Tissue necrosis under a Nance palatal arch: a case report

A Nance palatal arch is a method of reinforcing anchorage to help prevent mesial movement of maxillary first permanent molars. It is recognised that it is difficult to maintain oral hygiene around the appliance and that iatrogenic damage can occur. We present a case of a 22-year-old male patient in whom the palatal mucosa became necrotic, palatal bone became exposed and long-term periodontal damage occurred. We describe the case, his treatment and the resolution of the inflammation as well as exploring the causes for the damage and alternate treatment options.