title: Two cases of an atypical presentation of necrotizing stomatitis.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Periodontology, University of Granada School of Dentistry, Granada, Spain .
authors.forename: Antonio
authors.identifier: 0000-0001-6430-2276
authors.initials: A
authors.lastname: Magan-Fernandez
authors.affiliation: Department of Pathology, University of Granada School of Medicine, Granada, Spain .
authors.forename: Francisco
authors.identifier: 0000-0001-9207-2287
authors.initials: F
authors.lastname: O'Valle
authors.affiliation: Department of Periodontology, University of Granada School of Dentistry, Granada, Spain .
authors.forename: Elena
authors.identifier: 0000-0002-1801-4254
authors.initials: E
authors.lastname: Pozo
authors.affiliation: Department of Microbiology, University of Granada School of Medicine, Granada, Spain .
authors.forename: Jose
authors.identifier: 0000-0002-3838-7023
authors.initials: J
authors.lastname: Liebana
authors.affiliation: Department of Periodontology, University of Granada School of Dentistry, Granada, Spain .
authors.forename: Francisco
authors.identifier: 0000-0002-8293-2527
authors.initials: F
authors.lastname: Mesa
keywords: Histology; Microbiology; Necrotizing stomatitis; Necrotizing ulcerative gingivitis