Open Access

An unusual case of oral surgical management in a patient with isovaleric acidemia and schizophrenia: A case report

  • Authors:
    • Sho Miyamoto
    • Edward Hosea Ntege
    • Yasutsugu Chinen
    • Takahiro Goto
    • Jumpei Shirakawa
    • Shimpei Goto
    • Toshihiro Kawano
    • Yusuke Shimizu
    • Koichi Nakanishi
    • Hiroyuki Nakamura
  • View Affiliations

  • Published online on: June 7, 2022     https://doi.org/10.3892/br.2022.1547
  • Article Number: 64
  • Copyright: © Miyamoto et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Oral/dental surgical care in patients with chronic medical comorbidities, such as isovaleric acidemia (IVA), can be challenging. In addition to technical complications, different comorbidities also present a complex range of concerning factors/challenges, which can increase the incidence of morbidity and mortality associated with surgery. IVA, a congenital error of metabolism, is a rare organic acidemia with a predisposition towards acute acidosis and life‑threatening metabolic decompensation during stressful conditions, such as prolonged fasting and surgery. In addition, schizophrenia, a major neurological disorder, can result in manifestation of severe dental or periodontal conditions, including pericoronitis. The condition is associated with significant risk factors of postoperative complications, such as dangerous behaviors and adverse interactions between antipsychotic drugs and anesthetic agents. A case of comorbid dental disease with two coexisting chronic and life‑threatening medical conditions, one of which is rare, is an unusual encounter in oral/dental surgery that is seldomly published. Moreover, implementing a safe and effective surgical intervention in such patients requires several informed considerations. However, only a few reported experiences or guidelines exist, reporting appropriate perioperative management strategies to minimize risks. Hence, in this case report, our experience of managing one of these rare encounters of a 20‑year‑old man who suffered from bilaterally partially erupted third molars, associated with chronic pericoronitis and dental caries of both the maxilla wisdom teeth with coexisting IVA and schizophrenia comorbidities is described. Additionally, the presentation and anticipated complications of the comorbid disorders of the patient are briefly reviewed. In this case, the pericoronitis and dental caries were treated by surgically removing the impacted third molars and the antagonist maxilla wisdom teeth under regional anesthesia and application of antibiotics for 3 days. The patient recovered without any postoperative complications after 1 year of follow‑up.
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August-2022
Volume 17 Issue 2

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Spandidos Publications style
Miyamoto S, Ntege EH, Chinen Y, Goto T, Shirakawa J, Goto S, Kawano T, Shimizu Y, Nakanishi K, Nakamura H, Nakamura H, et al: An unusual case of oral surgical management in a patient with isovaleric acidemia and schizophrenia: A case report. Biomed Rep 17: 64, 2022
APA
Miyamoto, S., Ntege, E.H., Chinen, Y., Goto, T., Shirakawa, J., Goto, S. ... Nakamura, H. (2022). An unusual case of oral surgical management in a patient with isovaleric acidemia and schizophrenia: A case report. Biomedical Reports, 17, 64. https://doi.org/10.3892/br.2022.1547
MLA
Miyamoto, S., Ntege, E. H., Chinen, Y., Goto, T., Shirakawa, J., Goto, S., Kawano, T., Shimizu, Y., Nakanishi, K., Nakamura, H."An unusual case of oral surgical management in a patient with isovaleric acidemia and schizophrenia: A case report". Biomedical Reports 17.2 (2022): 64.
Chicago
Miyamoto, S., Ntege, E. H., Chinen, Y., Goto, T., Shirakawa, J., Goto, S., Kawano, T., Shimizu, Y., Nakanishi, K., Nakamura, H."An unusual case of oral surgical management in a patient with isovaleric acidemia and schizophrenia: A case report". Biomedical Reports 17, no. 2 (2022): 64. https://doi.org/10.3892/br.2022.1547