Polarized light and microradiographic study of natal teeth.
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A 26-year-old female is described with multiple facial syringomas, neonatal teeth and oligodontia. Her father has similar dental findings but no reliable evidence of syringomas. This combination of findings probably represents a new autosomal dominant ectodermal dysplasia with variable expression between the sexes.
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Natal teeth are present at birth, whereas neonatal teeth erupt during the first postnatal month. Mobile natal or neonatal teeth should be removed to prevent aspiration.
The following report is the first documented case of natal teeth associated with a recently described new entity, Pfeiffer syndrome type 3. The clinical manifestations consistent with the spectrum of this rare disorder are described with an emphasis on the concomitant natal teeth. Pfeiffer syndrome type 3 is one of the craniosynostosis syndromes and has been described in only two patients to date. Both mandibular incisors and maxillary molar natal teeth were found. Natal teeth are teeth, which are present in the oral cavity at birth. They are often associated with developmental abnormalities and recognized syndromes. Their incidence ranges from 1 in 2,000 to 3,500 births. The natal teeth found in this infant included both the mandibular primary incisors and maxillary primary first molars bilaterally. The clinical and histological considerations of natal teeth and their management are discussed. The presence of multiple natal teeth is extremely rare.
A case of natal teeth in a four-day-old female brought by a forty four year old mother is presented. These natal teeth were present in the upper and lower jaws. Of special interest was the shape and positions of these especially the upper tooth in the left canine region and the fact that these teeth were present in a child with Down's syndrome features. The anxiety of the mother and the desire to get them removed immediately underlines the superstition and misconceptions with which natal teeth are viewed. The multidisciplinary approach to management is also highlighted.
A case of natal teeth associated with traumatic ulceration to the ventral surface of the tongue (Riga-Fedes syndrome) in a four week old boy is presented. On radiographic examination, two teeth, present at birth, were found to be early erupted deciduous lower central incisors. A family history of natal teeth, all involving both lower deciduous central incisors associated with trauma to the tongue during suckling, was elicited. The ulceration healed over a period of four weeks using an innovative conservative treatment regime, involving the use of Stomahesive Wafer. Four months later the only sign of any previous pathosis was a fibrous scar on the ventral surface of the tongue.
This paper rresents a clinical, histological and microradiographic study of three patients with pachyonychia congenita with special reference to oral manifestations. The patients, who are relatives, exhibited thickening of finger- and toe-nails, follicular keratosis, palmoplantar keratosis and hyperhidrosis, oral leukokeratosis, and natal teeth. It is stated in the discussion that natal teeth and oral leukokeratosis may constitute the earliest clinical manifestations of pachyonychia congenita and that they appear to accur earlier than nail lesions. When there is a hereditary disposition for pachyonychia congenita, it is important to inspect the oral cavity at an early stage.
Oral-facial digital syndrome type II (OFP syndrome II; orofaciodigital syndrome II) is a rare autosomal recessive syndrome, first described by Mohr (1941). We present two sisters with Mohr syndrome from a consanguineous family. One is a three-day-old female patient, the other is 22-week-old fetus. Polydactyly with bifid thumbs in both hands, bilateral polysyndactyly of halluces, lateral polysyndactyly and bilateral pes equinovarus were demonstrated in the fetus sonographically. Corpus callosum agenesis, congenital heart disease, bilateral bifid thumbs and halluces and polydactyly were seen in both patients. In addition, post-mortem findings showed absence of olfactory nerve, single atrium. VSD, abnormal lung lobulation and natal teeth in the fetus. Absence of olfactory nerve and natal teeth have not been reported previously in Mohr syndrome.
Natal and Neonatal teeth although not unique anomalies, are observed in infants at birth or during the first 30 days of life. Here, the report of our four cases, in which the bilateral mandibular posterior natal teeth, which stands out to be a rare condition is presented. Etiological, clinical, histological features, complications and treatment modalities are discussed.
A review of the literature reveals a need to clarify the pathologic physiology of congenital polychlorinated biphenyl (PCB) poisoning, which is characterized by intrauterine growth retardation, brown staining of the skin and mucous membranes, as in Addison's disease, natal teeth, widely open fontanelles and sagittal suture and apparent overgrowth of the gingiva. The skull abnormalities may represent irregular calcification, with natal teeth appearing because the bone of the mandible is penetrated more easily than usual. Some fetuses were poisoned at the time the mothers ingested the oil; others were affected in the subsequent years from residual contamination in the mothers' bodies. The misadventure in Japan was repeated in Taiwan in 1979. The seven congenital cases in Taiwan reported thus far seem to differ from those in Japan. In Taiwan the noses were somewhat black, two of the infants did not have low birth weight and the osseous abnormalities of the skull and gingival hyperplasia were not observed. Systematic followup studies should be made in Taiwan of the children born within 2 years of maternal poisoning with PCBs. Special attention should be given to age at first dentition and skull X-rays for spotty calcification, among other measures of physical, neurologic and intellectual development.
In a survey of 18,155 infants, 7,155 of whom were examined personally, the prevalence of natal teeth was one in 716 for the infants examined and one in 3,667 for those surveyed. Another group of 38 infants and children with 61 natal and neonatal teeth were examined prospectively. All were mandibular central incisors. Sixty-one percent of the subjects had a pair of natal or neonatal teeth (or both). Ninety-five percent of the natal and neonatal teeth were normal primary central incisors, and 5% were supernumerary primary central incisors. Initially, in 31% of the teeth, enamel dysplasia was seen, the occurrence of which correlated with the duration of the gingival covering. It is recommended that natal and neonatal teeth be left in place, if possible, and removed only if they are extremely mobile, such that reattachment is unlikely.
Premature eruption of teeth occurs in 1 of every 2,000 births. The reported association between natal teeth and serious, rare, inherited syndromes suggests that particular caution should be exercised in examination of newborns having prematurely erupted teeth. The ectomesenchyma, from which the orofacial structures develop, undergoes a complex, coordinated series of steps of proliferation and differentiation during the first two months in utero. At approximately seven weeks the presumptive mandibular and maxillary arches show a bandlike ectodermal thickening called the dental lamina. Odontogenesis (tooth development) begins with budding of the dental lamina and continues into the second week of life. Remnants of odontogenic epithelium or of epithelium covering the embryonic facial processes may develop into cystic structures, causing intraoral swellings on the alveolar ridges or palate (i.e., Bohn's nodules and Epstein's pearls). Prematurely erupted natal and neonatal teeth are generally normal deciduous incisors. Hypermobility of these teeth, resulting from poorly formed roots, may stabilize within a short period of time. Extraction of natal and neonatal teeth should not be done precipitously.
Incidence, causes, complications, and treatment of natal and neonatal teeth are presented. It has been suggested that the terms mature and immature be added to the designation of this anomaly as those would imply the development and prognosis of the tooth and give clinical significance to the terms natal and neonatal. A case in a 2-week-old premature infant is described. As natal or neonatal teeth seldom develop properly and subsequent loss of space is not a long-term sequela, extraction is the preferred treatment.
A case of natal and neonatal teeth in a 25 days old infant and its management is reported.
The enamel of a natal tooth in a healthy full-term child and the enamel of a postnatally erupted tooth in a premature child have been studied with scanning electron microscopy on longitudinal and cross sections. The first case shows that following a normal development, amelogenesis was arrested. This is evident by the presence of the external aprismatic layer in spite of the narrowness of the enamel which corresponds to about a third of the normal thickness. This premature arrest of amelogenesis can be dated to about the 6th month "in utero". In the second case we observed a reversible amelogenesis disturbance as attested by the absence of the external aprismatic layer as well as by a new and fast enamel apposition that took a pseudonormal course. Happening about 10 weeks before birth, this disturbance has probably been induced by factors of maternal origin. In both cases, the eruption anomaly was associated with an enamel anomaly. These observations open new perspectives in the study of natal and neonatal teeth. By extension, such observations are likely to produce complementary informations in neonatology.
50 cases of natal and neonatal teeth were studied at Seth G. S. Medical College and K.E.M. Hospital in order to find out its most common location, sexual predilection, occurrence etc. The cases of natal and neonatal teeth usually report to the hospital due to difficulty in suckling, ulceration to the breast nipple and fear of aspiration of the teeth.