DOI QR코드

DOI QR Code

가철식 장치를 이용한 구강조직 자해 환자의 치료

TREATMENT OF SELF-INJURIOUS BEHAVIOR WITH INTRAORAL APPLIANCE IN EPILEPSY PATIENTS

  • 김익환 (연세대학교 치과대학 소아치과학교실) ;
  • 이고은 (연세대학교 치과대학 소아치과학교실) ;
  • 이제호 (연세대학교 치과대학 소아치과학교실) ;
  • 강정민 (연세대학교 치과대학 소아치과학교실)
  • Kim, Ik-Hwan (Department of Pediatric Dentistry, College of Dentistry, Yonsei University) ;
  • Lee, Ko-Eun (Department of Pediatric Dentistry, College of Dentistry, Yonsei University) ;
  • Lee, Jae-Ho (Department of Pediatric Dentistry, College of Dentistry, Yonsei University) ;
  • Kang, Chung-Min (Department of Pediatric Dentistry, College of Dentistry, Yonsei University)
  • 투고 : 2016.06.02
  • 심사 : 2016.06.17
  • 발행 : 2016.06.30

초록

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.

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.

키워드

참고문헌

  1. Chen LR, Liu JF : Successful treatment of selfinflicted oral mutilation using an acrylic splint retained by a head gear. Pediatr Dent, 18:408-410, 1996.
  2. Goldstein IC, Dragon AI : Self-inflicted oral mutilation in a psychotic adolescent: report of a case. J Am Dent Assoc, 74:750-751, 1967. https://doi.org/10.14219/jada.archive.1967.0136
  3. Kobayashi T, Ghanem H, Umezawa K, et al. : Treatment of self-inflicted oral trauma in a comatose patient: a case report. J Can Dent Assoc, 71:661-664, 2005.
  4. Peters TE, Blair AE, Freeman RG : Prevention of self-inflicted trauma in comatose patients. Oral Surg Oral Med Oral Pathol, 57:367-370, 1984. https://doi.org/10.1016/0030-4220(84)90151-8
  5. Pigno MA, Funk JJ : Prevention of tongue biting with a removable oral device: a clinical report. J Prosthet Dent, 83:508-510, 2000. https://doi.org/10.1016/S0022-3913(00)70005-9
  6. Saemundsson SR, Roberts MW : Oral self-injurious behavior in the developmentally disabled: review and a case. ASDC J Dent Child, 64:205-209, 228, 1997.
  7. Hanson GE, Ogle RG, Giron L : A tongue stent for prevention of oral trauma in the comatose patient. Crit Care Med, 3:200-203, 1975. https://doi.org/10.1097/00003246-197509000-00007
  8. Ngan PW, Nelson LP : Neuropathologic chewing in comatose children. Pediatr Dent, 7:302-306, 1985.