|LETTER TO EDITOR
|Year : 2015 | Volume
| Issue : 1 | Page : 105
Treville Pereira1, Subraj Shetty1, Svylvy Pereira2
1 Department of Oral Pathology and Microbiology, Dr. DY Patil Dental College and Hospital, Navi Mumbai, Maharashtra, India
2 Private Practice, 1101, Maruti Mount View, Sector 8-B, C.B.D. Belapur, Navi Mumbai, Maharashtra, India
|Date of Web Publication||8-Dec-2014|
Department of Oral Pathology and Microbiology, Dr. DY Patil Dental College and Hospital, Sector - 7, Nerul, Navi Mumbai - 400 706, Maharashtra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Pereira T, Shetty S, Pereira S. Lip dimples. Muller J Med Sci Res 2015;6:105
A ten-year-old male presented to our clinic with a complaint of decayed teeth in the upper and lower jaw. Clinical examination revealed three decayed teeth in the upper and lower jaws, that required restoration. On closer examination of the lower lip two prominent depressions were observed on either side of the midline [Figure 1]. The lip pits were present since birth. The parents mentioned that they considered it to be a beauty spot and hence never felt the need to get it examined by a physician. There was no relevant family history. The parents were from a low economic stratum.
Paramedian lip pits are congenital invaginations of the lower lip arising from persistent lateral sulci on the embryonic mandibular arch. They are also called as congenital fistulas or congenital lip pits and they normally disappear by six weeks of embryonic age. 
The etiology is unknown. They usually present as bilateral and symmetric fistulas on either side of the midline of the vermilion of the lower lip.  Occasionally only a single pit is present that may be centrally located.
Lip pits are blind sinuses that extend to a depth of 1.5 cm and may express salivary secretions. The greatest significance of paramedian lip pits is that they are usually inherited as an autosomal dominant trait in combination with a cleft lip and/or cleft palate. It is called the Van der Woude syndrome. The incidence of Van der Woude syndrome is 1:75,000 to 100,000.  Recent genetic studies have shown that a microdeletion at chromosome bands 1q32-q41 are the cause of this syndrome.
Paramedian lip pits are also a feature of the popliteal pterygium syndrome, which is characterized by popliteal webbing (pterygia), cleft lip and or cleft palate, genital abnormalities, and congenital bands connecting the upper and lower jaws (syngnathia). 
The case presented here showed none of the above features other than the lip pits.
The labial pits may be excised for cosmetic purpose. However, the most significant problem is associated with the congenital anomalies and the potential of transmission of the trait to subsequent generations. This case is presented here for its rarity. In spite of informing the parents of the syndrome associated with the lip pits, they were quite unruffled and refused any further investigations. This further emphasizes the need for regular patient education programs about unusual congenital anomalies.
| References|| |
Neville BW, Damm DD, Allen CM, Bouquot JE. Oral and Maxillofacial Pathology. 2 nd
ed. Pennsylvania: Saunders; 2004. p. 5.
Rintala AE, Lahti AY, Gylling US. Congenital sinuses of the lower lip in connection with cleft lip and palate. Cleft Palate J 1970;7:336-46.
Bardazzi F, Savoia F, Dika E, Rinaldi R. Van der Woude syndrome: A case report. Int J Dermatol 2006;45:299-301.