[A maxillary lip bumper used to manage labial self-mutilation]

Area of Science:

• Oral and Maxillofacial Surgery
• Orthodontics
• Pediatric Plastic Surgery

Background:

• Facial self-mutilation reconstruction success is often limited by inadequate protection of the surgical site.
• Persistent self-injurious behavior can lead to recurrent trauma, infection, and repair failure.
• Novel approaches are needed to safeguard reconstructions in pediatric patients with self-mutilation behaviors.

Observation:

• A case report details a four-year-old patient with a significant lower lip defect due to self-mutilation, occurring alongside multiple congenital malformations.
• The treatment regimen included antibiotics, local wound care, psychiatric support, and the application of a custom orthodontic appliance known as a lip bumper.
• This intervention aimed to prevent the patient from further traumatizing the lip, thereby protecting the healing process.

Findings:

• The integrated treatment approach, notably the inclusion of the lip bumper, resulted in a favorable outcome for the lip defect.
• Secondary reconstructive surgery was not required, indicating the effectiveness of the protective measures employed.
• The lip bumper successfully mitigated the cycle of agitation, mutilation, and subsequent infection.

Implications:

• The lip bumper demonstrates potential as a simple, effective adjunct in managing facial self-mutilation, particularly in pediatric cases.
• This orthodontic device offers a non-invasive method to protect surgical repairs and prevent re-injury.
• Further research into the application of orthodontic devices for self-mutilation behaviors may yield valuable clinical strategies.