Healing of Palatal Mucosal Necrosis During Maxillary Expansion with Adjunctive Ozone Therapy: A Rare Case Report with a 2-year Follow-up

¹Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey

²Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey

³Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey

⁴Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey

⁵Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey

^*Corresponding Author: Alparslan DILSIZ, DDS, PhD. Professor, Department of Periodontology, Faculty of Dentistry, Atatürk University, 25240-Erzurum, Turkey, Fax: + 90 442 2361375 Tel: +90 442 2313967, E-mail: [email protected]

Received Date: August 30, 2026

Published Date: September 22, 2026

Citation: Dilsiz A, et al. (2026). Healing of Palatal Mucosal Necrosis During Maxillary Expansion with Adjunctive Ozone Therapy: A Rare Case Report with a 2-year Follow-up. Dental. 8(2):26.

Copyright: Dilsiz A, et al. © (2026).

ABSTRACT

Aim: Oral soft tissue injuries may arise from accidental events, self-inflicted habits, or iatrogenic causes associated with dental treatment. Traumatic lesions affecting the oral cavity can result from chemical, thermal, or mechanical factors and frequently manifest as gingival recession, ulceration, burning sensations, or tissue necrosis. Among these conditions, iatrogenic injuries represent a recognized complication related to various dental procedures. Although rapid maxillary expansion appliances are widely used in orthodontics, reports describing palatal mucosal necrosis associated with these devices remain limited. Therefore, the present case report aimed to demonstrate the harmful effects of an orthodontic expander on palatal soft tissues and to present the successful management of the lesion.

Case Report: A 17-year-old female patient presented to our clinic complaining of intense pain and a burning sensation in the maxillary region that impaired her ability to eat, swallow, and speak comfortably. During anamnesis, she reported that the palatal mucosa had become traumatized approximately two weeks after placement of an orthodontic appliance. The treatment protocol included oral hygiene education, surgical removal of the necrotic soft tissue, topical ozone therapy, adjustment and polishing of the orthodontic appliance, and detailed postoperative instructions for the patient.

Results: Complete healing was observed four weeks after the surgical procedure and ozone therapy, and the affected area exhibited a clinically normal appearance at the three-month follow-up examination. She was followed for approximately 2-year postoperatively.

Conclusion: Traumatic lesions affecting the oral cavity may develop both in clinical settings and in daily life environments. Adequate clinical experience, professional competence, and current knowledge of dental practitioners play a critical role in minimizing the risk of iatrogenic injuries.

Keywords: Iatrogenic Trauma, Rapid Maxillary Expansion, Orthodontic Expander, Soft Tissue Necrosis, Ozone Therapy, Periodontal Surgery, Case Report