The Journal of Korea Assosiation for Disability and Oral Health (대한장애인치과학회지)

Korean Association for Disability and Oral Health (대한장애인치과학회)
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TREATMENT OF SELF-INJURIOUS LIP BITING WITH POSTERIOR BITE BLOCK APPLIANCE IN A BRAIN LESION PATIENT

교합 거상판을 이용한 뇌병변장애 환아의 자해성 구강 손상의 치료

  • Jun, Hyelim (Department of Pediastric Dentistry, College of Dentistry, Yonsei University) ;
  • Song, Je-Seon (Department of Pediastric Dentistry, College of Dentistry, Yonsei University) ;
  • Lee, Jae-Ho (Department of Pediastric Dentistry, College of Dentistry, Yonsei University) ;
  • Lee, Hyo-Seol (Department of Pediastric Dentistry, College of Dentistry, Yonsei University)
  • 전혜림 (연세대학교 치과대학 소아치과학교실) ;
  • 송제선 (연세대학교 치과대학 소아치과학교실) ;
  • 이제호 (연세대학교 치과대학 소아치과학교실) ;
  • 이효설 (연세대학교 치과대학 소아치과학교실)
  • Received : 2014.11.06
  • Accepted : 2014.12.22
  • Published : 2014.12.31
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Abstract

Brain disorder disability is assessed when organic brain lesion such as cerebral palsy, traumatic brain injury, or stroke causes physical impairment which limits daily activites substantially according to its level and range of paralysis or the presence of involuntary movement. According to the disabled person welfare law in Korea, grade I brain disorder is assessed when one is in continuous irreversible state of coma without the ability to prolong one's life without other's help. Self-injurious behavior is defined as the non-suicidal intentional or unintentional injury to one's own body which can occur repetitively temporarily or chronically. People with decreased consciousness often exhibit increased self-injurious behavior which is most commonly associated with tongue or lip biting. This report documents a successful self -injurious lip biting treatment of a brain lesion patient within a short time by applying a removable acrylic resin appliance including posterior bite block.

본 증례를 통하여 뇌병변 장애 1급 환아에 자해성 구강손상이 발생한 경우 치료에 대해 고려할 점은 다음과 같다. 뇌병변 장애 1급을 포함하는 의식 저하 환자에서는 혀, 입술 씹기 등의 자해성 구강손상 발생 빈도가 높다. 연성 구강보호장치의 용이성으로 우선적으로 고려될 수 있으나, 연성 구강 보호 장치로 병소가 개선되지 않을 경우, 교합 거상판을 포함한 아크릴릭 레진 가철성 장치를 고려할 수 있다. 교합 거상판을 포함하는 아크릴릭 레진 가철성 장치 장착이후 구강 위생 관리 및 치료 부위 유지를 위해 주기적인 치과 검진이 필요하다.

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References

  1. Hyman SL, Fisher W, Mercugliano M, et al. : Children with self-injurious behavior. Pediatrics, 85(3 Pt 2) : 437-441, 1990.
  2. Lucavechi T, Barberia E, Maroto M, et al. : Selfinjurious behavior in a patient with mental retardation : review of the literature and a case report. Quintessence Int, 38(7) : e393-398, 2007.
  3. Favazza AR, Conterio K : The plight of chronic self-mutilators. Community Ment Health J, 24(1) : 22-30, 1988. https://doi.org/10.1007/BF00755050
  4. Saemundsson SR, Roberts MW : Oral self-injurious behavior in the developmentally disabled : review and a case. ASDC J Dent Child, 64(3) : 205-209, 228, 1997.
  5. Peters TE, Blair AE, Freeman RG : Prevention of self-inflicted trauma in comatose patients. Oral Surg Oral Med Oral Pathol, 57(4) : 367-370, 1984. https://doi.org/10.1016/0030-4220(84)90151-8
  6. Lee H, Lee HS, Son HK et al. : Self-injurious behaviors due to various mental disorders : Oral manifestation and the treatment. J Korean Dis Oral Health, 9(1) : 39-41, 2013. https://doi.org/10.12655/jkdoh.2013.9.1.39
  7. Finger ST, Duperon DF : The management of self-inflicted oral trauma secondary to encephalitis : a clinical report. ASDC J Dent Child, 58(1) : 60-63, 1991.
  8. Fenton SJ : Management of oral self-mutilation in neurologically impaired children. Spec Care Dentist, 2(2) : 70-73, 1982. https://doi.org/10.1111/j.1754-4505.1982.tb01283.x
  9. Rover BC, Morgano SM : Prevention of self-inflicted trauma : dental intervention to prevent chronic lip chewing by a patient with a diagnosis of progressive bulbar palsy. Spec Care Dentist, 8(1) : 37-39, 1988. https://doi.org/10.1111/j.1754-4505.1988.tb00683.x
  10. Hanson GE, Ogle RG, Giron L : A tongue stent for prevention of oral trauma in the comatose patient. Crit Care Med, 3(5) : 200-203, 1975. https://doi.org/10.1097/00003246-197509000-00007
  11. Chen LR, Liu JF : Successful treatment of selfinflicted oral mutilation using an acrylic splint retained by a head gear. Pediatr Dent, 18(5) : 408-410, 1996.