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Prognosis after treatment with multiple dental implants under general anesthesia and sedation in a cerebral palsy patient with mental retardation: A case report

  • Hong, Young-Joon (Department of Oral and Maxillofacial Surgery, Seoul National University, School of Dentistry) ;
  • Dan, Jung-Bae (Woojung Dental Clinic) ;
  • Kim, Myung-Jin (Department of Oral and Maxillofacial Surgery, Seoul National University, School of Dentistry) ;
  • Kim, Hyun Jeong (Department of Dental Anesthesiology, Seoul National University, School of Dentistry) ;
  • Seo, Kwang-Suk (Department of Dental Anesthesiology, Seoul National University, School of Dentistry)
  • Received : 2017.06.19
  • Accepted : 2017.06.26
  • Published : 2017.06.30

Abstract

Cerebral palsy is a non-progressive disorder resulting from central nervous system damage caused by multiple factors. Almost all cerebral palsy patients have a movement disorder that makes dental treatment difficult. Oral hygiene management is difficult and the risks for periodontitis, dental caries and loss of multiple teeth are high. Placement of dental implants for multiple missing teeth in cerebral palsy patients needs multiple rounds of general anesthesia, and the prognosis is poor despite the expense. Therefore, making the decision to perform multiple dental implant treatments on cerebral palsy patients is difficult. A 33-year-old female patient with cerebral palsy and mental retardation was scheduled for multiple implant treatments. She underwent computed tomography (CT) under sedation and the operation of nine dental implants under general anesthesia. Implant-supported fixed prosthesis treatment was completed. During follow-up, she had the anterior incisors extracted and underwent the surgery of 3 additional dental implants, completing the prosthetic treatment. Although oral parafunctions existed due to cerebral palsy, no implant failure was observed 9 years after the first implant surgery.

Keywords

References

  1. Bax MC. Terminology and classification of cerebral palsy. Dev Med Child Neurol 1964; 6: 295-7.
  2. Nelson K, Emery 3rd E. Birth asphyxia and the neonatal brain: What do we know and when do we know it? Clin Perinatol 1993; 20: 327. https://doi.org/10.1016/S0095-5108(18)30396-8
  3. Nolan J, Chalkiadis G, Low J, Olesch C, Brown T. Anaesthesia and pain management in cerebral palsy. Anaesthesia 2000; 55: 32-41. https://doi.org/10.1046/j.1365-2044.2000.01065.x
  4. Seo KS, Lee JH, Shin TJ, Yi YE, Kim HJ, Yum K-W, et al. Intravenous sedation of cerebral palsy patient for dental implant ct taking-a case report. J Korean Dis Oral Health 2008; 4: 21-5.
  5. Nelson KB, Grether JK. Potentially asphyxiating conditions and spastic cerebral palsy in infants of normal birth weight. Am J Obstet Gynecol 1998; 179: 507-13. https://doi.org/10.1016/S0002-9378(98)70387-4
  6. Dite GS, Bell R, Reddihough DS, Bessell C, Brennecke S, Sheedy M. Antenatal and perinatal antecedents of moderate and severe spastic cerebral palsy. Aust N Z J Obstet Gynaecol 1998; 38: 377-83. https://doi.org/10.1111/j.1479-828X.1998.tb03091.x
  7. Badawi N, Watson L, Petterson B, Blair E, Slee J, Haan E, et al. What constitutes cerebral palsy? Dev Med Child Neurol 1998; 40: 520-7.
  8. Song JW, Lee KH. A statistical study on the dental caries incidence and plaque index in cerebral palsy person. J Korean Acad Pediatr Dent 2002; 29: 318-27.
  9. Chung JM, Seo KS, Yi YE, Han HJ, Han JH, Kim HJ, et al. Dental treatment of a patient with cerebral palsy under general anesthesia. J Korean Dent Soc Anesthesiol 2008; 8: 22-8. https://doi.org/10.17245/jkdsa.2008.8.1.22
  10. Seo KS, Jang KT, Kim HJ, Yum KW. The status of comprehensive dental treatment and type of disabilities of the patients treated under outpatient general anesthesia at the clinic for the disabled in seoul national university dental hospital. J Korean Dent Soc Anesthesiol 2006; 6: 82-8. https://doi.org/10.17245/jkdsa.2006.6.2.82
  11. Loyola-Rodriguez JP, Aguilera-Morelos AA, Santos-Diaz MA, Zavala-Alonso V, Davila-Perez C, Olvera-Delgado H, et al. Oral rehabilitation under dental general anesthesia, conscious sedation, and conventional techniques in patients affected by cerebral palsy. J Clin Pediatr Dent 2004; 28: 279-84. https://doi.org/10.17796/jcpd.28.4.e103u071237388h8
  12. Rogers J. Implant-stabilized complete mandibular denture for a patient with cerebral palsy. Dental update 1994; 22: 23-6.
  13. Lopez-Jimenez J, Romero-Dominguez A, Gimenez-Prats M. Implants in handicapped patients. Med Oral 2002; 8: 288-93.
  14. Kubo K, Kimura K. Implant surgery for a patient with parkinson's disease controlled intravenous midazolam: A case report. Int J Oral Maxillofac Implants 2004; 19:288-90.
  15. Ekfeldt A. Early experience of implant-supported prostheses in patients with neurologic disabilities. Int J Prosthodont 2005; 18:132-8.
  16. Oczakir C, Balmer S, Merickse-Stern R. Implant-prosthodontic treatment for special care patients: A case series study. Int J Prosthodont 2005; 18: 383-9.
  17. Cune MS, Strooker H, van der Reijden WA, de Putter C, Laine ML, Verhoeven JW. Dental implants in persons with severe epilepsy and multiple disabilities: A long-term retrospective study. Int J Oral Maxillofac Implants 2009; 24: 234-40.
  18. Feijoo J, Limeres J, Diniz M, Del Llano A, Seoane J, Diz P. Osseointegrated dental implants in patients with intellectual disability: A pilot study. Disabil Rehabil 2012; 34: 2025-30. https://doi.org/10.3109/09638288.2012.667189

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