Dental Management of Child with Myelomeningocele Associated with Type II Arnold-Chiari Malformation: Case Report and Review of Literature

脊髓脊膜膨出合并II型Arnold-Chiari畸形患儿的牙科治疗:病例报告及文献综述

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Abstract

AIM AND BACKGROUND: Myelomeningocele (MMC), the most severe form of spina bifida, is a congenital malformation of the spinal cord and brain, often associated with type II Arnold-Chiari malformation. This condition leads to significant complications such as hydrocephalus, cerebrospinal fluid (CSF) leakage, mobility impairment, and bladder/bowel incontinence. These issues, along with social and financial burdens, profoundly affect patients and their families. Children with MMC are also at higher risk of dental neglect, increasing the likelihood of severe oral health issues like dental caries and gingival disease. CASE DESCRIPTION: This case focuses on the dental management of a young child with MMC and type II Arnold-Chiari malformation. Due to the elevated risk of complications from general anesthesia or sedation, behavior management techniques were employed to provide comprehensive dental care. The treatment approach considered the child's medical complexities, mobility limitations, and neurosensory challenges, ensuring that oral health needs were met safely and effectively. CONCLUSION: Children with MMC and type II Arnold-Chiari malformation require careful treatment planning to avoid anesthesia-related risks. Comprehensive dental care can be successfully provided using behavior management strategies. CLINICAL SIGNIFICANCE: This case highlights the importance of adapting dental care to the needs of children with complex medical conditions. Nonpharmacological strategies can ensure safe treatment, reducing the risk of complications and improving overall health outcomes. HOW TO CITE THIS ARTICLE: Padmanabhan MY. Dental Management of Child with Myelomeningocele Associated with Type II Arnold-Chiari Malformation: Case Report and Review of Literature. Int J Clin Pediatr Dent 2025;18(6):738-744.

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