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

Mandibular Cortically Thickness as Indicator in Osteoporosis Screening

Systemic bone density variations have also echoed in maxillary bones, those being affected by osteoporosis with rest of the skeleton and radiological changes in their morphology are identifiable with panoramic radiographs. Purpose Correlation between assessments of age in women patients with the presence and the level of osteoporosis degree, and also with the impaired level of osseous edge at mandible. Material and methods In this study we selected two groups: first group study consisted in 12 postmenopausal women patients, aged between 54 and 71 years, diagnosed with osteoporosis and the second group, as group control, included 13 women patients, aged between 55 and 78 years, also in postmenopausal status health, but without osteoporosis. The osteoporosis diagnosis was based on non-invasive methods (ultrasonography at distal phalanges of the hand), and other laboratory investigations which results were significant in the quantification of bone mineral density. Clinical periodontal health indicators assessments were recorded in datasheets, by medical transcriptions, and all cases were submitted for panoramic digital radiographs examination. Correlations between age woman’s’ patient, the presence of osteoporosis and the impaired level of osseous edge at mandible were analysed using linear regression and a t-test (two-tailored). Results and discussion After mandible cortical thickness measurements (MCT) for each patient in both study groups, we’ve obtained the thickness average at 3.5 mm (0.4 OR) for control group (group 1) and thickness average at 2.3 mm (0.5OR) for the group with osteoporosis (group 2), and each group could be classified in one of the erosion categories C1 – C3 in infraosseous mandible basal bone. Conclusions Determination for MCT can be used as a method in patients’ selection with postmenopausal osteoporosis or prone to osteopenia

MICROBIOLOGICAL ANALYSIS OF PERIODONTAL PATHOGENS USING THE BANA TEST TO DIABETES MELLITUS PATIENTS

The aim of study was to evaluate the periodontal condition of 15 non-diabetic patients (age range, 30-77 years) compared to 15 patients without diabetes. The BANA (N-benzoyl-DL-arginine-naphthylamide) test was used to analyze subgingival microbiota.The diabetic group was subdivided into three groups according to the degree of diabetic control: controlled, moderately controlled and poorly controlled. When the diabetic patients were subdivided and compared to the control group, significance was detected (P<0.01) in the total frequencies of the BANA scores (negative, moderately positive and positive: 1, 2, and 3, respectively) in the 5, 6-, and 7 mm pockets and also in the 4 mm pockets in the controlled group

The place of azithromycin in the treatment of periodontal disease

Abstrac

CORRELATION BETWEEN PERIODONTAL AND MICROBIOLOGICAL STATUS AT PATIENTS WITH FIXED PROSTHETIC THERAPY

Aim of the study Benzoyl-DL-arginine-naphthylamide test (BANA) has been used by many researchers to quickly screen the contribution of red complex periodontal pathogens in patients with fixed prosthetics dentures. The purpose of this study was to determine periodontal pathogens BANA-positive to patients with fixed prosthesis made by cobalt-chromium alloys and nickel-chromium. Material and methods Before applying the prosthetic treatment, the score sheet was recorded, probing depths were measured and plaque samples were taken for laboratory analysis. Plaque samples were collected from each quadrant from the interproximal area between the primary molars and secondary premolars. After were taken the plaque samples for BANA test, were measured the depth of periodontal pockets of the selected teeth and plaque scores. The score board was then assessed using the index plaque O'Leary. Results and discussions This study found an increase in average of pocket depth during prosthetic treatment.The differences were generally small, but significant between visits 3, 4, and 5 versus baseline.Probing depths and scores plaque were more uniform growth after placing prosthetic devices. Also our study showed an increase in scores BANA prosthetic treatment.The scores at visits 2-5 were significantly higher than baseline, showing the largest increase in four months from applying of prosthetic treatment. BANA test was shown to be an reliable indicator for the presence of three suspected periodontal pathogens (red complex): P gingivalis, T denticola, and T forsythia. These bacteria have been linked to common forms of periodontal disease in adults. BANA test showed the presence of periodontal pathogens from all patients, with variations in the detected levels. Results showed over time statistically significant differences in BANA scores to adult patients undergoing prosthetic therapy. Conclusions In this study was detected a simultaneous increase of BANA - positive periodontal pathogens - P gingivalis, T denticola, and T forsythia during prosthetic treatment especially with Cr-Co alloys

Identification of Subgingival Periodontal Pathogens and Association with the Severity of Periodontitis in Patients with Chronic Kidney Diseases: A Cross-Sectional Study

Background. The aim of our study was to assess the subgingival profile of 9 periodontal pathogens, by means of real-time PCR, in a group of predialysis chronic kidney disease patients with and without periodontal disease and to identify the risk factors associated with periodontal disease in these patients. Material and Methods. This is a single centre cross-sectional cohort study performed on 70 CKD patients. Patients received a full-mouth periodontal examination and the following parameters were assessed: periodontal pocket depth (PPD), clinical attachment level, bleeding on probing, and plaque index; subgingival biofilm samples were collected from the deepest periodontal pocket of each quadrant and were pooled in one transporting unit. Clinical data were drawn from the medical file of the patients. Results. T. denticola (P=0.001), T. forsythia (P<0.001), and P. micros (P=0.003) are significantly associated with periodontal disease in CKD subjects but in a multivariate model only age and T. forsythia remain independent risk factors for periodontal disease in patients with CKD. Conclusions. In our cohort, age and T. forsythia are independently associated with periodontitis in CKD patients. Within the limits of this study, CKD was not significantly associated with a particular subgingival periodontal pathogens profile in periodontitis patients