cysts of the oral mucosa in newborns a clinical observation

7/25/2019 Cysts of the Oral Mucosa in Newborns a Clinical Observation

1/6

he UOEH Association of Health Sciences

NII-Electronic Library Service

UOEHAssociation

ofHealthSciences

J.

UOEH,

Cysts

5(2)i

of

163-168

(I98S)

theOral

Mucosain

Newborns

: A

CIinical

163

[Original]

Observation

Kunio

IKEMuRAL,

Yasuaki

KAKINoKI],

Kazukata

NIsHIo"

and

Yoshinori

]Dopartmertt

qf'

l)entistp/

and

Orai

Surgeo],llo.ipital,(.}tiv"msib'

ql'

Occapatienal

and

Environmental

Heatth,

Japan,

Kitalpzashu807,

Jopan

'"Dopartmeni

qf'

Dermatoiogy,School

qf

Adedicine,LTniversity

qf

Occiipationatand

EnvironmentalHealih,

Japan.

Kitakyusha807,

Japan

SUENAG,x2

Abstract:

Kev

wordsi

Nodules or cysts of

the

oral mucosa oceurred with an incidcnceof 88,7

per

cent in 541

Japancsc

ncwborn

infants. No

inf'antwas

over

a

[iays

old,

This

incidenccishigherthan

that

reported

in Caucasian

and

Ncgro

newborns.

It

may

bc

suggcsted

that

the

frequency

of

visiblc

nodule$

have

a

close

re]atiun

to

growth

and

develepment ln the fetallife,

becEtusethc

c},sts

seen

in newborns

can

bc

recognized

histologicallyin most

fetuses,as

demonstrated

in

other

papers,

Although

a

variet},

of

terminology

fbr thcse

nodules

have

been

used,

thesc

oral

cysts

caii

be

classified

as

follows:

ging.iva]

cyst

in the

ncwborn

(dental

iarninacyst)

and

mcdiaR

palatal

mucosa}

cyst

(Epstein's

pearl).

c},st, oral }nucosa, ne",born.

{Rcccived

15 February1983)

Introduction

Although

small

nodules

or

cysts

of'

the

oral

mucosa

are

a

very

common

findingin

newborn

infants,

they are not always

a

well-known

condition

to

general

clinicians and

there

are

only

a

few

reports

(pt'fonteleone

&

McLellan,

1964; Fromm, 19673 Cataldo &

Berkman,

1968) on

clinical

observations

of

a

large

number

of

newborns,

This

may

be

due to the fact

that

clinicians

have few

chances

to inspect

the

oral

mucosa

of

the newborn

or

they

disappear

spontaneously

(Catalclo

&

Berkman,

1968; Higuchi

et

al,,

1981).

It

is the

purpose

of

this

paper

to

describethe

results

of

clinical

observations

in

Japanese

newborn

infants

and

to

comment

on

the

tcrminology

for

these

nodules.

A

total

of

after

birth,sex

locationand

the

white

in

colour

Materials

541

infants

were

examined,

N() infant

was

over

8

days

old.

The

days

and

body

weight

were

recorded,

Subsequent

to

an

oral

examination,

thc

number

of

mucosal

nodules

were

recorded.

They

wcrc

white

or

}'ellowish-

and

varied

i,n

size

from

less

than

2

mm

to

5

mm

(Fig.

1),


2/6



UOEHAssociation

ofHealth

Sciences

164

K.

IKEMuRA et al.

Fig.

1.Nodules

of

the

max llary

gingiva

(twenty-day-eld

infant).

Table

1. Incidence

of

nedules

by

sex

Sex

No.

ofcases Noduie$present

Frequcnc},

(%)

Ma]eFemaleTotdl

261280541

236244480

90,487,188.7

Results

Of

541

newborn infants,

nodules

occurred

with

an

incidence

of

88,9

per

cent.

Male

infants exhibited

a

higherincidence

than

female infants

CTable

1).

The

inciclencein

newborns weighing between

2.0

and

3,9

kg

was approximately

90

per

cent

(Table

2),

When

comparing

this

percentage

with

the

incidencein

newborns

over

4.e kg bedy

weight,

a statistically significant

diflbrence

(P


3/6



ofHealthSciences

Cysts

of

Ora[

Mucosa

in

Newborns

T..a.ble

.2.z

I.f}f.iid-evce

k,.Lb.o.dy

yLnltlii.

165.

ttttttttYVeigl]t

[bf1.).

-..

2.0-2.4

2.5-2.9

3.0-3,4

3,5-3.9

4.0i.

Total

No

6f

.-m.ttg.sgi

28

l39

2.53

107

]4

541

Nocli.i]espresent

25

125

Z24

96

10

480

Frequency

t'

%)89

3S9,988.589.

771.488.7

..

Ti.lb.L,

3Incidence b>,days afterbirth

-

1)ays''ifi.er

birth

o

1

2

3

4

5

6

7

-.,Total -.

No'.ofcuses

39

85

85

98

91

55

56

3Z

541

Nodulesprc}sor)1.

"requen{lt/'

(%}

38

82

75

87

75

49

46

28480

rnctidenceby

site

97.4

96

.

i.,

88.2

88.8

82.4

89.1

82,1

87.5

-.5e,7

Tab]e

4.

Site

Nodu]espr'eserlt

ttttttttt tt

Frequency

(1%)

Median

palalal

mucosa

Maxillary

gingiva

Mandibu]ar

gingiva

36929:l

sE

.

IJ.icidencebyni]tnberofnodules

68,25,1,1li],s

Table

5,

N61'o'fnodules No. ofeases

o

l

2

3

4

5

6

7

8

9

leTotaL

6]13].

96

83

65

43

29

9

5

4

l5541

lirequency

-

ip-)---

1.1324,217.715.I312.0

7,9

5,4

1,7

O,9

O,7

2.8


4/6



UOEHAssociation

ofHealth

Sciences

166 K,

IKEMURA

et

aL

Discussion

In i967

Fromm

reported

that there

was

a

difllercnee

in

thc

incidcnce

of

mucosal

inc;lusioncysts

between

Caucasian

and

Negro

ncwborn

infants. He

examined

l367

new-

born infants,lessLhan 48 hours

old,

and

stated

that inclusion

cysts

of

the

oral

mucosa

were

fbuncllessfi'equentlyin Negro

newborn

infants than

in

Caucasian

counterparts

with

percentages

of

63.0

and

76.8

per

cent

respectively.

Our

observation

showed

that the

incidence

of

nodules

in

Japanese

newborn

infants

was

88.7

per

cent

and

that thc incidence

in

209

newborns

less

than

48

hours

old

was

93,3

per

cent

(Table

3). Monteleone,

&

N'Tcl.ellan

(1964)

obse,rved

ncwborn

infants within

the

first

24hours

after

birth

and

re-

portecl

that

Epstein's

pearl

fbrmation

occurred

in

79

per

cent

of

293

Negro

infants

and

85

per

cent

of

100 Caucasianint'ants."Jhen

our

cases

were

confined

to

the

same

condition,

the

incidence was

91.4

per

ccnt

of

124

cases.

Therefore,

present

studies

indicate

that the

nodules

are

scen

more

fi'equentlyin

the

,Japanese

newborn

infantsthan

in

thc

Caucasian

and

Ncgro

ncwborn

infants.

In

Fromm's

report

(1967)

no

correlation

existed

between the

weight

ef

the

infant and

the

incidence

of'

inclusion

c>,sts,

Howcver,

the

rcsults

obtained

here

show a statistical

corrclation

betwcen

budy

weight

and

the

incidence of

nodules,

bordering

4.0

kg

in

weight

(Table

2). In addition,

the

infantswho

were

examined

soon

after

birthhad

a

higher

frequency

than

other

groups

(Table

3)

and

in

most

cases

the

nodules

disappearcd

spon-

taneously

within

a

few months

(Cataldo

&

Berkman,

1968;

Higuchi et

al,,

1981). Furthermore,

the

histologicaifindings

of cys.ts seen

in

newborn

infants

can

be

rccognized in

most

fetuses

(Scott,

1955; Burke

et

at,,

1966; rV'Ioreillon& Schroeder, 1982),

and

Moreillon

& Schroeder

(}982)

state

that

the

high

number

of

fetal

microkeratocysts

gradually

decreases in

late feta}Iifeand

early

postnatal

Iife. [I]herefore,it

may

be

con-

cluded

that the

frequency

of

visible

nodules

have

a

close

relation

to

growth

and

develop-

ment

in the

fetallife

or

in the

early

postnatal

life,

The

most

cgmmon

location

was

the

median

palatal

mucosa

(Table

4). In

cornpari-

son

to

the

rcsults

reported

by

Cataldo

&

Berkman

(1968),

our

examination

showed

the

higherincidence

of

nodules

in the

rnandibular

gingiva.

As

to

the

number

of

nodules

(Table

5),description

sufi'icient

for comparison

could

not

be

obtained

from

other

reports.

'I'he

small

nodules

of

the

oral

mucosa

in infantshave

been

dcscribedby difllerent

terminology

(Monteleone

&

McLellan,

1964; Fromm,

1967). Nomenclatures

come

from

the

namc of

the

reporter

(Epstein)s

pearl,

Bohn's

nodule),

histologicalfindings

(epithelial

cysts,

inclusion-c>rsts,microkeratocysts.

mucous-gland

cy,sts),

and

confused

origin

(epithe-

lial

rests,

epithel{al

huds

of

the

enamel

organs,

epithelial

debris

ef

the

tooth

follicle,

abortive enamel

organs,

epithelial

remnants

of

the

dental

follicle). The

invcstigationsof

the

fetus

(Scott,

1955;

Burke

et

al.,

1966; Moreillon

&

Schroeder,

1982)

demonstrate

that

thc

nodules arisc frorn

the

clentallamina

and

the

fusionof

the

palatal

shelves.

Epstein's


5/6



UOEHAssociation

of

Health

Sciences

CNsts of

Oial NIucusa in

rNcwbvrnK 167

{sl

'{i

}ltltt-.M

s$

r.

.

as-ny

math-

e-me'

m"th`

"

.i).wwtwlst

Fig

2

k:f,{ui

,Ir

The

cysts

are

1inecl

keTatin

(HcmaloxyLm

and

eogin

stam

with

strd"fiedgquamous

epithehum

Ihe

ts(agntfication,

87

)

contentsaf

thege

cystg

are

pearl

mdicates the nodules

along

the

rnedian

palatine

raphe

and

Bohnig

nodulc

means

the

mucous-gland

cyst

riging

from the

remnants

of

the

mucoub

gldnd

(Fromm

1967),

possibl}

outside the midpdlatme

region

The

nodules

of

both

thc

median

palatal

mucoga

and

the

gmgiva

ghow

pathologicall}

the

cvst

(Fig

2) Thcse

cysts

of

the

orai

mucosa

m

new-

borns

may

be

classificd

as

fbllows

qmgwal

eyst

m

the

newborn

(dental

lamina

cygt)

and

median

palatal

mucosal

cyst

(Epstein's

pcarl)

The

former

is

used

to

aNoid

the

Loniu-

sion

with

gingiNal

ctrst

in

the

adult

and

the

latter to

diflleirentiatefrom

fissuralcyst

occurmng

in

the

maxillaiy

bone

Acknowledgement

XNe

are

deeply

gratefu1

to

all

staffs

of

Angel Hospital

in

KitakyushuCity

and

ot

the

Depdrtment

of

Obstetrics,Univtrsitv

of

Occupational

and

Lnvironmental

Health,

for

theii

coeperation m exammmg thc

oral

eavities

of

ncwborn

mfants

We

also

wish

to thank

Miss K Yasutake for

typing

the

manuscmpt


6/6



UOEH Assooiation of Health Soienoes

168

K KEMURA

et

at

References

Burke

G w

Jr

Fcagans

w M Elzay

R

R

et

at

966

Some

aspects

ofl

thc

origin

and

fate

of

midpalatal

ysts

in

hurnan

tuscs

Dcnt

Rcs

45

159

6

Catald

E

Berkman

M

D

968

GysLs

of

the

oral mucosa in newborns

AmeL

J

Dis

Child

ll6

44

48

FrQmm

A

967

Epstein

s

pearls

Bohn

s

nQdules

and

inclusioncysts

of

the

oral

cavity

J

Dcnt

Child

34

275

287

Higuchi

T

Yamamoto

M

Ogin

A

et at

981

Thc occurrence and equcncy Df oral microcysts

o

called

pstci s

pcarl

in

infants

Hifurinsho

23

249

252

n

Japanese

Monteleonc

L

McLellan

M S

964

Epstein

s

pearls

ohn

s nodu

of

the

palate

J

OralSurg

22

301

304

Moreiil

n

M

C

Schrocdcr

H

E

982

Numcricalfrequenc

fl

epithelial

abnormalities

particularly

microkeratocysts

in hc

dcvcloping

human

oral

mucosa

Oral

Surg

53

44

55

Scott

J

955

The early deve

pment

Df

oral

cysts in

man

Brit

Dent

J

98

lo9

ll4

2

2

1

U

P

541

88

1

2

L

pstein

2

J

UOEH

5

2

163

168

983

cysts of the oral mucosa in newborns a clinical observation

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