Different approaches to dental management of self-inflicted oral trauma: oral shield, botulinum toxin type A neuromuscular block, and oral surgery.
OBJECTIVE
To assess different approaches to the dental management of lip injuries caused by self-inflicted oral trauma in 7 patients.


METHODS
The patients were grouped based on 3 treatment approaches: group 1, placement of an oral appliance; group 2, botulinum toxin type A neuromuscular block; and group 3, oral surgery.


CONCLUSIONS
Neuromuscular block can be the first choice of treatment for patients with self-injurious behavior since botulinum toxin A injection is a well-tolerated, safe, and effective procedure, permitting improvement in muscle spasticity, bruxism, range of mouth opening, oral hygiene, and lip trauma. The second option would be the use of the oral appliance, and the last choice is oral surgery. Laser therapy was also found to be effective when applied to traumatic injuries in patients who present self-inflicted oral trauma.
Division of Dentistry for Persons with Disabilities, School of Dentistry, Universidade Cruzeiro do Sul, São Paulo, Brazil. drsantosmt@yahoo.com.br
Maria Teresa Botti Rodrigues
MT
Santos
Felipe Scalco
FS
Manzano
Walter João
WJ
Genovese
D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002012:Bruxism / Q000517:prevention & control; D002547:Cerebral Palsy / Q000150:complications; D002648:Child; D003128:Coma / Q000150:complications; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008046:Lip / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009064:Mouth Protectors; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D009910:Oral Hygiene; D019647:Oral Surgical Procedures / Q000379:methods*; D016059:Range of Motion, Articular / Q000502:physiology; D016728:Self-Injurious Behavior / Q000517:prevention & control*; D013035:Spasm / Q000517:prevention & control; D014059:Tongue / Q000293:injuries
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A