217 research outputs found
Oral Manifestations in Acute Leukemia as the First Sign; The Interdisciplinary Approach of Diagnosis and Treatment
Systemic diseases often present associated oral signs and symptoms, which can occur either from the beginning of the disease or during its evolution. In some cases the oral manifestations reveal an undetected and severe disease, like leukemia. According to the encountered oral signs and symptoms and their response to topical/ dental treatment, the dentist and physician should take into account specific additional tests, which could highlight a possible associated systemic disease.
The most frequent oral manifestations associated with leukemia are represented by paleness of oral mucosa/ local abnormal colour of the gum, gingival petechiae, ecchymosis, bleeding associating painless gingival hyperplasia, hemorrhages, ulcerative necrotic lesions and buccal infections. We presented in this paper the relevant literature data in respect to the oral manifestations encountered in leukemia, exemplified with two suggestive cases.
As a conclusion, dentists should be advised not only to recognize and treat the encountered oral lesions but also to refer the patient to specialized professionals for additional investigations, especially in the situation when suspect a severe systemic disease that require a precocious diagnosis or in the case when the establishment of diagnosis exceed the possibilities of the usual tests. Chemotherapy administration in association with topical/ oral solutions often leads to total or partial remission of the oral signs and symptoms
Finasteride adverse effects and post-finasteride syndrome; implications for dentists
Finasteride is a 5α-reductase inhibitor widely used in present in the therapeutic approach of androgenic alopecia. Adverse effects consist in variable sign and symptoms, the most common being represented by mental troubles (reduced feeling of life pleasure or emotions, depression), physical impairments (loss of muscle tone and/or mass) and sexual complains (loss of libido and sexual potency). An increasing number of studies identify and describe even a post-finasteride syndrome (persistent adverse affects three months or more after finasteride cessation) or new adverse effects including but not limited at the skin level or oral cavity (marginal periodontium).
We intend to present in this study several oral adverse effects encountered during finasteride administration, represented by mild and moderate signs which generally responded to topical procedures without to require the stop of the drug administration. New studies on large samples will further document the existing relation between the described oral adverse effects and the implied pathophysiological mechanisms. For this moment, we are taking into account as possible mechanisms- a direct action of finasteride administration, possible indirect consequences due to hormonal interferences, or coexisting factors with finasteride administration that were not detected
A new approach to balance dental fear and anxiety by using BachTM Flower Therapy
Treatments in dentistry currently consist of an interdisciplinary approach, including (but not necessarily limited to) the holistic perspective. The different fields of allopathic and complementary medicine are used together to ensure not only a high-quality restorative treatment, but also to provide patients with psychological and emotional support. This perspective also applies to dental anxiety, which consists of complex (emotional, vegetative and psychomotor) manifestations. One of the most well-known complementary therapies for reducing dental fear and anxiety is BachTM Flower Therapy. Even if the mechanism of action of this therapy is not yet scientifically documented, notable results have been and continue to be reported in the literature in several clinical studies on patients with dental diseases. It is indicated for both adults and children, in the latter when they go through major biological changes, such as primary and permanent dentition. As a conclusion, BachTM flower therapy is effective and complementary to dental treatments applied to patients, by reducing stress, anxiety, as well as creating a climate of peace, trust and confidence, both for the patient and the doctor. In addition, it is a relatively accessible and cheap form of care, with no significant adverse effects noted so far
Advances in understanding vitamin D deficiency as a risk factor in periodontal disease management
This study investigates the relationship between periodontal disease and vitamin D deficiency by correlating clinical periodontal parameters with serum levels of vitamin D; (2) Methods: Data from the literature and the periodontal status of two patients diagnosed with both periodontal disease and vitamin D deficiency were evaluated. Clinical parameters were measured, including plaque index, bleeding on probing, and bone resorption (%). Serum levels of vitamin D were also analyzed. Additionally, the patients underwent initial periodontal treatment to improve the periodontal status; (3) Results: Both patients exhibited advanced periodontal disease with elevated clinical parameters and significant bone resorption. Serum levels of vitamin D were below normal; (4) Conclusions: The findings suggest a significant association between vitamin D deficiency and periodontal disease severity. Low serum levels of vitamin D may exacerbate periodontal tissue destruction and bone resorption. Early detection and management of vitamin D deficiency could play a crucial role in preventing and treating periodontal disease
Correlation between periodontal status and Parkinson's disease; a literature review
This systematic review aims to explore the relationship between chronic inflammation of periodontal disease and neurodegenerative disorders (especially Parkinson's disease), focusing primarily on pathophysiological, clinical and immunological aspects. An exhaustive search on this topic was performed in several databases (including PubMed, Scopus and Web of Science) selecting articles published between 2006 and 2023. After reviewing the titles, abstracts and protocols of each study, 13 articles were extracted for detailed assessment. The main indicators in the study included clinical signs of gingival inflammation, bleeding on probing (BoP), bone loss (BL), periodontal probing depth (PPD), and clinical attachment loss (CAL). Additionally, levels of inflammatory markers such as epidermal growth factor (EGF), interleukin-8 (IL-8), interleukin-17 (IL-17), interferon γ-induced protein 10 (IP-10), and monocyte chemoattractant protein-1 (MCP-1) were monitored. The investigation also explored the presence of one of the main periodontal pathogens (Porphyromonas gingivalis) in the microbiota of Parkinson's disease patients. In conclusion, the data presented further support the intricated relationship between periodontal health and neurodegenerative processes, including aspects related to changes in clinical periodontal indices, immunological indices, as well as oral hygiene and patient medication
Severe early onset preeclampsia: short and long term clinical, psychosocial and biochemical aspects
Preeclampsia is a pregnancy specific disorder commonly defined as de novo hypertension
and proteinuria after 20 weeks gestational age. It occurs in approximately 3-5% of pregnancies and it is still a major cause of both foetal and maternal morbidity and mortality worldwide1. As extensive research has not yet elucidated the aetiology of preeclampsia, there are no rational preventive or therapeutic interventions
available. The only rational treatment is delivery, which benefits the mother but is not in the interest of the foetus, if remote from term. Early onset preeclampsia (<32 weeks’ gestational age) occurs in less than 1% of pregnancies. It is, however often associated with maternal morbidity as the risk of progression
to severe maternal disease is inversely related with gestational age at onset2. Resulting prematurity is therefore the main cause of neonatal mortality and morbidity
in patients with severe preeclampsia3. Although the discussion is ongoing, perinatal survival is suggested to be increased in patients with preterm preeclampsia
by expectant, non-interventional management. This temporising treatment option to lengthen pregnancy includes the use of antihypertensive medication to control hypertension, magnesium sulphate to prevent eclampsia and corticosteroids
to enhance foetal lung maturity4. With optimal maternal haemodynamic status and reassuring foetal condition this results on average in an extension of 2 weeks. Prolongation of these pregnancies is a great challenge for clinicians to balance between potential maternal risks on one the eve hand and possible foetal benefits on the other. Clinical controversies regarding prolongation of preterm preeclamptic pregnancies still exist – also taking into account that preeclampsia is the leading cause of maternal mortality in the Netherlands5 - a debate which is even more pronounced in very preterm pregnancies with questionable foetal viability6-9. Do maternal risks of prolongation of these very early pregnancies outweigh
the chances of neonatal survival? Counselling of women with very early onset preeclampsia not only comprises of knowledge of the outcome of those particular pregnancies, but also knowledge of outcomes of future pregnancies of these women is of major clinical importance.
This thesis opens with a review of the literature on identifiable risk factors of preeclampsia