• The Journal of Korea Assosiation for Disability and Oral Health
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• v.10 no.2
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• pp.93-96
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• 2014

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.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.12 no.1
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• pp.16-19
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• 2016

Oral self-injurious behavior (SIB) can be defined as the intentional, direct injuring of oral tissue, most often done without conscious suicidal intent and most commonly associated with tongue or lip biting. Chronic biting of oral mucosa is an innocuous self inflicted injury, commonly seen in children suffering from developmental and psychological problems. The cases presented in this report discuss oral SIB due to epilepsy, quadriplegia and their treatments. This report documents a successful self-injurious behavior treatment of epilepsy patients within a short time by applying a removable intraoral device. Clinicians should notice the possibility of oral SIB in various disorders. Moreover, different treatment should be performed according to the causative disorders and symptoms.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.5
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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.

• The korean journal of orthodontics
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• v.22 no.1
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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.

• Journal of Technologic Dentistry
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• v.36 no.3
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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.

• Archives of Craniofacial Surgery
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• v.19 no.3
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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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• v.48 no.3
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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.

• 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.

• 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 Pediatric Dentistry
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• v.47 no.1
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• pp.93-98
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• 2020

Lesch-Nyhan syndrome is a rare X-linked, recessively inherited disorder of purine metabolism, caused by complete absence of the enzyme hypoxanthine-guanine phosphoribosyl transferase. This syndrome is characterized by 3 major features: neurological dysfunction, hyperuricemia, and cognitive and behavioral disturbances (e.g., self-mutilation, which begins at 2 to 3 years of age). Uncontrollable self-mutilation begins with biting of the perioral tissues and extends into patterns such as finger biting and head hitting. This report describes the case of a 31-month-old boy who was diagnosed with Lesch-Nyhan syndrome with severe lip injuries caused by self-mutilative behaviors. The behaviors were blocked with a semi-fixed lip bumper for a short period. The device was applied to the patient on the day of the visit without the requirement for an oral impression. It was easy to manage oral hygiene and adjust the device because it was detachable by clinicians and guardians. Therefore, a semi-fixed lip bumper may be useful as an interim appliance to block selfmutilative behaviors in children with Lesch-Nyhan syndrome.