Dental Care for a Child with Congenital Hydrocephalus: A Case Report with 12-Month Follow-Up

Yasser Alsayed Tolibah, Chaza Kouchaji, Thuraya Lazkani, Mohammad Tamer Abbara, Saffana Jbara, Ziad D Baghdadi, Yasser Alsayed Tolibah, Chaza Kouchaji, Thuraya Lazkani, Mohammad Tamer Abbara, Saffana Jbara, Ziad D Baghdadi

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.

Keywords: child; dental care for the chronically ill; dental care for the disabled; facial asymmetry; hydrocephalus; oral health; tooth diseases.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) Frontal view of the child. (B) Lateral view of the child. Note the enlargement in the head’s posterior region due to hydrocephalus. (C) The ventriculoperitoneal (VP) shunt in the neck’s left side.
Figure 2
Figure 2
(A) The upper arch. (B) Frontal view of both arches in occlusion. (C) The lower arch.
Figure 3
Figure 3
A panoramic radiograph showing teeth #46 and #36 with extremely large carious lesions and periapical radiolucencies, tooth #16 with an extensive carious lesion, and large carious lesions in the upper primary molars.
Figure 4
Figure 4
(A) Apical lesions with extensive decay in tooth #36. (B) Verifying the placement of the MTA plug. (C) Completed root canal treatment and placement of a metallic crown.
Figure 5
Figure 5
(A) Apical lesions with extensive decay in tooth #46. (B) Biodentine placement, completed root canal treatment, and placement of a metallic crown.
Figure 6
Figure 6
(A) A pinpoint pulp exposure in tooth #16. (B) MTA placed.
Figure 7
Figure 7
(A) Cavitated carious lesion and hypomineralized spots on the buccal surface of tooth #21. (B) Resin-bonded restoration after finishing and polishing.
Figure 8
Figure 8
1 month after treatment. (A) The upper arch. (B) Anterior view in occlusion. (C) The lower arch.
Figure 9
Figure 9
(A) The upper arch with a palatal crib. (B) The palatal crib in occlusion. (C) The lower arch with the lingual holding arch.
Figure 10
Figure 10
(A) A panoramic radiograph one year after treatment. (B) The lower-right permanent molar immediately after the treatment. (C) The lower-right permanent molar one year after the treatment. Note apical healing. (D) The lower-left permanent molar immediately after the treatment. (E) The lower-left permanent molar one year after the treatment. Note apical healing. (F) The upper arch one year after the treatment. (G) Both arches in occlusion. Note the reduction in an open bite. (H) The lower arch one year after the treatment.
Figure 10
Figure 10
(A) A panoramic radiograph one year after treatment. (B) The lower-right permanent molar immediately after the treatment. (C) The lower-right permanent molar one year after the treatment. Note apical healing. (D) The lower-left permanent molar immediately after the treatment. (E) The lower-left permanent molar one year after the treatment. Note apical healing. (F) The upper arch one year after the treatment. (G) Both arches in occlusion. Note the reduction in an open bite. (H) The lower arch one year after the treatment.

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