International Journal of Clinical Pediatric Dentistry

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VOLUME 13 , ISSUE 1 ( January-February, 2020 ) > List of Articles

CASE REPORT

Full-mouth Rehabilitation of a Ventriculoperitoneal Shunt-treated Hydrocephalic Pediatric Patient: A Case Report

Anish Poonia, MM Dempsy Chengappa, Rajat Mitra, Parul Jain, Tarannum Ghavri

Keywords : General anesthesia, Hydrocephalus, Pediatric patient

Citation Information : 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 (1):103-106.

DOI: 10.5005/jp-journals-10005-1744

License: CC BY-NC 4.0

Published Online: 21-07-2020

Copyright Statement:  Copyright © 2020; The Author(s).


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.


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  1. Schrander-Stumpel C, Fryns JP. Congenital hydrocephalus: nosology and guidelines for clinical approach and genetic counselling. Eur J Pediatr 1998;157(5):355–362. DOI: 10.1007/s004310050830.
  2. Mori K, Shimada J, Kurisaka M, et al. Classification of hydrocephalus and outcome of treatment. Brain Dev 1995;17(5):338–348. DOI: 10.1016/0387-7604(95)00070-r.
  3. Cartwright CC, Wallace DC. Nursing care of the pediatric neurosurgery patient. Springer-Verlag Berlin Heidelberg 2013. 444.
  4. den Hollander NS, Vinkesteijn A, Schmitzvan Splunder P, et al. Prenatally diagnosed fetal ventriculomegaly; prognosis and outcome. Prenat Diagn 1998;18(6):557–566. DOI: 10.1002/(sici)1097-0223(199806)18:63.3.co;2-v.
  5. Pirttiniemi PM, Huggare JA, Kantomaa TJ, et al. Craniofacial asymmetries in shunt-treated hydrocephalic children. Cleft Palate Craniofac J 1991;28(4):369–372. DOI: 10.1597/1545-1569_1991_028_0369_caisth_2.3.co_2.
  6. Vilan Xavier AC, Pinto Silva LC, Oliveira P, et al. A review and dental management of persons with craniosynostosis anomalies. Spec Care Dentist 2008;28(3):96–100. DOI: 10.1111/j.1754-4505.2008.00019.x.
  7. Pirttiniemi P, Poikela A, Huggare J, et al. Dental maturation in children with shunt-treated hydrocephalus. Cleft Palate Craniofac J 2004;41(6):651–654. DOI: 10.1597/03-018.1.
  8. Lewis C, Robertson AS, Phelps S. Unmet dental care needs among children with special health care needs: implications for the medical home. Pediatrics 2005;116(3):e426–e431. DOI: 10.1542/peds.2005-0390.
  9. American Academy of Pediatric Dentistry. Guideline on behavior guidance for the pediatric dental patient. Pediatr Dent 2005;27(7 Suppl):92–100.
  10. Massimi L, Paternoster G, Fasano T, et al. On the changing epidemiology of hydrocephalus. Childs Nerv Syst 2009;25(7):997–1006. DOI: 10.1007/s00381-009-0844-4.
  11. de Morais Gallarreta FW, Bernardotti FPL, de Freitas AC, et al. Characteristics of individuals with hydrocephalus and their dental care needs. Spec Care Dentist 2010;30(2):72–76. DOI: 10.1111/j.1754-4505.2009.00122.x.
  12. de Carvalho RW, Pereira CU, Santos EA, et al. Retrograde migration of a ventriculoperitoneal shunt to the neck after dental treatment. J Dent Child (Chic) 2013;80(1):47–49.
  13. Forsberg H, Quick-Nilsson I, Gustavson KH, et al. Dental health and dental care in severely mentally retarded children. Swed Dent J. 1985;9(1):15–28.
  14. Dachs RJ, Innes GM. Intravenous ketamine sedation of pediatric patients in the emergency department. Ann Emerg Med 1997;29(1):146–150. DOI: 10.1016/s0196-0644(97)70321-4.
  15. Helpin ML, Rosenberg HM, Sayany Z, et al. Antibiotic prophylaxis in dental patients with ventriculo-peritoneal shunts: a pilot study. ASDC J Dent Child 1998;65(4):244–247.
  16. Wilson W, Taubert KA, Gewitz M, et al. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anaesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation 2007;116(15):1736–1754. DOI: 10.1161/CIRCULATIONAHA.106.183095.
  17. Sinner B, Beck K, Engelhard K. General anesthetics and the developing brain: An overview. Anaesthesia 2014;69(9):1009–1022. DOI: 10.1111/anae.12637.
  18. American Academy of Pediatric Dentistry. Reference manual: Guideline on Perinatal and Infant Oral Health Care. Pediatr Dent 2016;38:16–17.
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