Prevalence of Epstein’s Pearls and Bohn’s Nodules Among Congenital Oral Abnormalities

Abstract

INTRODUCTION: Epstein's pearls and Bohn's nodules are characterized as inclusion cysts of the newborn, resulting from epithelial remnants that were trapped during the fusion of palatal processes. They are asymptomatic and transient cystic lesions and, therefore, do not require treatment by means of drugs or surgical intervention. This issue is problematic, since dental or pediatric professionals find it difficult to accurately identify and diagnose the cyst, failing to inform parents who are often distressed to realize the pathology. OBJECTIVE: The purpose of this paper is to develop an integrative literature review to analyze whether, in fact, Bohn's nodules and Epstein pearls are the most common congenital oral lesions in newborns. METHODOLOGY: Articles indexed in SciELO, PubMed / Medline and Lilacs. The keywords used were: Epstein's pearls, Bohn's nodules, newborn, prevalence, palatine cysts, gingival cysts. As inclusion criteria, complete articles published in the last 10 years, in the Portuguese and English languages and that answered the research question. We found 23 articles and after applying the inclusion criteria, we selected 17 articles, 9 of which formed the present abstract, using them to explore the content. RESULTS AND DISCUSSION: Epstein's pearls and Bohn's nodules appeared in the literature as high frequency oral abnormalities among newborns. The data obtained in the base articles took age, location and gender as criteria, with differences between their percentages. Despite this dissonance, research has always resulted in about 50% more cases, compared to other congenital oral abnormalities. Thus, there is a comparative table between the studies that shows the results more easily in order to make explicit the prevalence of these cystic oral lesions. No evidence was found on causes related to these pathologies, only embryological origin, and further research is needed. CONCLUSION: Based on the findings, it is noticeable the prevalence of Epstein Pearls and Bohn's Nodes, given the high frequency of these inclusion cysts in the clinical routine. Given this, the present literature review brings the necessary keys to clarify the predominance of these congenital oral anomalies so that it is possible to set up an accurate diagnosis and clarification of parents.

Inborn or acquired changes in children under three years of age – a review of the literature

“…Their size ranges between 1 mm and 1 cm and are filled with keratin [4,[93][94][95]. Surgical intervention or pharmacological treatment is not required due to the fact that these lesions are asymptomatic and transient [93,95]. Their most common location is the midline of the hard palate, confirmed in the study by Perez-Aguirre et al [93] and George et al [94].…”

“…variable [4,93,95,98] 1 mm to 6 mm [98,[100][101][102][103][104] Correlation with gender not observed [14] higher incidence in males [22,27], or no correlation with gender [31] more common in females [33,38,50], or no correlation with gender [34,37,39,49,57] much higher incidence in females at ratio of 8:11 [66,67,73,82] no correlation with gender [4] no correlation with gender [4,93] female predisposition [105] or no correlation with gender [4,93] Localisation anterior sector of mandible [5][6][7]9,12] primary first maxillary molars in both jaws [11] ventral tongue surface [16,17,19,20,[22][23][24][25][26][27]<...…”

“…no pain, discomfort upon palpation [73,75]. ; large lesion, causing difficulty in eating [66,69,70,72,76,77,80,81] and breathing [72,74] asymptomatic and transient [93,95] asymptomatic and transient [4,93,95,96]. asymptomatic and transient [4,93,94] Diagnosis clinical examination; radiological examination, in stand-alone eruption cyst not recommend [5,7,15]; histopathological examination not essential [6,11] physical examination; excisional biopsy not necessary [16,17,20,25,29] interview with the child's parents, clinical examination, and X-ray scans [36,39,40,51,53,62].…”

“…Epstein pearls are small, whitish, raised, rigid nodules, usually arranged in groups of three. Their size ranges between 1 mm and 1 cm and are filled with keratin [4,[93][94][95]. Surgical intervention or pharmacological treatment is not required due to the fact that these lesions are asymptomatic and transient [93,95].…”

“…Bohn's nodules, similarly to Epstein pearls and gingival cysts, are classified as inclusion cysts [93,96]. These nodules were first described by Henrich Bohn in 1866 as "mucous gland cysts" derived from the epithelial remains of developing palatine salivary glands [95]. Nowadays, Bohn's nodules can also be found along the buccal and lingual surface of the maxillary and mandibular dental ridges and are considered reminiscent of glandular mucosal tissue [4,95].…”