Reactive soft tissue growth: a case report of onset post-extraction of natal tooth

Natal teeth occur in approximately 1 in 2,000-3,000 live births and may cause oral soft tissue trauma such as Riga-Fede disease. This report describes a late-preterm female neonate with two mandibular incisor natal teeth, which were extracted. Following extraction, an erythematous gingival swelling developed at the site, which enlarged over five months into a firm, pink, pedunculated mass. Excision was performed under local anesthesia using a diode laser. Histopathology revealed a peripheral ossifying fibroma (POF)-a reactive inflammatory hyperplastic lesion that is exceedingly rare in infants. Healing was uneventful, with no recurrence. This case highlights the importance of monitoring extraction sites for delayed reactive lesions in neonates, even after resolution of the initial trauma, and emphasizes the value of histopathologic evaluation to guide management.