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Dental management of patient with Duchenne Muscular Dystrophy under general anesthesia in a child: A case report

대한장애인치과학회지 2020년 16권 1호 p.48 ~ 52
성영제, 송지수, 현홍근, 김영재, 김정욱, 장기택, 이상훈, 신터전,
소속 상세정보
성영제 ( Sung Young-Jae ) - Seoul National University School of Dentistry Department of Pediatric Dentistry
송지수 ( Song Ji-Soo ) - Seoul National University School of Dentistry Department of Pediatric Dentistry
현홍근 ( Hyun Hong-Keun ) - Seoul National University School of Dentistry Department of Pediatric Dentistry
김영재 ( Kim Young-Jae ) - Seoul National University School of Dentistry Department of Pediatric Dentistry
김정욱 ( Kim Jung-Wook ) - Seoul National University School of Dentistry Department of Pediatric Dentistry
장기택 ( Jang Ki-Taeg ) - Seoul National University School of Dentistry Department of Pediatric Dentistry
이상훈 ( Lee Sang-Hoon ) - Seoul National University School of Dentistry Department of Pediatric Dentistry
신터전 ( Shin Teo-Jeon ) - Seoul National University School of Dentistry Department of Pediatric Dentistry

Abstract


Duchenne Muscular Dystrophy (DMD) is a disease caused by a mutation in a gene on X chromosome, which prevents the production of dystrophin, a normal protein in muscle tissue. This gender-linked, recessive disorder affects males at a rate of one in 3,500 births. Patients affected by DMD have progressive loss of muscle functions and weakness in their early childhood.
A 5-year-old boy with DMD visited Seoul National University Dental Hospital Department of pediatric dentistry for caries treatment. Clinical and radiographic examinations revealed multiple carious lesions on deciduous teeth. Based on patient’s underling disease, age, and level of distress tolerance, dental treatment under general anesthesia with total intravenous anesthesia was scheduled. All posterior molars were treated with pulpectomy and stainless-steel crown. Maxillary incisors were treated with zirconia crown.
Macroglossia, open-bite, maxillary and mandibular arch expansion, facial muscle malfunction, delayed tooth emergence are commonly observed in patients with DMD. Loss of muscle function in arms and hands often results in poor oral hygiene level. Therefore, dental and prophylactic treatment should be provided earlier. Recent case reports suggest that some patients with DMD are at risk of developing malignant hyperthermia related to general anesthesia with inhaled anesthetics. When planning general anesthesia for dental treatment, total intravenous anesthesia should be considered as an anesthetic technique for these patients.

키워드

Duchenne Muscular Dystrophy (DMD); Dental treatment; Total intravenous anesthesia

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