Dental management of moyamoya disease: A silver lining for the clouds of smoke

Moyamoya disease (MMD) is a rare, chronic, and typically bilateral vasculopathy characterized by progressive stenosis at the terminal portion of the intracranial internal carotid arteries, often leading to complete occlusion. While hereditary, infectious, and inflammatory factors have been implicated, the exact etiology remains unknown. The prevalence of MMD is estimated to range from 1.6 to 16.1 per 100,000 live births. Although the disease can affect both children and adults, it is most commonly observed in individuals aged 5–15 and 30–40 years, with a female-to-male ratio of approximately 2:1. This case report presents the dental management of a 9-year-old female patient diagnosed with MMD and right-sided hemiplegia. Clinical findings and treatment procedures are described in detail. Dental extractions were performed under local anesthesia without complications. The treatment plan focused on preventive and restorative approaches, along with proactive counseling for the patient and her parents. All procedures were completed in two to three dental visits by a single operator.