ISSN 0970 - 4388

Unusual neonatal tooth in maxillary 1st molar region: A case report

SUBRATA SARKARa, SOUMYABRATA SARKARb

Abstract
Teeth erupting within the rst month after birth are known as neonatal teeth. Incidence of neonatal teeth is very low. Neonatal teeth erupt in various regions of the maxillary and mandibular arch. Incidence of neonatal teeth in molar region is only 1%. A case of an unusual neonatal tooth in the maxillary molar region has been presented. Key words: Maxillary 1st delicious molar region, neonatal tooth

Introduction

Massler and Savara[1] suggested that natal teeth are present in the oral cavity from birth; on the other hand, neonatal teeth erupt during neonatal period, i.e., within 30 days after birth. Incidence of natal teeth is more than neonatal teeth and its ratio varies from 1: 2000 to 1: 6000.[1-8] Bodenhoff [9] reported the incidence of natal and neonatal teeth to be 0.3-0.5%.

Natal and neonatal teeth erupt in the same position as that of deciduous teeth in the arch, more common in mandibular arch than maxillary arch, and are more common in the incisor region than the canine and molar regions. Various investigators noted that 85% erupt in mandibular incisor region, 11% in maxillary incisor region, 3% in mandibular canine region and 1% in maxillary canine and molar regions.[1,2,8,9] Shor and Hajare[3] noted that incidence is more in girls than in boys.

Sponge and Feasby,[4] classified natal and neonatal teeth; as mature or immature. Etiology of natal and neonatal teeth is not known. Various investigators have put forth various views.

During initiation and proliferation stage excessive development causes formation of natal teeth,[10] Hyperactivity of osteoblastic cells within the tooth germ may also be a reason, as suggested by another group of investigators. Superficial positioning of tooth germs during developmental period may also be a reason.[11] Oral pathologists suggested endocrinal disturbances, or they may be associated with various syndromes.[12-14]

Prof. & HOD Pedodontia, Guru Nanak Institute of Dental Science and Research, Kolkata, Ex-Principal & HOD, Department of Pedontia, Dr. R. Ahmed Dental College & Hospital, bDental Surgeon, Guru Nanak Institute of Dental Science and Research Kolkata, India
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Case Report Discussion

The incidence of natal/ neonatal teeth in Muslim children is more than Hindu children.[15] Crowns of these teeth are like those of normal teeth, without any radicular portion due to lack of root formation.[16-17] Ground section of natal and neonatal teeth showed hypomineralized enamel, irregular arrangement of enamel rods, irregular dentino-enamel junction, dentinal tubules, more cellular and numerous vascular channels with endothelial cells and large pulp chamber.[18] Present paper aims to evaluate means to prevent various complications occurring due to an unusual neonatal tooth in maxillary arch (in first molar region) in a 3-month-old Bengalee child.

Apparently good health aged 3 months male child came to our clinic with complaints of whine type crying throughout the day, mainly at the time of feeding. On oral examination, an unusual neonatal tooth was found in maxillary arch (in the left deciduous 1st molar region), which had caused mild ulceration in the mandibular arch and tongue [ Figure 1]. After thorough hematological examination, the neonatal tooth was extracted under proper aseptic conditions. Extracted tooth was rootless [Figure 2].

Teeth appearing in the oral cavity within 30 days of birth are known as neonatal teeth. Incidence of this type of teeth is very low. Incidence of neonatal teeth in maxillary arch in the molar region is only 1%. [1,2,8,9] Etiology of natal and neonatal teeth is still unknown. Various investigators have postulated various views. Hyperactivity of osteoblastic cells within tooth germ during initiation[10] or proliferation stage of development of tooth may be the reason.[10] SEM study on neonatal teeth of two female babies with cleft lip
J Indian Soc Pedod Prevent Dent - Supplement 2007

Unusual neonatal tooth in maxillary rst molar region

Figure 1: Neonatal tooth in maxillary left molar region

and cleft palate noted irregular hypoplastic superficial enamel layer, regular dentinal layer with arrangement of dentinal tubules-like normal teeth and with only 300 root formation.[12] Anegundi et al.[18] also observed similar findings.

Early eruption of neonatal tooth causes ulceration in the opposite arch, gum pad and tongue due to sharp edge of tooth.

References
1. 2. 3. 4. 5. 6. 7. 8. 9.

Massler M, Savera BS. Natal and neonatal teeth: A review of 24 cases reported in the literature. J Pediatr 1950;36:349-59 Bodenboff J, Gorlin RJ. Natal and neonatal teeth: Folklore and fact. Pediatrics 1963;32:1087-93 Shori DD, Hajare VK. Natal and neonatal teeth. JIDA 1983;55:371-2 Sponge JD, Feasby WH. Erupted teeth: In new born. Oral Surg Oral Med Oral Pathol 1966;22:198-208 Leung AK. Natal teeth. Am J Dis Child 1986;140:249-51 Chow MH. Natal and neonatal teeth. J Am Dent Assoc 1980;100:215-6 Zhu J, Kind D. Natal and neonatal teeth. ASDC J Dent Child 1995;62:123-8 Gardina JH. Erupted teeth in the newborn. Proc R Soc Med 1961;54:504-6 Bodenhoff J. Dentiles Connatelis et Neonalatis. Odon T 1959;67:645-95

J Indian Soc Pedod Prevent Dent - Supplement 2007

Th is a PD si F te i ho s a st va (w ed ila w by ble w .m M fo ed ed r fr kn kn ee ow ow do .c Pu w om b nl o ). lica ad tio fr ns om

Figure 2: Extracted neonatal tooth
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10. Dixon GH, Stewart RE. Genetics aspects of anomalus tooth development. Quoted from Oral Facial Genetics by Stewart AE, Prescott GH. The CV Mosby Comp: St Lows; 1976. p. 124-50 11. Ooshima T, Mihara J, Saito T, Sobue S. Eruption of tooth like structure following the exfoliation of natal tooth: Report of case. ASDC J Dent Child 1986;53:275-8 12. Jasmin JR, Clergeau-Guerithault S. A scanning electron microscopic study of enamel of neonatal teeth. J Bio Buccale 1991;19:309-14 13. Diaz-Romero RM, Shor-Hass F, Benitez-Tirado C, FernandezCarrocera L. Anomalies of the oral cavity in Mexican neonates. Bio Med Hosp lnfane Max 1991;48:832-5 14. Gorlin RJ, Pindbrog JJ. Syndromes of the head and neck. McGraw Hill Book Comp: New York; p. 71, 435, 436, 450, 457 15. Barwala DR. Natal and neonatal teeth: A reviews of 5 cases. J Indian Soc Pedod Prev Dent 1996;14:21-3 16. Kaur P, Sharma A, Bhuller N. Conservative management of a complication of neonatal teeth: A Case Report. J Indian Soc Pedod Prev Dent 2003;21:27-30 17. Hals H. Natal and neonatal teeth histological investigation in two brothers. Oral Surg Oral Med Oral Pathol 1975;10:509-21 18. Anegundi RT, Sudha R, Kaveri H, Sadanand K. Natal and neonatal teeth a report of four cases. J Indian Soc Pedod Prev Dent 2002;20:86-92