Self-inflicted oral-dental mutilations (SIODMs) in paediatric patients: a systematic review of case reports and case series

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ABSTRACT

Aim

Self-inflicted oral-dental mutilations (SIODMs) are the result of an intentional or unintentional action that leads to anatomical and functional damage to the soft and hard tissues of the oral cavity. In paediatric patients they can be associated with both organic and functional diseases. A systematic review was conducted aiming to consolidate and integrate the existing knowledge on SIODM in paediatric patients.

Methods

Literature search, study design and data analysis were performed in accordance with PRISMA guidelines. The research question was structured using the PICO framework (PROSPERO n° CRD42023433727).

Conclusion

This is the first systematic review aimed to synthesize the findings of studies on SIODM in paediatric patients. The extensive heterogeneity of underlying diseases, anatomical sites and nature of mutilation, as well as of the proposed treatments, make SIODM in paediatric population a challenging clinical field, in which only a multidisciplinary approach can provide adequate know-how in terms of prevention and therapeutic interventions.

Study Selection

59 case reports and 12 case series were identified, for a total of 92 patients (27 females and 65 males). Average age: 6.8 (± 4.52) years. The most commonly conditions linked to SIODM were Hereditary Sensory Autonomic Neuropathies (32.61%) and Lesch-Nyhan Syndrome (26.09%), respectively. Lips were the most frequently involved site, followed by tongue, teeth, gum, buccal mucosa and bone. The most observed mutilation was ulcerative lesion (60.87%). The treatment approaches were categorized into five groups: conservative treatment, psychotherapeutic intervention, pharmacological therapy, mechanical interventions, surgical procedures. A total resolution was observed in 70.96% of cases; a partial resolution in 23.39% and no resolution in 5.65% of cases.

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