Clinical, Radiographic, and Histopathologic Evaluation of Multiple, Non-Syndromic Hyperplastic Dental Follicles: A Unique Pediatric Case Report

Background: Hyperplastic Dental Follicle (HDF) is a hamartomatous oral lesion. HDF is characterized by the presence of fibromyxomatous connective tissue with nests and strands of odontogenic epithelial rests. HDF are infrequently reported and only accounts for 5-6% of all the pediatric jaw lesions that are biopsied. The mean age of HDF finding has been reported to be around 19 years. HDF is commonly associated with syndrome; however, non-syndromic HDF is rarely reported. HDF commonly affects posterior teeth and the canines. Description: Here, we presented a non-syndromic pediatric case with multiple HDF affecting canines and one premolar in an eight-year-old Hispanic female with three-year follow-up. The medical and dental history for the patient was non-contributory. A routine panoramic radiograph demonstrated multiple unilocular radiolucencies affecting all permanent canines and lower left second premolar. One of the mandibular canines spontaneously resolved while the contralateral canine needed surgical intervention. This case report provides a comprehensive literature review on HDF. Conclusion: Timely diagnosis, shorter follow-ups, and surgical intervention are key for management of HDF to allow for normal tooth eruption and the prevention of adjacent tooth displacement and root resorption.