Images in Clinical Medicine

By Dr. Pegah Mosannen Mozaffari , Dr. Seyyed Amir Seyyedi , Dr. Maryam Amir Chaghmaghi
Corresponding Author Dr. Pegah Mosannen Mozaffari
Oral and Maxillofacial Research Center, Oral Medicine Department, Mashhad Univer, Oral and Maxillofacial Research CenternSchool of DentistrynVakilAbad Blv,Azadi SQR nMashhad,Khorasan Razavi Province,Irann P.O.Box:984n - Iran (Islamic Republic of) 91735
Submitting Author Dr. Pegah Mosannen-Mozafari
Other Authors Dr. Seyyed Amir Seyyedi
Mashhad Dental School, - Iran (Islamic Republic of)

Dr. Maryam Amir Chaghmaghi
Oral and Maxillofacial Research Center, Oral Medicine Department,School of Dentistry, Mashhad Univer, - Iran (Islamic Republic of)


Palatal Perforation, Etiology, Drug Abuse, Cleft, Fictitious, Cocaine, Autoimmune, Leprosy, Impacted Canine

Mosannen Mozaffari P, Seyyedi S, Amir Chaghmaghi M. Palatal Perforation: Causes and Features. WebmedCentral ORAL MEDICINE 2011;2(4):WMC001890
doi: 10.9754/journal.wmc.2011.001890
Submitted on: 22 Apr 2011 05:22:52 AM GMT
Published on: 23 Apr 2011 05:34:35 AM GMT


Here we explain potential causes of palatal perforation and demonstrate some features.
During the sixth week of prenatal period, palatal shelve coalesce to form the hard palate. Failure to this integration results in cleft palate.(Illustration 1) Some syndromes, maternal alcohol consumption and cigarette smoking, folic acid deficiency, corticosteroid use and anticonvulsant therapy are some causative agents for this abnormality. (1)Sometimes an elderly edentoulous denture wearer complaines of a perforation in his/her palate. Due to bone resorption a previously impacted canine may emerge in the form of a palatal perforation. An orthopantomograph can easily reveal the impacted tooth.(Illustration 2)
2. Infectious:
There are some infections resulting in palatal perforation. In leprosy, tertiary syphilis, tuberculosis, rhinoscleroderma, naso-oral blastomycosis, leishmaniasis, actinomycosis, histoplasmosis, coccidiomycosis and diphtheria The palatal roof may be perforated.(2-3) (Illustration 3)
3. Autoimmune:
There are some autoimmune diseases which results in palatal perforation. Examples are lupus erythematous, sarcoidosis, Crohn's disease and Wegener granulomatosis.(4)
4. Neoplastic:
differenttumors can extend from maxillary sinus or nasal cavity and perforate the palate. Although these neoplasms usually form a mass, but in advance cases perforation of palate may occur in course of disease or following treatment(5)
5. Drug related:
palatal perforation due to cocaine abuse is a well-known situation. Other drugs (heroine, narcotics) can be responsible for palatal perforation.(6-7)(Illustration 4)
6. Iatrogenic:
Sometimes following a tooth extraction an oro-antral fistula remains.(Illustration 5). Other procedures such as tumor surgery(maxillectomy), corrective surgeries(e.g.septoplasty) or intubation can cause palatal perforation.(8)
7. Rare causes:
Rhinolithcan result in palatal perforation. Patients with psychologic problems may present with a fictitiouspalatal perforation.(Illustration 6)





Source(s) of Funding

This study was funded by the vice chancellor of research of Mashhad University of Medical Sciences.

Competing Interests



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Palatal Perforation
Posted by Dr. William J Maloney on 16 Feb 2014 01:55:02 AM GMT Reviewed by Interested Peers
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