Display options
Share it on

Int J Dent. 2014;2014:396830. doi: 10.1155/2014/396830. Epub 2014 Jul 02.

A modified intraoral resin mouthguard to prevent self-mutilations in lesch-nyhan patients.

International journal of dentistry

Giulia Ragazzini, Alessia Delucchi, Enrico Calcagno, Roberto Servetto, Gloria Denotti

Affiliations

  1. Scuola di Specializzazione in Ortognatodonzia, Università degli Studi di Cagliari, UOC Odontoiatria Istituto Giannina Gaslini, Padiglione 20, Via Gerolamo Gaslini 5, 16147 Genova, Italy.

PMID: 25101126 PMCID: PMC4102014 DOI: 10.1155/2014/396830

Abstract

Lesch-Nyhan syndrome, described in 1964 by Lesch and Nyhan, is a X-linked recessive disorder, occurring in 1 : 100000 to 1 : 380000 live births. LNS is characterized by a decrease in activity of hypoxanthine guanine phosphoribosyl transferase, an enzyme involved in purine metabolism, resulting in overproduction of uric acid. Hyperuricemia and neurological features including choreoathetoid spasticity, self-mutilation, and mental retardation clinically characterize this syndrome. In LNS patients the typical feature is loss of tissue from biting themselves with partial or complete amputation of fingers, lips, and tongue. The self-mutilation compares with the eruption of the deciduous teeth. Several drugs trials have been administered to improve self-destructive behavior and invasive treatment approaches, such as extractions of teeth and orthognathic surgery, have been suggested with variable effectiveness. Nowadays prevention is, therefore, the standard of care. The role of dentistry is essential in the management of the self-mutilating behavior, because the teeth represent the main self-injury instrument. This report presents a revision of various therapeutic approaches to manage self-destruction, highlighting the effectiveness of a preventive treatment. It describes a new technique: a resin mouthguard, realized at Gaslini Hospital, to obtain immediate healing of the oral lesions, confirmed in the follow-up period.

References

  1. ASDC J Dent Child. 1969 Jul-Aug;36(4):277-80 - PubMed
  2. Int J Paediatr Dent. 2003 Jan;13(1):51-6 - PubMed
  3. Dev Med Child Neurol. 2005 Sep;47(9):636-9 - PubMed
  4. Neurosci Biobehav Rev. 1985 Summer;9(2):169-78 - PubMed
  5. Int J Oral Maxillofac Surg. 1992 Jun;21(3):133-6 - PubMed
  6. Behav Modif. 2000 Apr;24(2):202-22 - PubMed
  7. Dent Traumatol. 2010 Dec;26(6):496-500 - PubMed
  8. Int J Oral Maxillofac Surg. 1994 Feb;23(1):37-8 - PubMed
  9. Pediatr Dent. 2003 Jan-Feb;25(1):62-6 - PubMed
  10. Oral Surg Oral Med Oral Pathol. 1993 Oct;76(4):437-40 - PubMed
  11. Am J Med. 1964 Apr;36:561-70 - PubMed
  12. J Autism Child Schizophr. 1976 Sep;6(3):235-52 - PubMed
  13. ASDC J Dent Child. 2002 Jan-Apr;69(1):66-9, 12 - PubMed
  14. Pediatr Dent. 1982 Jun;4(2):127-30 - PubMed
  15. Clin Neuropharmacol. 2008 May-Jun;31(3):180-3 - PubMed
  16. Annu Rev Med. 1973;24:41-60 - PubMed
  17. Proc Natl Acad Sci U S A. 1980 May;77(5):2810-3 - PubMed
  18. Pediatr Dent. 1996 Sep-Oct;18(5):408-10 - PubMed
  19. Pediatr Dent. 2006 Jul-Aug;28(4):341-4 - PubMed
  20. J Inherit Metab Dis. 1997 Jun;20(2):171-8 - PubMed
  21. J Oral Pathol Med. 2005 Oct;34(9):573-5 - PubMed

Publication Types