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Alsayed Tolibah Y, Kouchaji C, Lazkani T, Abbara MT, Jbara S, Baghdadi ZD. Dental Care for a Child with Congenital Hydrocephalus: A Case Report with 12-Month Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1209. [PMID: 33572890 PMCID: PMC7908211 DOI: 10.3390/ijerph18031209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 01/14/2021] [Accepted: 01/25/2021] [Indexed: 11/16/2022]
Abstract
Hydrocephalus affects the central nervous system as a result of progressive ventricular dilatation from the accumulation of cerebrospinal fluid in the brain's lateral ventricles. This paper reports on the oral characteristics of a child with congenital hydrocephalus, discusses her complex dental care needs, and presents dental management of this case. Despite the complex and challenging dental needs, this child received dental treatment in a chairside approach without general anesthesia. A thorough knowledge of the patient's medical condition, together with expert clinical skills, was indispensable for managing the child and improving the quality and length of her life.
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Affiliation(s)
- Yasser Alsayed Tolibah
- Department of Pediatric Dentistry, College of Dentistry, Damascus University, Al-Mazzeh St., Damascus P.O. Box 3062, Syria; (Y.A.T.); (C.K.)
| | - Chaza Kouchaji
- Department of Pediatric Dentistry, College of Dentistry, Damascus University, Al-Mazzeh St., Damascus P.O. Box 3062, Syria; (Y.A.T.); (C.K.)
| | - Thuraya Lazkani
- Department of Restorative Dentistry and Endodontics, College of Dentistry, Damascus University, Al-Mazzeh St., Damascus P.O. Box 3062, Syria; (T.L.); (M.T.A.)
| | - Mohammad Tamer Abbara
- Department of Restorative Dentistry and Endodontics, College of Dentistry, Damascus University, Al-Mazzeh St., Damascus P.O. Box 3062, Syria; (T.L.); (M.T.A.)
| | - Saffana Jbara
- Department of Preventive Dental Science Division of Pediatric Dentistry, Dr. Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, MB R3E 0W2, Canada;
| | - Ziad D. Baghdadi
- Department of Preventive Dental Science Division of Pediatric Dentistry, Dr. Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, MB R3E 0W2, Canada;
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Fleagle J. Subcutaneous emphysema following dental care of a patient with ventriculoperitoneal shunt: Case report. SPECIAL CARE IN DENTISTRY 2020; 40:488-492. [PMID: 32579279 DOI: 10.1111/scd.12490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 06/03/2020] [Accepted: 06/05/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Pediatric dental treatment utilizing an air-driven handpiece and triplex syringe in the operating room has been common practice for many decades. Adverse effects with compressed air are rarely reported in the dental community but can cause serious complications for pediatric patients in the unlikely event they occur. CASE REPORT We present a case of subcutaneous emphysema of a 4-year-old presenting for dental rehabilitation under general anesthesia, which was further complicated by the presence of a ventriculoperitoneal (VP) shunt and the patient's neuroatypical status. The subcutaneous emphysema was apparent at case completion with right unilateral swelling in the cervicofacial area extending from the infratemporal space to the periorbital buccal region. The most probable etiology was compressed air from a high-speed handpiece dissecting through infected tissue during a crown preparation. Subcutaneous emphysema was managed by diagnostic radiographs, antibiotics coverage, and hospital observation due to patient's multiple health factors. CONCLUSION Subcutaneous emphysema appears to be a rare event in pediatric dental care; however, there is increased risk for complications in the unintentional occurrence. Subcutaneous emphysema is an important differential for facial swellings. Medically complex patients, such as this case, should involve a multidisciplinary team approach due to the proximity of the VP shunt.
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Affiliation(s)
- Jenelle Fleagle
- Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware
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Poonia A, Chengappa MD, Mitra R, Jain P, Ghavri T. Full-mouth Rehabilitation of a Ventriculoperitoneal Shunt-treated Hydrocephalic Pediatric Patient: A Case Report. Int J Clin Pediatr Dent 2020; 13:103-106. [PMID: 32581490 PMCID: PMC7299888 DOI: 10.5005/jp-journals-10005-1744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Hydrocephalus is characterized by accumulation of cerebrospinal fluid in the lateral ventricles of the brain, which results in progressive ventricular dilatation and an increased intracranial pressure. A ventriculoperitoneal shunt (VPS) is the most common treatment for hydrocephalus. Delayed development, behavioral disturbance, chronological changes in the eruption of their teeth, changes in the occlusion, greater accumulation of plaque, and increased caries prevalence are some of the clinical manifestations in these patients, which are encountered by a pediatric dentist. Behavioral disturbance in these patients makes sedation or general anesthesia the most feasible behavior management technique. During dental treatment of shunt-treated patients, care should be taken to avoid applying excessive force on the catheter. A referral to a neurosurgeon is recommended for patients with shunts undergoing invasive dental procedures for assessment of the need for prophylactic antibiotics. The present case report discusses full-mouth rehabilitation of a pediatric patient under general anesthesia who presented with severe early childhood caries and a medical history of ventriculoperitoneal shunt-treated hydrocephalus. How to cite this article: Poonia A, Chengappa MMD, Mitra R, et al. Full-mouth Rehabilitation of a Ventriculoperitoneal Shunt-treated Hydrocephalic Pediatric Patient: A Case Report. Int J Clin Pediatr Dent 2020;13(1):103–106.
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Affiliation(s)
- Anish Poonia
- Department of Pedodontics and Preventive Dentistry, Army Dental Centre, Research and Referral, New Delhi, India
| | - Mm Dempsy Chengappa
- Department of Pedodontics and Preventive Dentistry, Army Dental Centre, Research and Referral, New Delhi, India
| | - Rajat Mitra
- Department of Pedodontics and Preventive Dentistry, Army Dental Centre, Research and Referral, New Delhi, India
| | - Parul Jain
- Department of Pedodontics and Preventive Dentistry, Army Dental Centre, Research and Referral, New Delhi, India
| | - Tarannum Ghavri
- Department of Pedodontics and Preventive Dentistry, Army Dental Centre, Research and Referral, New Delhi, India
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Bignardi L, Prates T, De Rossi A, Nelson-Filho P, de Carvalho FK, de Siqueira Mellara T, de Queiroz AM. Strategies and dental care in the treatment of patients with myelomeningocele. SPECIAL CARE IN DENTISTRY 2018. [PMID: 29512828 DOI: 10.1111/scd.12276] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Myelomeningocele (MMC) is a congenital malformation that occurs in the embryonic period, characterized by failure in closure of the caudal portion of the neural tube during central nervous system formation. Alterations and complications can be associated with this condition, such as hydrocephalus, neurogenic bladder, orthopedic problems, and motor and cognitive impairment. This patients with MMC also have predisposition to develop latex allergy and high caries risk and activity due to deficient oral hygiene, fermentable carbon hydrate-rich diet and prolonged use of sugar-containing oral medications. This paper reports the oral findings and dental treatment in a 15-year-old female patient diagnosed with MMC and describes the strategies used to improve dental treatment conditions and reduce the impact of associated risks to her health. The measures and precautions adopted in this case could be useful to reduce the barriers for patients with the same condition to access oral health care: regular visits to the dentist, initiating as early as possible; frequent reinforcement of oral homecare instructions and diet counseling; minor adaptions to the dental chair and dental office to improve ease of access due to patients' mobility problems; prevention of latex-related allergic reactions; reduction of gag reflex during dental procedures.
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Affiliation(s)
- Leticia Bignardi
- MSc student, Department of Pediatric Clinic, Preventive and Community Dentistry, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Talita Prates
- MSc student, Department of Pediatric Clinic, Preventive and Community Dentistry, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Andiara De Rossi
- Professor, Department of Pediatric Clinic, Preventive and Community Dentistry, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Paulo Nelson-Filho
- Professor, Department of Pediatric Clinic, Preventive and Community Dentistry, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Fabrício Kitasono de Carvalho
- Professor, Department of Pediatric Clinic, Preventive and Community Dentistry, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Talitha de Siqueira Mellara
- Department of Pediatric Clinic, Preventive and Community Dentistry, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Alexandra Mussolino de Queiroz
- Professor, Department of Pediatric Clinic, Preventive and Community Dentistry, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, SP, Brazil
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Relationship between Dental Procedures and Shunt Infections in Hydrocephalic Patients: A Narrative Review. J Clin Pediatr Dent 2018; 42:67-71. [PMID: 28937908 DOI: 10.17796/1053-4628-42.1.12] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Oral physicians frequently encounter medically compromised patients in their everyday practice and a sizable number of these patients are in urgent need of specialized care. One such medically specialized category is that of patients suffering from hydrocephalus. A large number of medical reports and citations in support of surgical care of the hydrocephalic disorder are available in literature. However, reports on dental studies offer contradictory statements on the relationship between hydrocephalic shunts and oral manoeuvres. The present narrative review aims to delineate the historical journey of the association between shunt infections and dental procedures, decode the existing controversies and provide updated information on antibiotic prophylaxis prior dental treatment for hydrocephalic patients.
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Mesquita-Guimarães KSF, De Rossi A, Freitas AC, Nelson-Filho P, da Silva RA, de Queiroz AM. Changes in caries risk and activity of a 9-year-old patient with niemann-pick disease type C. Case Rep Dent 2015; 2015:571098. [PMID: 25685563 PMCID: PMC4313064 DOI: 10.1155/2015/571098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 12/08/2014] [Accepted: 12/09/2014] [Indexed: 11/17/2022] Open
Abstract
Objective. This case report describes the changes in caries risk and activity and dental treatment of a 9-year-old patient who presented with signs and symptoms of Niemann-Pick disease type C (NPC). Treatment. The preventive dental treatment included instructions to caregivers for oral hygiene and diet. A calcium hydroxide pulpotomy and restorative dental treatments were performed in a dental office with desensitization techniques and behavioral management. The patient was attended every 3 months for the control of dental plaque biofilm, for topical fluoride application, and for observing the pulpotomized tooth. Results. The bacterial plaque biofilm was being adequately controlled by the caregiver. After 2 years, the clinical and radiographic examination of the pulpotomized tooth showed the absence of internal root resorption and bone rarefaction, and clinical examination showed tooth sensitivity, dental pain, and gingival swelling. Conclusion. The pulpotomy prevented clinical and radiographic success. Dentists must be aware of and be able to identify systemic and local aspects associated with caries risk of children with NPC disease. Furthermore, dentists must employ stringent preventive measures and provide instructions to caregivers to reduce caries risk.
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Affiliation(s)
- Késsia Suênia Fidelis Mesquita-Guimarães
- Department of Pediatric Clinics Dentistry, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café, s/n, Monte Alegre, 14040-904 Ribeirão Preto, SP, Brazil
| | - Andiara De Rossi
- Department of Pediatric Clinics Dentistry, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café, s/n, Monte Alegre, 14040-904 Ribeirão Preto, SP, Brazil
| | - Aldevina Campos Freitas
- Department of Pediatric Clinics Dentistry, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café, s/n, Monte Alegre, 14040-904 Ribeirão Preto, SP, Brazil
| | - Paulo Nelson-Filho
- Department of Pediatric Clinics Dentistry, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café, s/n, Monte Alegre, 14040-904 Ribeirão Preto, SP, Brazil
| | - Raquel Assed da Silva
- Department of Pediatric Clinics Dentistry, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café, s/n, Monte Alegre, 14040-904 Ribeirão Preto, SP, Brazil
| | - Alexandra Mussolino de Queiroz
- Department of Pediatric Clinics Dentistry, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café, s/n, Monte Alegre, 14040-904 Ribeirão Preto, SP, Brazil
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