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SHORT COMMUNICATION
Year : 2013  |  Volume : 4  |  Issue : 3  |  Page : 135-136

Congenital gingival cyst of neonate: Dentist's enigma


1 Department of Pedodontics and Preventive Dentistry, H.P. Government Dental College and Hospital, Jaipur, Rajasthan, India
2 Department of Orthodontics, H.P. Government Dental College and Hospital, Jaipur, Rajasthan, India
3 Department of Pedodontics and Preventive Dentistry, Nims Dental College and Hospital, Jaipur, Rajasthan, India
4 Department of Community Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India

Date of Web Publication20-Nov-2013

Correspondence Address:
Deepak Chauhan
Department of Pedodontics and Preventive Dentistry, H.P. Government Dental College, Shimla - 171 001, Himachal Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0976-433X.121643

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  Abstract 

Gingival cysts of the newborn are small keratin-filled cysts on the alveolar mucosa of infants that exists at birth. They are remnants of the dental lamina and are usually multiple in numbers, but do not increase in size. The diagnosis is made at the clinical level. Since, this lesion tends to undergo involution or regresses spontaneously within a few weeks or months after birth so unnecessary therapeutic intervention is avoided. Complications are rarely observed. Pain on sucking, refusal to feed and airway obstruction can occur in rare instances. However parents remain anxious about the prevailing condition. Hence they should be reassured by providing suitable information about the simple nature of this lesion.

Keywords: Gingival cyst, mucosal lesion, newborn


How to cite this article:
Chauhan D, Sharma KR, Kaundal JR, Thakur S, Parasher K, Chauhan T. Congenital gingival cyst of neonate: Dentist's enigma. SRM J Res Dent Sci 2013;4:135-6

How to cite this URL:
Chauhan D, Sharma KR, Kaundal JR, Thakur S, Parasher K, Chauhan T. Congenital gingival cyst of neonate: Dentist's enigma. SRM J Res Dent Sci [serial online] 2013 [cited 2022 Oct 3];4:135-6. Available from: https://www.srmjrds.in/text.asp?2013/4/3/135/121643


  Introduction Top


Gingival cyst appears as multiple or solitary, asymptomatic whitish nodules of 1-3 mm in diameter in infant's or newborn's oral cavity and are generally seen in the anterior part of the alveolar ridges of the maxilla or mandible. The cysts are usually present during the time of birth and rarely seen after 3 months of age. [1],[2] They regress spontaneously, so no treatment is usually required. [3] Fromm [4] classified oral mucosal cysts as Epstein's pearls, Bohn's nodules and dental lamina cysts according to their presence and location in the oral cavity.

A simpler classification based on location divide these cysts into "palatal" and "alveolar cysts." Those located at the midpalatine raphe are referred as palatine cysts while those present on the buccal, lingual, or crest of alveolar ridge as alveolar (or gingival) cysts. [5]

The reported prevalence of alveolar cysts in newborn ranges from 25% to 53%, while for palatal cyst is about 65%. [6],[7],[8] Although prevalence is high, these cysts are rarely seen by the general dentist or pediatric dentist because of the transient nature of these cysts, which disappears within 2 weeks to 5 months of postnatal life. [5],[9]


  Case Report Top


Here is a case report of 2-week-old neonate who was brought to the Department of Pedodontics and Preventive Dentistry of Himachal Pradesh Government Dental College, Shimla with swelling in his lower anterior alveolar ridge of the mandible. On the basis of clinical findings, characteristic appearance of the lesion and its peculiar location a diagnosis of dental lamina cyst or gingival cyst of new born was made. Intraoral examination revealed a 2 cm Χ 2 cm exophytic, soft, yellowish pink lesion in the anterior portion of the alveolar ridge of mandible. No other abnormalities were seen on the buccal mucosa, tongue, palate or on the floor of the mouth. Since these lesions are self-limiting in nature, the child was kept under observation after giving oral hygiene instructions to the parents.


  Discussion Top


Dental lamina cyst, also known as gingival cyst of newborn, is true cyst as it is lined by thin epithelium and shows a lumen usually filled with desquamated keratin, occasionally containing inflammatory cells. [2]

Treatment options are no treatment and follow-up, marsupialization or surgical extraction if natal or neo-natal teeth are associated with it. The role of histopathology in establishing the final diagnosis is not essential, however, differential diagnosis with hemangioma, melanoma, unicystic ameloblastoma, keratinizing cystic odontogenic tumor, mucocele is of utmost importance when the treatment is surgical intervention, i.e. marsupialization or enucleation of the lesion. [10]

Although the histopathological analysis is not essential to establish the final diagnosis, a needle aspiration biopsy would definitely confirm the fluid filled aspect, ruling out solid lesions. The evaluation of the aspirated cystic content may demonstrate the presence of cholesterol crystals presenting a slightly yellow color and of low viscosity. Unlike other odontogenic cysts, where radiography is essential for diagnosis, eruption cyst EC is not detectable on radiographic examination because there is usually no bone involvement. Even so, radiography is highly recommended for evaluation of the morphology of the involved tooth or its surrounding jaw bone. [10]

The present case was managed by close monitoring of the lesion, without any invasive procedure. Both child and mother had no complications during feeding and normal eruption of primary teeth occurred slightly earlier than for its normal schedule by the 5 th month. Although in this case monitoring of the lesion was the ideal approach, but treatment of choice must be case specific with adequate analysis of clinical and radiographic findings.

 
  References Top

1.Neville WB, Damm DD, AllenCM, BouquotJE. Oral & Maxillofacial Pathology. 2 nd ed Philadelphia, W.B. Saunders Co, 2004: pp. 601-603.  Back to cited text no. 1
    
2.Shafer WG. Cysts and tumors of odontogenic origin. In: Hine MK, Levy BM, Tomrich CE, editors. Textbook of Oral Pathology. 4 th ed. India: W.B. Saunders Co, Prism (Reprint); 1993. p. 268-9.  Back to cited text no. 2
    
3.Kumar A, Grewal H, Verma M. Dental lamina cyst of newborn: A case report. J Indian Soc Pedod Prev Dent 2008;26:175-6.  Back to cited text no. 3
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4.Fromm A. Epstein's pearls, Bohn's nodules and inclusion-cysts of the oral cavity. J Dent Child 1967;34:275-87.  Back to cited text no. 4
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5.Paula JD, Dezan CC, Frossard WT, Walter LR, Pinto LM. Oral and facial inclusion cysts in newborns. J Clin Pediatr Dent 2006;31:127-9.  Back to cited text no. 5
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6.Friend GW, Harris EF, Mincer HH, Fong TL, Carruth KR. Oral anomalies in the neonate, by race and gender, in an urban setting. Pediatr Dent 1990;12:157-61.  Back to cited text no. 6
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7.Jorgenson RJ, Shapiro SD, Salinas CF, Levin LS. Intraoral findings and anomalies in neonates. Pediatrics 1982;69:577-82.  Back to cited text no. 7
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8.Cataldo E, Berkman MD. Cysts of the oral mucosa in newborns. Am J Dis Child 1968;116:44-8.  Back to cited text no. 8
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9.Flinck A, Paludan A, Matsson L, Holm AK, Axelsson I. Oral findings in a group of newborn Swedish children. Int J Paediatr Dent 1994;4:67-73.  Back to cited text no. 9
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10.Woldenberg Y, Goldstein J, Bodner L. Eruption cyst in the adult - A case report. Int J Oral Maxillofac Surg 2004;33:804-5.  Back to cited text no. 10
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