2020 Volume 58 Issue 1 Pages 9-16
Congenital syphilis is an infection transmitted from a syphilitic mother to her fetus through the placenta. In infected neonates, manifestations of syphilis are classified as early congenital (birth to age 2 years) and late congenital (＞age 2 years). Although it is well known that congenital syphilis is associated with abnormalities of permanent teeth, those of primary teeth with early congenital syphilis are unknown. We experienced a case of early congenital syphilis at the age of 3 years 3 months at the first visit and performed a dental analysis.
The patient was born with a low birth weight and state of asphyxia, from an untreated mother with syphilis during pregnancy. The medical history of the child stated that antibiotic therapy with PCG was administered for 10 days after birth for neurosyphilis combined with congenital syphilis. The physical status was syphilitic pemphigus and hepatitis, but it became stable after the acute phase, and pediatric follow-up had ended at 1 year 4 months old.
Hellman's dental age was ⅡA stage, tooth number 81 was already missing, and tooth 82 was mesial tipping with the root exposed to the oral cavity, so it was extracted at the first oral examination. At the age of 4 years 0 months, teeth numbers 71 and 72 were extracted due to exposure of their roots to the oral cavity. It was also confirmed that tooth 61 was prematurely lost at 4 years 9 months old.
The mesiodistal widths of all primary teeth of this patient were extremely small, with an average value of －2SD to －7SD.
Oral pathological examination by undecalcified sections using extracted tooth 82 revealed enamel hypoplasia in the incisal edge and calcareous degeneration in pulp and root resorption.
This case report describes that microdonts and enamel hypoplasia, and premature loss of primary incisors due to apical periodontitis are related to early congenital syphilis.
