Natal and neonatal teeth

Abstract

A 3 week old infant presented with persistent hypoxaemia and was diagnosed with pulmonary arteriovenous malformations. Her family history was positive for hereditary haemorrhagic telangiectasia. She was treated successfully with coil embolotherapy at the age of 4 months. Transcatheter embolisation may be considered the primary treatment for pulmonary arteriovenous malformations in infancy.H ereditary haemorrhagic telangiectasia (HHT), also known as Rendu-Osler-Weber syndrome, is an autosomal dominant mucocutaneous and visceral vascular dysplasia, characterised by the occurrence of telangiectasia and arteriovenous malformations (AVMs). Patients are usually recognised by the presence of telangiectasia, recurrent epistaxis, and a positive family history. Clinical symptoms usually appear after puberty.First reports appear to be from around 1864 when Sutton and Babington described patients with recurrent epistaxis and vascular abnormalities. Rendu, Osler, and Weber later recognised the combination of epistaxis in a familial pattern with telangiectasia. Pulmonary AVM is the most dangerous localisation of HHT because of the risk of paradoxical septic embolism.1 In 1897, the first pulmonary AVM was found at the postmortem examination of a 12 year old boy.2 Reported series of patients with pulmonary AVM, however, indicate that such findings are uncommon in children.3-6 To our knowledge, only 12 cases of pulmonary AVM diagnosed during the first year of life have been described from 1975 onwards, the last one being reported in 2000.6 Most of the previously described cases were treated primarily with surgery. We report on a 3 week old infant who presented with persistent hypoxaemia as a result of pulmonary AVM. CASE REPORTA 3 week old Dutch Antillean girl was admitted after an apparently life threatening event. The pregnancy was uncomplicated, and the patient was born term with a birth weight of 2420 g (p13). Apgar scores were 8 and 9 after one and five minutes respectively. There had been no remarkable events until the day of admission, when she had an apnoeic episode after several coughs. The pregnancy had been the mother's seventh. Two older children originate from another relationship; four pregnancies were terminated by legal abortion. The history later revealed the occurrence of HHT in the family, with a confirmed mutation in the gene coding for endoglin on chromosome 9. This family, 3655, and the mutation have been described previously.7 The patient's mother has been diagnosed recently with HHT, and the presence of the same mutation is under investigation.Physical examination at admission showed a healthy and alert black neonate without fever. Besides mild tachypnoea and a persistent percutaneous oxygen saturation of 87%, vital signs were stable. Auscultation of the chest showed normal heart sounds with a slight early systolic murmur, maximal at the upper left sternal border, attributed to a persistent ductus arteriosus as evidenced by cardiac ultrasonography. On revision three weeks later, it was no longer audible o...

Natal tooth in preterm newborn: a case report

“…However, this risk, in truth, is unlikely, as no reports exist of an actual occurrence of aspiration 24 . Nevertheless, cases of spontaneous exfoliation have been reported [9][10] . The uniqueness of this case stems from the presence of the natal tooth in a preterm newborn, whose data, as provided by the mother, were corroborated by hospital records.…”

“…An examination of the HUCAM patient records, conducted subsequently, confirmed the information supplied by the mother. Despite the existence of this relationship between prematurity and the delay in eruption of the first deciduous tooth, cases have been reported in the literature of preterm newborns that have natal or neonatal teeth [9][10][11][12][13] . In a retrospective study of 17,000 children, between 1984 and 2001, the presence of natal teeth was observed in just five newborns, of which two were preterm 14 .…”

Conséquences locales et générales de la présence d’une dent natale chez le nouveau-né. À propos d’un cas clinique

“…La taille et la forme d'une dent natale ressemblent à celles d'une dent temporaire, mais la dent natale est habituellement plus petite, conique avec une couleur jaune ou marron opaque. Elles sont peu développées, avec peu ou pas de formation radiculaire [1,3]. Les dents les plus souvent incriminées sont les incisives centrales mandibulaires (85 %), suivies par les canines et molaires mandibulaires (3 %), les incisives centrales maxillaires (1 %), puis les canines et molaires maxillaires (moins de 1 %).…”

“…Les superstitions concernant les dents natales sont nombreuses [1,2]. En Angleterre, les enfants nés avec cette particularité étaient destinés à devenir des soldats célèbres.…”

Neonatal tooth in a preterm infant

“…Eruption of a natal/neonatal tooth is a subject of interest for both pediatricians and dentists. There is only one report of a natal tooth in the literature of an extreme premature infant [3]; however, to our knowledge, this is the first reported case of a neonatal tooth in a preterm infant.…”