Saemundsson S R, Roberts M W
Department of Pediatric Dentistry, School of Dentistry, University of North Carolina, Chapel Hill, USA.
ASDC J Dent Child. 1997 May-Jun;64(3):205-9, 228.
Self-injurious behavior occurs in conjunction with a variety of psychiatric disorders as well as various developmental disabilities and some syndromes. The behavioral and biochemical aspects of self-injurious behavior are poorly understood and several etiologies have been suggested. Treatments for self-injurious behavior in developmentally disabled individuals fall into three main categories: pharmacological, behavior modification and physical restraints. The dental management of self-injurious behavior is often difficult. Numerous appliances of various design have been reported in the literature. Osteotomies or extraction of the offending teeth may have to be considered if less invasive methods are unsuccessful. A case is reported where a child engaged in tonic lip biting secondary to a neurological and seizure disorder is treated using a removable lip-protruding device. No impression or lab construction is required. The appliance presents minimal interference with oral hygiene procedures and it can be removed and reinserted as needed. We conclude that a removable lip-bumper may be a viable option in treating transient and acute episodes of self-injurious behavior involving the lower lip and buccal mucosa.
自伤行为与多种精神疾病、各种发育障碍及一些综合征同时出现。自伤行为的行为学和生物化学方面目前了解甚少，人们提出了多种病因。发育障碍个体自伤行为的治疗主要分为三类：药物治疗、行为矫正和身体约束。自伤行为的牙科处理往往很困难。文献中报道了许多设计各异的矫治器。如果侵入性较小的方法不成功，可能不得不考虑进行截骨术或拔除致病牙齿。本文报告了一例患有神经和癫痫障碍的儿童，其出现强直性咬唇行为，使用了一种可摘式唇部突出装置进行治疗。无需取印模或实验室制作。该矫治器对口腔卫生程序的干扰最小，可根据需要取下和重新佩戴。我们得出结论，对于涉及下唇和颊黏膜的自伤行为的短暂急性发作，可摘式唇部缓冲器可能是一种可行的治疗选择。
