Um Caso Raro de Dentes Neonatais

Abstract

RESUMOOs dentes neonatais correspondem a um distúrbio raro da erupção dentária, surgindo na cavidade oral no primeiro mês de vida, habitualmente na região anterior da mandíbula, sendo a sua etiologia desconhecida. Podem motivar dificuldades na amamentação e ser alvo de aspiração ou deglutição. Descreve-se o caso de um recém-nascido prematuro que no segundo dia de vida apresentava edema, hiperemia gengival e uma pequena tumefação na região dos incisivos centrais inferiores. Dez dias depois, foram detetados, nesse local, dois pequenos dentes com hipermobilidade, pelo que se procedeu a exodontia. Com este caso clínico pretende-se salientar a raridade dos dentes neonatais, sobretudo em recém-nascidos prematuros, a sua possível associação a várias síndromes e a necessidade de uma abordagem multifatorial na decisão terapêutica (exodontia/tratamento conservador). Palavras-chave: Dentes Natais; Língua/lesões; Prematuro; Recém-Nascido; Úlceras Orais. ABSTRACTNeonatal teeth is a rare disorder of tooth eruption, arising in the oral cavity, usually in the anterior mandible, in the first month of life. Its etiology is unknown. This condition can cause breastfeeding difficulties, besides aspiration or swallowing of the teeth. We describe the case of a premature infant in the second day of life presented with gingival edema, redness and discrete swelling in the region of the mandibular central incisors. Ten days later, two small teeth with hypermobility were detected. Extraction of those teeth was performed.With this clinical case we intend to show the rarity of this entity, especially in premature infants, the possible association with various syndromes and the need for a multifactorial approach to the treatment decision (extraction / conservative treatment). Keywords: Infant, Newborn; Infant, Premature; Natal Teeth; Oral Ulcer; Tongue/injuries. INTRODUÇÃOA erupção dentária é um processo fisiológico que se inicia, em média, aos seis meses de vida, com o aparecimento dos incisivos centrais inferiores decíduos.1 Porém, existem casos descritos na literatura de recém-nascidos (RN) que apresentam, ao nascimento ou durante o primeiro mês de vida, elementos dentários parcial ou completamente erupcionados, denominados dentes natais e neonatais, respetivamente.2 A sua etiologia permanece desconhecida, podendo estar associados a várias síndromes.1 A decisão terapêutica subordina-se a uma abordagem multifatorial, designadamente à dentição à qual o dente pertence, suas características e complicações. 1 CASO CLÍNICORN do sexo feminino, gestação não vigiada, com serologias maternas periparto sem evidência de infeção ativa. Parto distócico por cesariana às 28 semanas (prematuridade espontânea), com peso ao nascimento de 1 240 g. No exame objetivo ao nascimento não apresentava dismorfias aparentes. Na primeira hora de vida foi internado na Unidade de Cuidados Intensivos Neonatais (UCIN) pela prematuridade e risco infecioso. No segundo dia de vida o RN apresentava edema e hiperemia do tecido gengival, na posição 71/81, associado a uma pequena...

Natal and neonatal teeth: two clinical cases report

“…If the tooth presents good implantation and is part of the normal primary dentition, the first treatment of choice will be the maintenance of the tooth in the oral cavity, as long as it does not cause harm to the child 4 , as reported in the first clinical case. However, if it is interfering with breastfeeding or presenting great mobility, with risk of displacement and aspiration, the tooth must be removed 3,4,11 , as in the second clinical case. Although some authors report the possibility of aspiration of these teeth, there are no reports in the literature confirming this occurrence 4 .…”

“…Concerning the clinical point of view, there was no doubt about the diagnosis and the therapeutic approach, thus avoiding to subject babies to unnecessary radiation 17 . Still, due to the small opening of the mouth and the lack of cooperation inherent to babies' age [18][19][20] , the radiographic procedure would be very uncomfortable, adding small benefits to the case.…”

“…However, most of the time, they are small, conical and poorly developed, presenting a ▼ ▼ ▼ ▼ ▼ yellow-brown coloration and enamel hypoplasia 6,9 . The soft tissue around the teeth may be hyperplastic, with edema, hyperemia and/or bleedin 10,11 . Radiographic images show low radiopacity, wide and minimal pulp chamber, or root formation absence 12 .…”

Natal tooth in preterm newborn: a case report

“…An extreme treatment would involve the extraction of the natal tooth, which is recommended in the case of a supernumerary tooth, when associated with Riga-Fede syndrome or if is there is excess mobility without bone insertion 12,22 . The concern over excess mobility resulting from insufficient root development stems from the fact that this tooth may constitute a risk to the airways due to the possibility of aspiration 13,23 . However, this risk, in truth, is unlikely, as no reports exist of an actual occurrence of aspiration 24 .…”

“…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 .…”