment with Nance palatal arch: a case report

Romeo Patini, Anna Alessandri Bonetti, Andrea Camodeca, Edoardo Staderini, Patrizia Gallenzi

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)125-128
Number of pages4
JournalJournal of Orthodontics
Issue number2
Publication statusPublished - Apr 3 2018


  • Haematemesis
  • Nance palatal arch
  • orthodontic appliances
  • orthodontics
  • palatal necrosis

ASJC Scopus subject areas

  • Orthodontics


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