Riga-Fede disease: A systematic review and report of two cases

Aim The term Riga-Fede disease has been used historically to describe traumatic ulceration that occurs on the ventral surface of tongue, buccal mucosa, gum or floor of the tongue in newborns and infants. It is most often associated with natal and neonatal teeth in newborns. The painful symptoms may be absent or acute, up to the point of preventing the baby from feeding. The aim of this work is to offer a description of the therapeutic solutions for the treatment of this pathological condition, with a review of the literature and the report of two cases. Materials and methods A systematic review of the literature of articles presenting Riga-Fede Disease associated with natal and neonatal teeth was performed following the PRISMA protocol (Prefered Reporting Items for Systematic Reviews and Meta-Analyses). This bibliographic search was performed through two databases, PubMed and Google Scholar. Results Fifty-two articles were included as they were compatible with the relevant inclusion criteria, with a total of 57 case reports of Riga-Fede disease associated with natal and neonatal teeth. A statistical analysis of the results was then carried out. A single treatment was performed in 44 patients; of these, 36 patients underwent extraction only (81.8%), 3 were treated with excisional biopsy (6.9%), 2 treated with occlusal plate (4.5%), 1 received ameloplasty only (2.3%) and 2 patients underwent a direct restoration of the incisal margin (5.8%), 13 patients received a combined treatment which saw the use of cortico steroids in 5 patients, lidocaine gel in 2 patients, topical benzocaine in 2 patients, H2O2 in 1 patient, Vasa (acantacea plant) in 1 patient, low laser therapy in 1 patient, and a single patient received fluoride varnish. Conclusions Extraction and ameloplasty are the most effective treatments in the resolution of the Riga-Fede disease associated with natal/neonatal teeth. In the case of high dental mobility, resulting in an increased risk of exfoliation and possible tooth ingestion/inhalation, extraction is the therapeutic treatment of choice. When nutrition is not compromised, ameloplasty is the treatment of choice, as it is less invasive and more conservative.