• 대한장애인치과학회지
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• 제10권2호
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• pp.93-96
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• 2014

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.

• 대한장애인치과학회지
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• 제12권1호
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• pp.16-19
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• 2016

본 증례의 환아들의 경우, PEG-tube를 통한 식이로 구강 위생관리가 용이하며, 사지마비 및 의식 저하로 스스로 장치의 탈착이 어렵다는 점에서 가철성 장치를 장착한 결과 양호한 치유 양상이 관찰되었다. 구강조직에 자해로 인한 손상이 발생한 경우, 환자의 병력, 현재 상태, 치료 기간 등을 고려하여, 환자에게 가장 바람직한 치료 계획을 세워야 한다. 가철성 장치를 이용하는 경우, 구강 위생 관리 및 병소의 관찰을 위하여 주기적인 치과 검진이 필요하다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권5호
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• pp.457-463
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• 2001

In the unconscious patient with general muscle rigidity, the natural teeth can be luxated and then bite wounds may be occurred around lip, owing to the pathologic involuntary self-biting habit. If the forceful biting is generated continuously, the teeth may be avulsed and aspirated into the aerodigestive tract with the infection of biting wound. For the prevention of pulmonary aspiration of the teeth and wound infection, the biting teeth should be cared before the fact. The authors treated the teeth as endodontic drainage with removal of the crown or iodoform gauze drainage into the socket with extraction of the teeth. The prognosis was more favorable without biting wounds.

• 대한치과교정학회지
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• 제22권1호
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• pp.253-271
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• 1992

The purpose of this study was to investigate the difference of EMG activity of the Orbicularis oris and Mentalis muscle between normal occlusion and class III malocclusion group during various lip position and to find out whether any correlations exist between the muscular activity and craniofacial morphology. In this study, 50 subjects with a mean age of 22.9 Years (range 20.0-26.0) were investigated (25 subjects were normal occlusion, and 25 subjects were class III malocclusion). EMG data were recorded from the Orbicularis oris and Mentalis muscle during rest lip posture, lip position at maximum biting, lip position at maximum sealing effort, lip position at chewing, swallowing and phonation with the Medelec MS-25 electromyographic machine. Lateral cephalometric radiographs was taken with the mandible in intercuspal position on all subjects. All data were recorded and statistically processed. The findings of this study can be summerized as follows: 1. In normal occlusion, the maximal mean amplitude of upper lip during the lip position at chewing was lower than that of lower lip and mentalis muscle. But the maximal mean amplitude of orbicularis oris and mentalis muscle during the other lip position was not statistically different. 2. In Class III malocclusion, the maximal mean amplitude of upper lip during the lip position at chewing, swallowing and phonation was lower than that of lower lip and mentalis muscle. But the maximal mean amplitude of orbicularis oris and mentalis muscle during the other lip position was not statistically different. 3. Compare to normal occlusion, the Class III malocclusion was showed low maximal mean amplitude of upper lip during rest lip posture and the lip position at swallowing of saliva, and showed great maximal mean amplitude of lower lip and meantalis muscle during the lip position at chewing and phonation. 4. In normal occlusion, the maximal mean amplitude of upper lip during various lip position was not correlated with the length and thickness of upper lip, but the maximal mean amplitude of lower lip during the lip position at chewing and swallowing was positively correlated with the thickness of lower lip. 5. In Class III malocclusion, the maximal mean amplitude of upper lip during rest lip posture was negatively correlated with the thickness of upper lip, and the maximal mean amplitude of lower lip and mentalis muscle during the lip position at chewing and swallowing was positively correlated with the thickness of lower lip and mentalis muscle. But the maximal mean amplitude of orbicularis oris and mentalis muscle during the other lip position was not correlated with the cephalometric measurements of soft tissue. 6. The correlation between the maximal mean amplitude of orbicularis oris and mentalis muscle and cephalometric measurements of incisors was not nearly present. 7. In normal occlusion, the maximal mean amplitude of lower lip and mentalis muscle during the lip position at maximum biting was negatively correlated with the angle between palatal plane and mandibular plane. In Class III malocclusion, the maximal mean amplitude of upper lip, lower lip and mentalis muscle during function was negatively correlated with the length of maxilla, the maximal mean amplitude of upper lip and lower lip during function was negatively correlated with the SNA and SNPo, and the maximal mean amplitude of lower lip during the lip position at chewing was negatively correlated with the ANB.

• 대한치과기공학회지
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• 제36권3호
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• pp.187-196
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• 2014

Purpose: This study aims to examine correlation between temporomandibular disorder and oral habits that have been known to cause temporomandibular disorder with both male and female undergraduates. Methods: To figure out correlation between temporomandibular disorder and oral habits, a survey was conducted to 500 students of two universities located in Daegu Metropolitan City and Gyeongsangbuk-do, and excluding the ones unreliably answered or indicating errors, total 427 (85.4%) out of 500 questionnaire sheets were used for final analysis. Results: Female students showed higher prevalence rates than male students in temporomandibular joint pain and temporomandibular joint clicking, and students having the lip biting habit, tongue thrust habit, or bruxism habit indicated a higher prevalence rate of temporomandibular joint pain than normal students. Also, students having the tongue thrust habit indicated a significantly higher prevalence rate of temporomandibular joint clicking than normal students not having it. And about trismus, students having the bruxism habit showed a significantly higher prevalence rate than normal students not having it. Conclusion: The findings imply that oral habits like lip biting, tongue thrust, or bruxism are closely related with temporomandibular joint pain, tongue thrust influences temporomandibular joint clicking, and bruxism does affect trismus.

• 대한두개안면성형외과학회지
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• 제19권3호
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• pp.222-226
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• 2018

A 70-year-old male with a history of diabetes mellitus, hypertension, and coronary stent insertion visited our hospital 7 days after biting his lower lip. Swelling and inflammation had worsened despite debridement and antibiotic treatment. On the 8th hospital day, fungal infection with Candida albicans and superimposed bacterial infection with Klebsiella pneumoniae were found on tissue culture. Extensive necrosis resulted in a defect of approximately 3/4 of the entire lower lip and a full-layer skin defect from the vermilion to the gingivobuccal sulcus at the right corner of the mouth. To correct drooling, incomplete lip sealing, and trismus, staged reconstruction was performed with consideration of cosmetic and functional features. The treatment process using staged reconstruction and antifungal treatment for an extensive lower lip defect caused by fungal stomatitis is described.

• Archives of Plastic Surgery
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• 제48권3호
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• pp.282-286
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• 2021

Recent reports have described several cases of double muscle transfers to restore natural, symmetrical smiles in patients with long-standing facial paralysis. However, these complex procedures sometimes result in cheek bulkiness owing to the double muscle transfer. We present the case of a 67-year-old woman with long-standing facial paralysis, who underwent two-stage facial reanimation using two superficial subslips of the serratus anterior muscle innervated by the masseteric and contralateral facial nerves via a sural nerve graft. Each muscle subslip was transferred to the upper lip and oral commissures, which were oriented in different directions. Furthermore, a horizontal fascia lata graft was added at the lower lip to prevent deformities such as lower lip elongation and deviation. Voluntary contraction was noted at roughly 4 months, and a spontaneous smile without biting was noted 8 months postoperatively. At 18 months after surgery, the patient demonstrated a spontaneous symmetrical smile with adequate excursion of the lower lip, upper lip, and oral commissure, without cheek bulkiness. Dual-innervated muscle transfer using two multivector superficial subslips of the serratus anterior muscle may be a good option for long-standing facial paralysis, as it can achieve a symmetrical smile that can be performed voluntarily and spontaneously.

• 대한장애인치과학회지
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• 제2권2호
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• pp.156-160
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• 2006

각각의 환자에게 알맞은 장치를 제작하여 장착한 결과 모두 양호한 치유양상을 보였다. 자해를 관리하기 위해서는 고정성, 가철성 장치를 모두 사용할 수 있다. 장치의 선택은 환자의 상태에 따라 결정되어야 한다. 파괴적인 행위가 중단되어 구강 내 상처부위가 회복되어도 아주 높은 빈도로 재발이 일어나므로 이를 방지하기 위해 정기 내원 관리가 필요하다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권4호
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• pp.228-232
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• 2023

Lesch-Nyhan syndrome (LNS) is a rare X-linked recessive disorder caused by a mutation in the hypoxanthine phosphoribosyltransferase 1 (HPRT1) gene. This syndrome is characterized by excessive production of uric acid, mental retardation, self-mutilation, choreoathetosis, and spasticity. The most distinctive symptom is compulsive self-mutilation. For patients with LNS, different methods have been tried to reduce self-biting behaviors including restraints, behavioral treatment, medications, deep brain stimulation, tooth extraction and botulinum toxin A injection. In this report, we present a case of LNS undergoing cheiloplasty due to self-mutilation and tooth extraction of the left deciduous maxillary canine.

• 대한소아치과학회지
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• 제47권1호
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• pp.93-98
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• 2020

Lesch-Nyhan 증후군은 hypoxanthine-guanine phosphoribosyl transferase 결핍으로 인해 발생한 purine 대사 장애의 열성 유전 질환이다. 이 증후군은 신경 장애, 행동 장애 및 과요산혈증(hyperuricemia) 등의 증상이 나타난다. 특징적으로 자해 습관은 2 - 3세경 시작되는데, 구강 주위 조직이나 손, 발을 물어 뜯는 양상이 나타난다. 이 증례는 2세 7개월의 Lesch-Nyhan 증후군 환아의 자해습관을 반 고정식 립 범퍼를 이용하여 차단한 증례를 보고하는 바이다. 반 고정식 립 범퍼는 전통적인 인상채득 방식을 필요로 하지 않고 내원 당일 치료해 줄 수 있는 장점이 있으며, 보호자에 의해 탈, 부착이 가능하여 환아의 구강위생 관리에 용이하였다. 장치 장착 2 개월 후, 치아 주위 조직이 회복되고 연속성이 유지되는 양호한 결과를 보였다. 장치 장착 11개월 후, 양호한 회복양상이 유지되었으며 추가적인 외상이나 자해행동의 악화는 관찰되지 않았다. 따라서, semi-fixed lip bumper는 Lesch-Nyhan syndrome 환아의 자해습관을 차단하기 위한 interim appliance로 사용하는데 유용할 것으로 사료된다.