Full-Mouth Dental Rehabilitation Under General Anesthesia in an 8-Year-Old Male with Dandy-Walker Syndrome: A Case Report
Author(s): Rotana A Qari *, Amjad Hassan AlTayim, Haitham Abdulhadi Alraddadi, Abdullah Alharbi
Abstract
The Dandy-Walker Syndrome (DWS) is a rare congenital malformation characterized by hypoplasia of the cerebellar vermis, enlargement of the fourth ventricle, and a variety of symptoms, including developmental delay, motor deficits, and craniofacial abnormalities. The present case report describes an 8-year-old male patient with DWS, who had a history of marked dental caries and multiple dentoalveolar abscesses, who underwent comprehensive full-mouth rehabilitation under general anesthesia.
After repeated courses of antibiotics, the patient presented with severe pain and multiple posterior dental abscesses. On clinical assessment, retentive fissures, carious lesions, abscessed molars, and a non-restorable root stump were observed. General anesthesia was required for behavioral and motor limitations. Treatment consisted of quadrant rehabilitation with fissure sealants, composite restorations, stainless-steel crowns, and multiple extractions, including the lower canine for orthodontic consideration. Pathological findings were documented in detail using preoperative radiographs and intraoral photographs. Postoperative treatment comprised oral hygiene education, emphasizing prevention, and the use of pain drugs, antibiotics, and the patient's caregivers' education on oral hygiene, with motor and cognitive deficits.
Many dental management challenges exist in children with DWS and can be addressed through multidisciplinary planning and the use of the most appropriate individualized dental treatment plans and preventive oral health strategies. For severe diseases, performed under general anesthesia, a full-mouth rehabilitation may be indicated, and long-term care with caregiver participation is required for good oral health and to reduce the risk of recurrence.