Oral rehabilitation under dental general anesthesia, conscious sedation, and conventional techniques in patients affected by cerebral palsy

The purpose of this report is to find the use of different alternatives for dental treatment, from general

anesthesia to conventional techniques, in patients affected by cerebral palsy (CP) in a dental school setting.The

sample was divided into two groups: (1) children, and (2) adolescents and young adults; 38 patients (20 female

and 18 male) with diagnostic of CP were included. Risks and benefits of conscious sedation and general

anesthesia were written into a consent form and these were discussed with parents or guardians of each affected

patient.The mean age was 7.14 ± 2.2 years for children´s group and 18.5 ± 3.06 years for adolescent and young

adult group.Most children (77.3%) were classified as ASA II with a level of behavior I-II according to Frankl´s

scale and these patients were treated under general anesthesia (GA). For patients that were classified as of

positive behavior with little necessity of dental procedures, independent of the medically compromised level,

dental treatment was done with conventional techniques or with conscious sedation. Dental frequency procedures

were as follows: composites, dental prophylaxis, and dental extractions in children; in adolescents and

adults, important to point out is that in anterior teeth and molars endodontic treatment, and surgical procedures

increased in frequency. The mixture sevoflurane-propofol worked well during pre-, peri-, and post-operative

procedures. During the discharge process, most patients needed a recovery of 20-40 minutes, after which they

were awake and oriented, breathing comfortably with stable vital signs. It was concluded that GA with

sevoflurane-propofol and conscious sedation are an excellent tool to provide dental treatment in CP patients in

a dental school setting without most of the major postoperative complications, such as nausea and vomiting.

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