The onychophagia is a relatively common habitual behavior in children. Cosmetic problem is frequently involved, but it can lead to serious morbidity such as damage to nail, paronychia, secondary bacterial infections, dental problems and the phalangeal osteomyelitis. We report one case of surgically treated phalangeal osteomyelitis of distal interphalangeal joint of long finger using shortening procedure in an onychophagia patient.
Bacterial Infections ; Child ; Cosmetics ; Fingers ; Humans ; Joints ; Nail Biting ; Nails ; Osteomyelitis ; Paronychia

We report 3 cases of traumatic nail dystrophy,, developed in 11 years old girl (Case 1), 10 years old(case 2) and 15 years old boys(case 3) Dystrophic nails show transverse ridging with longitudinal axis on the both thumb nails in case 1 R 3, and transverse ridging with transverse axis on the left thumb nail in case 2 Mothers overprotection(case 1, 3) and indifference(case 2) were considered to be of the most important causes of the nail biting and playing with nails in our cases.
Adolescent ; Axis, Cervical Vertebra ; Child ; Female ; Humans ; Mothers ; Nail Biting ; Thumb

Finishing is usually accomplished about four to seven months before the removal of orthodontic appliance in order to achieve ideal occlusion and excellent aesthetics. This process, called finishing, is the key to obtain excellent final results. Some of orthodontists believe it can be accomplished at the final stage of orthodontic treatment, and they complete it without their special rationale and criteria for finishing. However, it should be considered as a part of the total treatment plan from the beginning to end, and a guideline for finishing, which is based on rationale and criteria for the removal of orthodontic appliance, is needed to obtain the desired results. The guideline should include a checklist for finishing. This checklist is divided into four categories: occlusal, aesthetic, periodontal, and habitual factors. Occlusal factors include alignment, marginal ridge discrepancy, interproximal contact, anterior inclination, posterior inclination, over-jet, over-bite, arch form, and functional occlusion. Aesthetic factors include gingival form, crown form, crown width, and crown length. Periodontal factors include root angulation, bone level, and black hole in periodontal factors. Habitual factors consist of mouth breathing, tongue position at rest, tongue thrust, lip biting, nail biting, and finger sucking.
Checklist ; Crowns ; Esthetics ; Fingersucking ; Lip ; Mouth Breathing ; Nail Biting ; Orthodontic Appliances ; Tongue

Although the purpose of orthodontic treatment id to increase the function and aesthetics of the jaws as well as to increase stability, there are side effects from the treatment itself such as root resorption and alveolar bon resorption. Such resorption of the apical root is unpredictable and may even proceed into the dentin layer. Once the process has begun, it is irreversible. By evaluation the effects of different oral habits, especially that of nail biting, and their correlation with the root and the periodontal tissues, the appropriate biomechanics for orthodontic treatment can be taken into consideration. The possibility of root resorption and alveolar bone loss during orthodontic treatment can also be considered. Also, any legal problems that might occur may be pondered as well. Among the male and female patients of the ages 10~15, 63 were chosen as the test group with known nail biting habits at time of examination and within the same age range those without nail biting habits as the control group. The test group was composed of 30 males and 33 females. The control group had 31 males and 32 females. The result from this study were as follows : 1. Of the 63 patients of both the test and control groups, the male-to-female-ratio was 1:1, and had no statistically significant difference in male and female root resorption. 2. In comparing crown length of the test and control groups, no significant difference existed, but in root lenght, maxillary and mandibular right and left central incisors and mandibular right lateral incisors had a smaller value.(p<0.001) 3. Average crown-to-root ratio of the test group on the periapical view show a noticeably high value for the maxillary and mandibular right and left central incisors and mandibular right and left lateral incisors.(p<0.01) 4. In comparing and evaluating the alveolar bone loss measured from the cemento-enamel junction to the alveolar bone crest, mesial surfaces of the maxillary and mandibular right and left central incisors and distal surface of maxillary right central incisor of the test group showed greater loss of crestal bone than the control.(p<0.05)
Alveolar Bone Loss ; Crowns ; Dentin ; Esthetics ; Female ; Humans ; Incisor ; Jaw ; Male ; Nail Biting* ; Root Resorption

BACKGROUND: Washboard nail most commonly involves the thumbnail or great toenail. As its name implies, it resembles a washboard with a series of evenly spaced ridges across the nail. A central depression can be seen as well. This can develop as the result of repeated habitual trauma to the proximal nail fold by the other fingers or by biting the nailplate. Thus, it is also called habit tic deformity or traumatic nail dystrophy. Although it is known to be not uncommon, there have been no studies on this with a sufficient number of cases and long term follow up. OBJECTIVE: This study was conducted to provide a better understanding of washboard nail and to estimate the outcome of it. METHODS: We reviewed all the medical records and clinical photographs of 21 patients who had been diagnosed with washboard nail at our department between July 2000 and July 2009. RESULTS: The male to female ratio was 1:1.3. The patients' ages varied from 6 to 68 years, with an average of 25.4 years. The mean duration at the first visit was 4.4 years. The most common involved site was both thumbnails. Predisposing factors were found in 42.9% of the patients, which included nail picking or onychophagia. The treatment options were primarily intralesional triamcinolone injection and topical steroid. If the patient had the habitual tic, we educated them to restrain it. The follow up periods varied from 1 to 32 months with a mean of 7.9 months. Among the 14 patients with adequate follow up, 50% of these patients showed clinical improvement. CONCLUSION: This study demonstrated the clinical features of washboard nail. Physicians should closely observe the nail changes and long-term follow up is needed to determine the therapeutic response of patients with washboard nail.
Bites and Stings ; Congenital Abnormalities ; Depression ; Female ; Fingers ; Follow-Up Studies ; Humans ; Male ; Medical Records ; Nail Biting ; Nails ; Tics ; Triamcinolone

OBJECTIVES: The main purpose of this study was aimed at examining the epidemiological and clinical data of firesetters in Konju forensic psychiatric hospital. METHOD: The thirty firesetters were admitted at Konju forensic psychiatric hospital from January. 1, 1998 to December. 1, 1995, They carefully investigated from January. 3, 1996 to July. 31, 1996 through the methods of psychiatric interview, chart review, the written judgement review and telephone interview. RESULTS: There are significant differences in education level and intelligence quotient among three groups. Prevalence of febrile convulsion, nail biting, and enuresis are highest among the firesettes. Alcohol-related family history is significantly high in firesetters. Most frequently reported motivation of firesetters were psychosis, and anger or revenge.
Anger ; Education ; Enuresis ; Hospitals, Psychiatric* ; Humans ; Intelligence ; Interviews as Topic ; Motivation ; Nail Biting ; Prevalence ; Psychotic Disorders ; Seizures, Febrile

Although the purpose of orthodontic treatment is to increase the function and esthetics of the jaws along with increasing stability, there are many side effects during the treatment itself, such as root resorption and alveolar bone resorption. Such resorption of the apical root is unpredictable, and may even proceed into the dentin layer. Once the process has begun, it is irreversible. By evaluating the effect of many oral habits, especially that of nail biting, in correlation with the root and the periodontal tissues, the appropriate biomechanics for orthodontic treatment can be taken into consideration, along with the possibility of root resorption and alveolar bone loss during orthodontic treatment, and any legal problems that might occur. Among the male and female patients of the ages 10~15 without skeletal deformity, 63 were chosen as the experiment group with known nail biting habits at time of examination, and within the same age group without nail biting habits as the control. After the orthodontic treatment, number of the experiment group was 31 and the control group was 22. The periapical radiographies of anterior teeth were taken and the assesment of the root length and alveolar bone level were taken before(T1) and after(T2) the orthodontic treatment. The results from this study were as follows : 1. Before the orthodontic treatment, average crown-to-root ratio of the experimental group showed noticeably high values in 4 maxillary incisors and mandibular right central incisor. 2. Before the orthodontic treatment, comparing the root length, maxillary and mandibular right central incisors and both mandibular incisors had a smaller value in the experimental group. 3. Before the orthodontic treatment, comparing and evaluating the alveolar bone loss measured from the cemento-enamel junction to the alveolar bone crest, some crestal bone of the experiment group showed greater loss than the control. 4. After the orthodontic treatment, there was shortening of the root length and loss of the crestal bone in both groups. 5. After the orthodontic treatment, the changes of C/R ratio and the shortening of root length were significantly high in the experimental group. 6. After the orthodontic treatment, the level of alveolar crestal bone showed greater loss in the experimental group.
Alveolar Bone Loss ; Bone Resorption ; Congenital Abnormalities ; Dentin ; Equidae ; Esthetics ; Female ; Humans ; Incisor ; Jaw ; Male ; Nail Biting* ; Root Resorption ; Tooth

BACKGROUND: Trichotillomania appears as incomplete alopecia due to patients own repeated manipulations of the hair. But there are few available clinicopathologic data in Korea. OBJECTIVE: The purpose of this study was to evaluate the clinicopathological feature of trichotillomania and the experimental pathologic findings after hair plucking in rabbits. METHOD: Through retrospective study on patients who were diagnosed as trichotillomania from 1988 to 1997 at the Department of Dermatology in Pusan National University Hospital, we observed the clinical and histopathological findings in 20 cases of trichotillomania as well as histopathologic changes of hair follicle and associated structure after hair plucking in rabbits with 4 days interval. RESULTS: 1. The mean age of onset was 15.7 years and female were 12 cases(60%). 2. The school age(between 7 and 18 years) was most common as 15cases(75%) 3. Among initial sites of involvement, parietal region was the most common(10 cases, 55%), followed by frontal(5 cases, 25%), temporal(2 cases, 10%), and occipital(2 cases, 10%) region. 4. Some patients complained pruritus(25%), chronic headache(10%) and had onychophagia (20%), trichophagia(5%) and thumb sucking(5%). 5. Many patients were not typical in history, and 14 cases(70%) denied hair-plucking history. 6. Results of twelve patients with psychiatric consultation revealed obsessive disorder(4 cases, 33%), social phobia(2 cases, 17%) and dysmorphic disorder(1 case, S%). 7. The most common presumptive triggering factor was mental stress related to school work(5 cases, 25%). 8. The characteristic findings of histopathologic examination in 20 cases were empty hair follicles without perifollicular infiltration(100%) and increased catagen hair(90%) with normal anagen hair(85%), trichomalacia(40%). 9. In experimental hair plucking of rabbit, soon after hair plucking, dilated empty root sheaths, perifollicular hemorrhage were observed. These findings are similar in trichotillomania. Catagen evolution, sebaceous proliferation and hyperplasia at 4th day, prominent bulge region at 8th day, growing epithelial sheaths into deep dermis at 12th day, many anagen hair at 20th day were observed. CONCLUSION: Trichotillomania was more frequent in young than adolescent and female than male. Histopathologically, the most characteristic finding was increased catagen hair without perifollicular inflammation. In hair follicle regeneration of rabbit after plucking, all hair follicles changed into catagen and telogen stage simultaneously and new hair growth was observed.
Adolescent ; Age of Onset ; Alopecia ; Busan ; Dermatology ; Dermis ; Female ; Hair Follicle ; Hair* ; Hemorrhage ; Humans ; Hyperplasia ; Inflammation ; Korea ; Male ; Nail Biting ; Rabbits* ; Rabeprazole ; Regeneration ; Retrospective Studies ; Thumb ; Trichotillomania*

PURPOSE: In order to render substantial solutions to control the refractory enterobiasis, factors were evaluated which were associated with treatment failure in Enterobius vermicularis infestation. METHODS: An epidemiological study was done in 20 patients with refractory entrobiasis and in 107 preschoolers as a control. The possible symptoms and hygienic habits which may associated with entrobiasis were surveyed by questionnaires. RESULTS: The egg positive rate was 35.0% and 19.6% in patients and control, respectively. The incidence of enterobiasis peaked in 3-9 years of age. Finger sucking, nail biting, bed type, toy sucking, bed sharing with siblings, nocturnal anal pruritus, and nighttime crying/irritability were resulted in as significant factors denoting refractory enterobiasis. CONCLUSION: The prevalence of pinworm was very high in Suwon vicinities. Along with the factors contributing to the refractory enterobiasis, misuse of anti-parasitic drugs was suggested as one of the major causes.
Enterobiasis* ; Enterobius ; Epidemiologic Studies* ; Epidemiology ; Fingersucking ; Gyeonggi-do ; Humans ; Incidence ; Nail Biting ; Ovum ; Play and Playthings ; Prevalence ; Pruritus ; Surveys and Questionnaires ; Siblings ; Treatment Failure