Comprehensive dental treatment in pediatric patients with chronic renal failure. Case Report

Abstract

ABSTRACT: Pediatric patients with chronic renal failure (CRF) may present with developmental enamel defects, alterations in the development of the dentition, xerostomia, increased salivary pH, pallor of the oral mucosa due to anemia, and bleeding and gingival enlargement induced by immunosuppressants. The purpose of dental treatment is to maintain oral health and eliminate sources of infection. Objective: To present the clinical case, diagnosis and interdisciplinary treatment plan in a pediatric patient with CKD. Case presentation: A 5-year-old female patient presented with a history of compensatory hydronephrosis of the left single kidney, due to pielocalicial stenosis, . He has had repeated infections and admission to the pediatric ICU. The clinical and radiographic dental examination revealed early childhood caries affecting: 52, 55, 54, 65, 75, 74, 84, 85; with pulp involvement in 54, 84. The patient was anxious at dental consultation and had a planned urological surgical procedure. Joint treatment was performed, under general anesthesia in a hospital environment, with an interdisciplinary team involving urology and pediatric dentistry. Pulpotomies were performed with Biodentine in 54 and 84, restoration with Equia Forte for 54 and 84, class II composite restorations for 64 and 74, and class I for 65, 75 and 85, sealants of pits and fissures in 65. Conclusion: The use of bioactive materials for patients with special dental care requirements was successful in this case. Therapeutic planning for pediatric patients with systemic compromise should be done in an interdisciplinary manner, guaranteeing the quality of life related to oral health.