• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.1
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• pp.151-156
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• 1999

Self-injurious behavior is defined as deliberate harm to one's own body without suicidal intent. It usually occurs as head banging or hitting, skin cutting, or finger biting and includes ocular, genital and oral self-mutilation. Lesch-Nyhan syndrome is a rare X-linked recessively inherited disorder, caused by complete absence of hypoxanthin-guanine phosphoribosyl transferase(HPRT) activity. Clinical presentation is characterized by mental retardation, chorea, athetosis, hyperuricemia, uricosuria and self-mutilating behavior. In these patients, the most typical feature is loss of tissue from biting themselves, even though they are not insensitive to pain. The dental management of self-mutilation includes treatment with appliances such as soft mouthguard or lip bumper, extraction of all the teeth, and orthognathic surgery. We report a 25-month-old boy who was a known case of Lesch-Nyhan syndrome and presented with severe self-mutilation wound on his lower lip. Vital pulpectomy and coronal resection was done as a more conservative approach than extracting all primary anterior teeth. Due to maintaining the root portion of the teeth in the bone, it is expected that the normal growth of the alveolar bone will be achieved.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.4
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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.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.14 no.1
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• pp.53-63
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• 2003

The autistic disorder is identified as an independent clinical entity, since the first description of Leo Kanner. The etiologies of the autistic disorder are almost unclear and the autistic disorder has several abnormalities in aspect of morphology and function of brain. Self-mutilation is observed in the low functioning autistic patients, and early treatment for self mutilation are needed in order not to be chronic. This article reviewed the drugs for the several symptoms of the autistic disorder, especially for self-mutilation. The serotonin reuptake inhibitors does not have clear primary anti-aggressive effects. The dopamine blockers have considerable effects in order to decrease aggression and self injury, and the risperidone is most recommended because of side effects of conventional drugs. The naltrextone does not have consistent study results yet. The clonidine has aggression-decreasing effect. Also lithium is effective on the treatment for aggressive and self-injurious behaviors. And the anticonvulsants including carbamazepine are effective on aggressive explosive behaviors. In the future the pharmacotherapy for self-mutilation will be advanced through stalbe diagnosis and measurement of treatment response.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.2 no.2
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• pp.156-160
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• 2006

Self-injurious behavior is defined as deliberated harm to one's own body without suicidal intent. It usually occurs as head banging or hitting, body hitting, skin cutting, or finger biting and includes ocular, genital, and self-inflicted oral mutilation. Self-injurious behavior can occur with mental retardation, comatose status, psychotic problem, poisoning, or character disorders. In pediatric patients, self-injurious behavior usually is reported to lip, cheek and tongue biting, and many kinds of dental management methods have been introduced to prevent self-injurious behavior patients from self biting. This report presents some self-inflicted oral mutilation patients who were all treated successfully with several appliances.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.2 no.2
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• pp.147-152
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• 2006

Lesch-Nyhan syndrome is rare X-linked genetic disorder involving absence of the enzyme hypoxanthine guanine phosphoribosyl transferase (HGPRT) related to purine metabolism. The deficiency of HGPRT activity leads to an excesscive uric acid production and consequent hyperuricemia. It occurs almost exclusively in males, and the incidence is estimate to be 1/100,000~380,000. Clinical presentation is characterized by developmental delay, mental retardation, choreoathetosis, spastic cerebral palsy, nephrolithiasis, obstructive nephropathy and acute gouty arthritis. A characteristic feature of Lesch-Nyhan syndrome is the appearance of intractable self-mutilation behavior. Self-mutilation behavior is complicated by secondary infection and tissue loss as well as pain. The dental management of self-mutilation includes presertive methods of using appliances such as lip bumper or soft mouthguard and radical methods such as extraction of all teeth or orthognathic surgery. A case of Lesch-Nyhan syndrome patient with self-mutilation and severe lower lip injury is presented. He was treated successfully with soft mouthguard.

• Journal of Korean Dental Science
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• v.16 no.2
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• pp.204-210
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• 2023

Lesch-Nyhan syndrome is a rare X-linked recessive disorder characterized by a deficiency of the enzyme hypoxanthine-guanine phosphoribosyl transferase, which is important in the metabolism of purines. Prevalence of Lesch-Nyhan syndrome is 1:100,000 to 1:380,000 live births, and Lesch-Nyhan syndrome mainly affects males. It is characterized by neurologic dysfunction, uric acid overproduction, and cognitive and behavioral disturbances. The self-mutilation is the most distinctive symptom in Lesch-Nyhan syndrome, appearing about 1 year of age. It is expressed as persistent bites in the oral mucosa, tongue, lips, and fingers, which leads to the total or partial destruction of the affected tissues. Several medical and dental management methods might be performed in Lesch-Nyhan syndrome patients. Dental approaches to prevent injuries caused by self-mutilation include treatments with oral appliances such as mouth guards or lip bumpers, extraction, and orthognathic surgery. This report described two brothers with Lesch-Nyhan syndrome, who injured themselves on oral tissues. The methods of tooth reduction and extraction were performed to prevent injuries caused by self-mutilation.

• Journal of Veterinary Clinics
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• v.9 no.2
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• pp.367-372
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• 1992

To investigate the effect of neck collars for the protection of self-mutilation, attainable sites of the body in dogs with collars and durability of collars were examined for 7 days. The collars used in the present experiment were hand made plastic basket collar, IASIS$\^$R/ ( heat moldable plastics), commerical plastic and cardboard collars The hand made plastic basket collar was made of basket which could buy at any supermarkets. The dogs with hand made plastic basket collar and IASIS$\^$R/ which was cast from the neck to the scapular region could lick only on digits of the forelimb. However, the dogs with commercial plastic and cardboard collars could lick not only the digits of forelimb but femur and digits of the hindlimb. It was suggested that hand made plastic basket collar was superior to the other collars in easiness of putting, durability, protection of self mutilation and economy.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.2
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• pp.244-250
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• 2005

Self-injurious behavior is defined as deliberated harm to one's own body without suicidal intent. It usually occurs as head banging or hitting, body hitting, skin cutting, or finger biting and includes ocular, genital, and self-inflicted oral mutilation. Self-injurious behavior can occur with mental retardation, coma, psychotic problem, poisoning, or character disorders. In pediatric patients, self-injurious behavior usually is reported to lip, cheek and tongue biting, and many kinds of dental management methods have been introduced to prevent self-injurious behavior patients from self biting. This report presents two self-inflicted oral mutilation patients who were all treated successfully with appliances such as modified activator without wire for retention, modified tongue-rake appliance and mouth guard.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.4 no.1
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• pp.17-20
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• 2008

In the brain of epilepsy patients, sudden and unusually intense bursts of electrical charges are occurred repeatedly. So, epilepsy patient experiences seizure. Seizure shows various frequency and precipitating factor and has a prodrome. Also, epilepsy patient present various behavior pattern during seizure. If the biting injury occurred during seizure, there would be pain, infection, defect of soft tissue and esthetic problem. The dental management of self-mutilation includes preserve methods of using appliances such as lip bumper or soft mouth guard and radical methods such as extraction of all teeth or orthognathic surgery. A case of epilepsy patient with self-mutilation of mento-labial sulcus is presented. She was treated successfully with soft mouth guard.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.30 no.3
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• pp.100-108
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• 2019

Objectives: Adolescence involves a number of developmental processes, as well as unique psychological characteristics and behaviors. An increased rate of internet and game addictions, school violence, and suicide may either represent aspects of adolescence or a psychopathological phenomenon. There is an urgent need to develop software programs that can prevent and resolve adolescent behavioral problems. We applied the mentalization theory to interpret and find solutions for problems faced by adolescent characters in literature. Methods: In Joan Rowling's novel "Casual Vacancy," Sukhvinder is a girl with problems representative of those encountered by modern adolescents; she is a victim of bullying and engages in self-mutilation. We targeted her problematic behaviors as representative of a prementalized state. Results: Born into an upper-class English family with Pakistani origins, Sukhvinder, unlike her siblings, fails her parents' expectations. Whenever she faces a psychological crisis, she regresses into the teleological mode (the most primitive pre-mentalization stage) and regains her sense of self by cutting herself. After her friend's suicide, however, she begins to communicate with her parents and moves toward mentalization. Conclusion: By analyzing Sukhvinder's behavior, we assessed patterns of attachment, empathy, and mentalization, and identified corrective approaches for problematic behaviors. We believe that the presented interpretation may serve as a foundation for the development of models for understanding adolescent deviant behaviors.