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5(2)i 163-168 (I98S)

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163

[Original]

Cysts
Kunio

Mucosain

theOral

of

Newborns

A CIinical Observation

IKEMuRAL, Yasuaki KAKINoKI], Kazukata NIsHIo"

Yoshinori SUENAG,x2

and

Orai Surgeo],llo.ipital,
(.}tiv"msib'
ql'Occapatienaland
Heatth,
Kitalpzashu
807,
Environmental
Japan,
Jopan
'"Dopartmeni Dermatoiogy,
School qf Adedicine,LTniversity
and
qf'
qf Occiipationat
]Dopartmertt

and
qf'l)entistp/

Environmental
Healih,
Japan.Kitakyusha807,Japan

Abstract: Nodules

mucosa
oceurred
with
an
incidcnceof 88,7 per cent in 541
No inf'ant
a [iays old,
This incidenccis higherthan
was
over
in Caucasian and Ncgro newborns.
It may bc suggcsted
that the frequency of
have a close
re]atiun
to growth and
develepment ln the fetallife,becEtuse
thc

or

cysts

that

reported

visiblc

nodule$

c},sts

papers,
caii
be

other

cysts

wordsi

c},st,

oral

oral

infants.

newborns

classified

recognized
of

histologically
in most

terminology

fbr thcse

follows:ging.iva]cyst in
(Epstein's
pearl).

as

the

fetuses,
as demonstrated
in
have been

nodules

thesc

used,

iarninacyst)
(dental

ncwborn

oral

and

cyst

mucosa}

}nucosa,

bc
variet},

can

Although

palatal

mcdiaR

Kev

in

seen

the

of

Japancscncwborn

ne",born.

15 February 1983)
{Rcccived

Introduction
Although

small

nodules

infants, they

newborn

there are

only

few

Berkman, 1968) on
due to the factthat
or

they

disappear

are

not

clinical

of'

always

observations

clinicians

the oral

mucosa

are

of

infantsand

to

paper

to

comment

describethe
on

very

the

to

and
general clinicians
1964; Fromm, 19673 Cataldo &

This
of

1968; Higuchi
results

tcrminology

findingin

common

largenumber
of newborns,
to inspectthe oral mucosa

& Berkman,
(Catalclo
this

condition

well-known

have few chances

spontaneously

of

cysts

& McLellan,
(pt'fonteleone

reports

It is the purpose
newborn
Japanese

or

of

clinical

et

for these

al,,

the

may

be

newborn

1981).

observations

in

nodules.

Materials
A total
after

birth, sex

locationand
white

of

in

the

colour

541 infantswere

N() infantwas 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 }'ellowishvaried
i,nsize from less than 2 mm
and
to 5 mm
(Fig.1),
examined,

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K. IKEMuRA et al.

164

Fig. 1.Nodules

of the

Table 1.
No.

max!llary

Incidence
ofcases

Sex

Ma]eFemaleTotdl

infant).
gingiva (twenty-day-eld

of

nedules

by

sex

Noduie$present

261280541

236244480

Frequcnc},

(%)

90,487,188.7

Results
Male
infants,
nodules
occurred
with an incidence
of 88,9 per cent.
female infantsCTable1). The inciclencein
infants exhibited
a higher incidencethan
90 per cent
newborns
weighing
between 2.0 and 3,9 kg was approximately
(Table
comparing
this
with
the
incidence
in
newborns
over
4.e
kg
bedy
2), When
percentage
a statistically
significant
diflbrence
As fbrthe incidenceby
weight,
(P<5%) was noted.
a
higher
frequency than the
earlier had
days after birth (Table3), the group examined
later,
without
statistical significance,
group examined
raphe
of
the hard palate(Table
The nodules were mest often seen along the median
were
fbund in the region of the soft palate. In the maxillary
4). No nodules
gingiva,
nodules
were
frequentlyseen on the buccal side while the mandibular
gingivademon3,3 in 480 newa lingual predominance,
Thc average number
of nodules
was
strated
5) and the highest number
recorded
was
twentyboms with nodules
present (Table
four. The number
of nodules
had no relation to the age of the infantat examination,
Of 541

newborn

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Cysts

Ora[ Mucosa in Newborns

of

165.

k,.Lb.o.dy
yLnltlii.

T..a.ble

I.f}f.iid-evce
ttttttttYVeigl]t .2.z

6f

No

Nocli.i]espresentFrequency

-.. .-m.ttg.sgi
[bf1.).

%)89

t'

28

25

2.5-2.9

l39

125

3.0-3,4

2.53

Z24

3,5-3.9

107

2.0-2.4

4.0i.

Total

96

]4

10

480

3Incidence
Ti.lb.L,

1)ays''ifi.er
birth

771.488.7

541

b>, days

..

3S9,988.589.

afterbirth

Nodulesprc}sor)1.
I"requen{lt/'
(%}

No'.ofcuses

39

38

97.4

1
2

85
85

82

96 .i.,

75

88.2

98

87

88.8

91

75

82.4

55

49

89.1

6
7

56

46

82,1

3Z

28480

87.5

541

-.,Total -.

Tab]e 4.

-.5e,7

rnctidence by

site

ttttt
tt
tt

Nodu]espr'eserlt
Site
Median palalal mucosa
Maxillary gingiva

36929:l

Mandibu]ar gingiva

tt

Frequency
(1%)
68,25,1,1li],s

sE

byni]tnberofnodules
. IJ.icidence

Table 5,
N61'o'fnodules

No. ofeases

lirequency

!ip-)---

6]13].

l
2

96

83

65

5
6

43

7,9

29

5,4
1,7

8
9

O,9

O,7
2.8

leTotaL

l5541

1.1 324,217.715.I312.0

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166

K, IKEMURA

et aL

Discussion
In i967 Fromm

that

reported

inc;lusioncysts between Caucasian

there was

Negro

and

born infants,lessLhan 48 hours old,

and

the incidence

cases.

in
difllercnee

thc incidcnce of mucosal

infants.

ncwborn

He

l367

examined

new-

inclusioncysts of the oral mucosa

fbuncl less fi'equentlyin Negro newborn
infants than in Caucasian counterparts
were
with
Our observation
showed
that the
percentagesof 63.0 and 76.8 per cent respectively.
in Japanese
newborn
infantswas 88.7 per cent and that thc incidence
incidenceof nodules
in 209 newborns
lessthan 48 hours old was 93,3 per cent (Table3). Monteleone, &
ncwborn
infants within
N'Tcl.ellan
obse,rved
the first24hours after birthand
re(1964)
that
Epstein's
fbrmation
occurred
in 79 per cent of 293 Negro infants and 85
portecl
pearl
per cent of 100 Caucasian int'ants."Jhen our cases were confined to the same condition,
nodules
and

are

91.4 per

was

scen

Ncgro

more

ncwborn

In Fromm's

(1967)
no

(Table2).

In

Therefore, present

correlation

inclusionc>,sts,

betwcen budy

corrclation

124

of

fi'equentlyin the ,Japanese

infants.

report

the incidence of'

ccnt

that

stated

Howcver, the

weight

infantswho

the

addition,

between the

rcsults

the incidence

and

were

infants than in thc Caucasian

newborn

existed

of

indicate that the

studies

the infant and

ef

here show

obtained

a statistical

bordering 4.0 kg in

nodules,

examined

weight

soon

after

birthhad

weight

higher

disappearcd spongroups (Table3) and in most cases the nodules

taneously
within
a
few months
& Berkman, 1968; Higuchi et al,,
(Cataldo
1981). Furthermore,the histologicaifindings of cys.ts seen in newborn
infantscan be
rccognized
in most fetuses(Scott,
1955; Burke et at,, 1966; rV'Ioreillon
& Schroeder, 1982),
Moreillon & Schroeder (}982)
state
that the high number
and
of fetal microkeratocysts
frequency

than

other

gradually decreases in late feta} Iifeand

nodules
cluded
that the frequency of visible
in

ment

The
son

to

fetal lifeor

the
most

the

cgmmon

in

it may
postnatal Iife. [I]herefore,
have a close relation
to
growth and

the median

small

terminology
the namc

of

nodules

of

by Cataldo & Berkman

the oral

lialrests,

& McLellan, 1964; Fromm,

(Monteleone
the reporter
(Epstein)s
pearl, Bohn's

abortive

our
(1968),

1967).

nodule),

epithel{al

enamel

organs,

huds

of

epithelial

the

fetus(Scott,
1955; Burke

thc

nodules

arisc

the

mucous-gland
enamel

organs,

remnants

et al.,

con-

develop-

In

examination

cornpari-

showed

the

of nodules
gingiva. As to the number
could
not
from other reports.
be obtained
in infantshave been dcscribedby difllerent

mucosa

inclusion-c>rsts,
microkeratocysts.

cysts,

4).
(Table

palatal mucosa

higher incidenceof nodules in the rnandibular

sufi'icient
for comparison
5),description
(Table
'I'he

be

postnatal life,

early

locationwas

reported

rcsults

the

early

of

the

Nomenclatures

come

from

histologicalfindings (epithelial

cy,sts), and

confused

debris ef

epithelial

origin

the

tooth

(epithefollicle,

dental follicle). The invcstigationsof

1966; Moreillon & Schroeder,1982) demonstratethat

frorn the clentallamina

and

the

fusionof

the

palatal shelves.

Epstein's

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CNsts of Oial NIucusa in rNcwbvrnK

as-ny
s$
math-.e-me'
"

'{i

{sl

r.

167

,Ir

k:f,{ui

m"th`

}ltltt-.M
.i).wwtwlst

Fig

The

cysts

are

the

pearl mdicates

cyst

mucous-gland

gmgiva

borns may
sion

palatal mucosal

gingiNalctrst

with

occurmng

from

stam

the rnedian

along

nodules

riging

eogin

the remnants

The

region

of

the

in

maxillaiy

(Epstein's
pcarl)

cyst

the

in

adult

and

and

the mucoub

the

gldnd

both thc

thege

contentsaf

cystg

are

palatineraphe
of

nodules

Ihe

epithehum

ts(agntfication,
87

Thcse
pathologicall} the cvst (Fig2)
be classificd as fbllows qmgwal eyst m the

ghow

median

strd"fiedgquamous

and

the midpdlatme

outside

1inecl with

(HcmaloxyLm

keTatin

median

cysts

of

newborn

The former is

Bohnig

nodulc

the

means

(Fromm 1967), possibl}

palatalmucoga
the

orai

and

mucosa

new-

lamina cygt)
(dental
used

to

aNoid

the

the

and

Loniu-

latter to diflleirentiate
from fissuralcyst

bone

Acknowledgement
XNe

are

Depdrtment

of

coeperation

Miss K

Angel Hospitalin Kitakyushu City and ot the

Obstetrics,
Univtrsitvof Occupationaland Lnvironmental Health, for theii

deeply gratefu1 to
exammmg

all staffs

thc oral

Yasutake for typing

the

of

eavities

of ncwborn

mfants

We

also

wish

to thank

manuscmpt

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168

K IKEMURA

et at

References

1966 Some aspects ofl thc origin and fate of

Dcnt
45 1596
midpalatal
cysts inhurnantuscs

Rcs
Catald E Berkman M
D 968 GysLs of the oral mucosa
in newborns

Childl l6
AmeL JDis

44

48
FrQmm A 1967 Epstein s pearls Bohn s nQdules
and inclusion
cysts of the oral cavity
Dcnt
J

Child

34
275
287

Higuchi T
M
and
equcncy
Df oral
microcysts
Yamamoto
Ogin A et at 1981 Thc occurrence

so called
Epstci s pcarl
inJapanese
in infants

Hifurinsho 23 249 252

1964
Epstein

Monteleonc
L
McLellan
M
S
s

Bohn
s

nodu
c
of

the

OralSurg

pearls

palate
J

22 301 304

Moreiil n
M
C
Schrocdcr
H
E
1982 Numcrical
frequenc
particularly

oflepithelial abnormalities

microkeratocysts
in

hc
dcvcloping
human
oral
mucosa

Oral
Surg

44

55
53

Df
cysts
in man
ScottJH 1955 The early deve opment
oral
98 lo9 ll4
BritDentJ
Burke

G
w
Jr
Fcagans

w
M
Elzay
R
R
et

at

2
2

P

U

7
88

Epstein 2

JUOEH

541

2 L

5 2 163 168 1983

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