The Journal of Contemporary Dental Practice

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 19 , ISSUE 9 ( 2018 ) > List of Articles

ORIGINAL RESEARCH

Oral Management of Steinert's Disease and Role of Anxiolysis

Rocco Franco, M Miranda, L Di Renzo, A Barlattani, A De Lorenzo, P Bollero

Keywords : Anxiolysis, Myotonic dystrophy, Oral management

Citation Information : Franco R, Miranda M, Renzo LD, Barlattani A, Lorenzo AD, Bollero P. Oral Management of Steinert's Disease and Role of Anxiolysis. J Contemp Dent Pract 2018; 19 (9):1157-1160.

DOI: 10.5005/jp-journals-10024-2398

License: CC BY-NC 3.0

Published Online: 01-10-2016

Copyright Statement:  Copyright © 2018; The Author(s).


Abstract

Background: Myotonic dystrophy type I (DM1) is a genetic autosomal dominant disorder; malignant hyperthermia is a possible complication. It may occur following administration of some halogenated general anesthetics, muscle relaxants, or surgical stress Aim: The purpose of this case report is to evaluate the dental management of patients with Steinert's disease. Case report: The patient needed dental extraction. A locoregional paraperiosteal anesthesia was performed using bupivacaine without vasoconstrictor and sedation with nitrous oxide. The syndesmotomy of the elements 3.1, 4.1, and 4.2 was executed. The elements were dislocated through a straight lever and avulsed with an appropriate clamp. The socket was courted, washing with saline solution, inserting a fibrin sponge, and applying sutures (silk 3-0). Conclusion: Dental treatment of the patient with Steinert's dystrophy must be carried out under a hospital environment and the use of local anesthetic without vasoconstrictor and with use of nitrous oxide; anxiolysis is recommended. Clinical significance: This case report describes the precautions to perform oral surgery in patients with Steinert's disease and emphasizes the role of anxiolysis to avoid episodes of malignant hyperthermia.


PDF Share
  1. Santoro M, Masciullo M, Silvestri G, Novelli G, Botta A. Myotonic dystrophy type 1: role of CCG, CTC and CGG interruptions within DMPK alleles in the pathogenesis and molecular diagnosis. Clin Genet 2017 Oct;92(4):355-364.
  2. Meola G, Cardani R. Myotonic dystrophies: an update on clinical aspects, genetic, pathology, and molecular pathomechanisms. Biochim Biophys Acta 2015 Apr;1852(4):594-606.
  3. Finsterer J, Rudnik-Schöneborn S. Myotonic dystrophies: clinical presentation, pathogenesis, diagnostics and therapy. Fortschr Neurol Psychiatr 2015 Jan;83(1):9-17.
  4. Parness J, Bandschapp O, Girard T. The myotonias and susceptibility to malignant hyperthermia. Malignant hyperthermia and neuromuscular disease. Anesth Analg 2009 Oct;109(4):1054-1064.
  5. Iannaccone ST, Castro D. Congenital muscular dystrophies and congenital myopathies. Continuum (Minneap Minn) 2013 Dec;19(6 Muscle Disease):1509-1534.
  6. Schieren M, Defosse J, Bohmer A, Wappler F, Gerbershagen MU. Anaesthetic management of patients with myopathies. Eur J Anaesthesiol 2017 Oct;34(10):641-649.
  7. Carsana A. Exercise-induced rhabdomyolysis and stressinduced malignant hyperthermia events, association with malignant hyperthermia susceptibility, and RYR1 gene sequence variations. Sci World J 2013 Feb;2013:531465.
  8. Reifenstahl EF, Rowshan HH. Malignant hyperthermia and its implications in general dentistry. Gen Dent 2009 May- Jun;57(3):242-246, quiz 247-248.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.