Microdontic teeth succedaneous to natal teeth: a report of two cases.
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The purpose of this study was to review cases of natal teeth in babies born between January 1984 and December 1988 at the Queen Elizabeth Hospital Hong Kong. There were 53678 births at the hospital during this period and 48 babies had natal teeth, a prevalence of 1:1118. The 48 babies had 72 natal teeth, all mandibular central incisors. The natal teeth in two babies were supernumerary teeth of a predeciduous dentition. Twenty nine natal teeth were extracted because they were hypermobile, three were extracted because they traumatized the ventral surface of the babies's tongue, and 16 were not extracted. The subjects were reviewed one day after the initial examination, and then after 1 week, 1 month and at 6-month intervals. No appreciable space loss occurred following the extractions. Root development occurred in teeth that were not extracted, but the crowns were hypoplastic in three cases.
1. Obtain dental radiographs whenever possible before removing natal teeth in order to better advise the parents of complications. 2. Leave natal teeth in the mouth as long as possible in order to decrease the likelihood of removing permanent tooth buds with the natal tooth. 3. Obtain the parents' consent and rule out neonatal hypoprothrombinemia before removing natal teeth. 4. Recommend postoperative evaluation by a pedodontist in order to obtain diagnostic radiographs and necessary treatment.
The case of a newborn girl with two mandibular incisor natal teeth and bilateral mandibular odontogenic harmartomas is presented. The hamartomas were evident as pedunculated masses on the posterior mandibular gum pads. The natal teeth were extracted at birth, and the hamartomas were excised at 5 months of age. Microscopic investigation of the hamartoma demonstrated the presence of all odontogenic tissues with the exception of an enamel organ. In addition, there was a strong family history of natal teeth, which may suggest a hereditary basis for the development of the odontogenic hamartoma.
An 18-month-old Japanese boy with multiple natal teeth was examined. Fourteen hard structures were reported to have been present at birth at the regions of the anterior teeth and first primary molars in both jaws. The structures were excessively mobile and 11 of the structures had exfoliated successively since 5 months of age. The three structures remaining at the regions of the first primary molars had bonelike appearance and color, and were smaller in overall dimension than the corresponding primary teeth. Radiographic examinations showed that the structures had neither roots nor pulp chambers and their radiopacity corresponded to that of mandibular bone. Furthermore, there were no permanent successors except for the upper central incisors and left lateral incisor at the regions where the structures were situated. Histological examinations revealed that the specimens consisted of dentin with tubular structure, osteodentin-like structure, and cementumlike structure.
A Chinese family is reported in which five generations have exhibited natal teeth and generalized multiple steatocystomas. This autosomal dominant condition is not similar to the two reported types of pachyonychia congenita, because nail lesions, palmoplantar keratosis and hyperhidrosis, follicular keratosis, and oral leukokeratosis were not observed. Therefore, it is suggested that this family exhibits a newly recognized syndrome.
The second monozygotic twin pair concordant for Van der Woude syndrome is reported. Clinical manifestations of this autosomal dominant clefting syndrome included bilateral lower lip pits, cleft lip, and cleft palate. Both sibs were found to have a natal tooth. No other cases of Van der Woude syndrome with this feature have been described previously. It is uncertain whether the presence of a natal tooth in this instance represents a low-frequency association of this disorder. However, it appears more likely that its occurrence was incidental, since natal teeth have been reported before in twin pairs as an isolated finding.
A new syndrome, consisting of natal or defective teeth, or both, steatocystomas of the skin, and epidermal cysts of the scalp, is described in several generations. One member of the family had eruptive molars. Male-to-male transmission suggests autosomal dominant inheritance. This syndrome should be separated from pachyonychia congenita I and II.
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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.
A 20-day-old black male infant with two rare posterior natal teeth was referred for examination and care. Oral radiographs suggested that the teeth were the right and left maxillary primary molars. The hypermobile teeth and associated suspicious soft tissue masses were removed. Histologic examination revealed irregular tooth structures and infiltrate consistent with inflamed dental follicles.
Described are four oral anomalies--natal teeth, palatal cyst, bilateral lymphangiomas of the alveolar ridge, and median alveolar notch--found in a newborn. Immediate and long-term treatment considerations are outlined.
Natal teeth, defined as those that are the mouth at birth, are rare: one case in 2,000 to 3,500 births. In this case, that of a nine-month-old Japanese boy, it is reasonable to infer that the tooth-like structure, described as a hard-tissue conglomerate with a bone-like appearance, originated in the remnant of the dental papilla and Hertwig's sheath of the natal tooth. Both dentin and root formation were thereby induced.
Two male infants with a pseudo-hydrocephalic progeroid syndrome with natal teeth are compared with two very similar female cases reported in the literature and interpreted as congenital progeria. All these cases may represent a separate entity, a previously unrecognized genetic progeroid syndrome.