An 8-day-old infant boy was referred to the Clinic of Pediatric Dentistry of Osaka University Dental Hospital for examination of natal teeth. An intraoral examination showed that two natal teeth had emerged into the oral cavity in the region of the mandibular primary central incisors, with the edge of one in the region of the mandibular right primary central incisor found to be in contact with the undersurface of the tongue. The affected tooth displayed severe mobility and the edge appeared to produce sublingual erosion; thus, it was extracted. In addition, a natal tooth in the opposite quadrant appeared to be attached to the surrounding gingiva with moderate mobility. Although we attempted to preserve that tooth, his parents reported that it was spontaneously exfoliated a few days later. Five months later, the patient returned to our clinic with swelling of the gingiva in the mandibular left primary central incisor region and a pedunculated epulis-like lesion was recognized in the gingiva of the mandibular left primary central incisor. A periapical X-ray photograph demonstrated thin radiopaque tissue with the appearance of a root in the area of the previously exfoliated natal tooth. We decided to remove the epulis-like lesion and associated thin hard tissue under local anesthesia. Histopathological analysis demonstrated that the lesion was composed of periodontal fibers covered by a layer of squamous epithelium cells, along with hemorrhage and vasodilatation under the mucosa. Taken together, the pathologist diagnosed the lesion as an epulis with inflammatory change.
- Natal teeth
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Dentistry (miscellaneous)