Case report: transpalatal arch resulting in soft tissue damage of the tongue 3 years post-orthodontic treatment

A transpalatal arch is a fixed orthodontic appliance used to reinforce posterior anchorage during orthodontic treatment. It consists of bands cemented to the upper first permanent molars and 1.0 mm stainless steel wire lying over the hard palate and separated from the soft tissue by 0.5–1mm (Figure 1).

A 19-year-old female had a history of attending both her general medical and dental practitioners regarding an asymptomatic tongue lesion. The patient first became aware of an ulcerated lesion on her tongue during orthodontic treatment, which was completed at the age of 16. During the course of the orthodontic treatment, she remembered that a transpalatal arch was fitted. The advice from her orthodontist was that the lesion would disappear once the transpalatal arch was removed. Three years post-treatment, however, the lesion was still present and the patient was concerned about its appearance. The area was occasionally uncomfortable and she reported a history of ulceration when traumatized.