1
|
von Stein Cubas Warnavin S, Valenga HM, Costa TBC, Chaves JDP, Spolidorio LC, Spolidorio DMP, Feres M, Soares GMS, Steffens JP. Periodontal clinical status, microbial profile, and expression of interleukin-1β in men under androgenic anabolic steroids abuse. Clin Oral Investig 2020; 25:3567-3575. [PMID: 33179177 DOI: 10.1007/s00784-020-03679-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 11/04/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Androgenic anabolic steroids (AAS) abuse is a serious health problem associated to several systemic complications. Here, we evaluated the periodontal clinical status, microbial profile, and expression of total protein (TP) and interleukin (IL)-1β in men using AAS. MATERIALS AND METHODS Men using AAS were recruited (case group) and matched for age with men who had never used AAS (control group) but also performed physical activities. Plaque index (PI), marginal bleeding (MB), probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BoP) were evaluated. Crevicular fluid and subgingival biofilm were collected from healthy and diseased sites (PD ≥ 4 mm with CAL ≥ 1 mm and BoP) and evaluated for TP, IL-1β, and proportions of 40 bacterial species. RESULTS Thirty patients were included (n = 15/group). AAS consumers had significantly higher mean PD and higher percentage of diseased sites; sites with PD ≥ 4 mm or with CAL ≥ 1 mm than non-consumers. Also, AAS users showed a more dysbiotic biofilm containing lower proportions of host-compatible species and higher proportions of pathogens. IL-1β expression was statistically higher in diseased than in healthy sites only in the control group. A statistically positive correlation was detected between periodontal pathogens and IL-1β expression. The number of AAS cycles was positively associated with higher percentages of periodontal pathogens, but not with IL-1β or total protein concentrations. CONCLUSIONS AAS intake can worsen clinical and immunological periodontal conditions and the biofilm composition in healthy sites. CLINICAL RELEVANCE Dental care professionals should perform full mouth periodontal screening and schedule regular follow-up appointments for patients under AAS use.
Collapse
Affiliation(s)
| | - Henrique Meister Valenga
- Graduate Program in Dentistry, Universidade Federal do Paraná, Av. Pref. Lothário Meissner, 632, Curitiba, PR, 80210-170, Brazil
| | - Thainá Biudes Conforto Costa
- School of Dentistry, Universidade Federal do Paraná, Av. Pref. Lothário Meissner, 632, Curitiba, PR, 80210-170, Brazil
| | - Joao Daniel Paganella Chaves
- School of Dentistry, Universidade Federal do Paraná, Av. Pref. Lothário Meissner, 632, Curitiba, PR, 80210-170, Brazil
| | - Luis Carlos Spolidorio
- Department of Physiology and Pathology, School of Dentistry at Araraquara, UNESP-Univ Est Paulista, Rua Humaitá, 1680, Araraquara, SP, 14801-903, Brazil
| | - Denise Madalena Palomari Spolidorio
- Department of Physiology and Pathology, School of Dentistry at Araraquara, UNESP-Univ Est Paulista, Rua Humaitá, 1680, Araraquara, SP, 14801-903, Brazil
| | - Magda Feres
- Postgraduate Program in Dentistry, Universidade Guarulhos, R. Eng. Prestes Maia, 88, Guarulhos, SP, 07023-070, Brazil
| | - Geisla Mary Silva Soares
- Graduate Program in Dentistry, Universidade Federal do Paraná, Av. Pref. Lothário Meissner, 632, Curitiba, PR, 80210-170, Brazil
| | - Joao Paulo Steffens
- Graduate Program in Dentistry, Universidade Federal do Paraná, Av. Pref. Lothário Meissner, 632, Curitiba, PR, 80210-170, Brazil.
| |
Collapse
|
2
|
Brusca MI, Verdugo F, Amighini C, Albaina O, Moragues MD. Anabolic steroids affect human periodontal health and microbiota. Clin Oral Investig 2013; 18:1579-86. [PMID: 24221579 DOI: 10.1007/s00784-013-1126-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 10/21/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aims to evaluate periodontal microbiological differences between systemically healthy nonsmoker males taking anabolic androgenic steroids (AASs) and non-AAS users and to find associations between disease severity and AAS use. METHODS Ninety-two men practicing bodybuilding were included in the study. They were divided into AAS users and a matched control nonuser group and subgrouped based on their most severe periodontal condition. Pooled subgingival samples from each individual were cultured to evaluate specific periodontopathogen infection. RESULTS AAS users had significantly higher prevalence of severe periodontitis. AAS users had greater gingival inflammation and clinical attachment loss of ≥ 3 mm than nonusers (odds ratio (OR) = 2.4; p = 0.09; 95 % confidence interval (CI) 0.8-6.4). AAS users were 4.9 times more likely to be infected with Prevotella intermedia than AAS nonusers (OR = 4.9; p = 0.003; 95 % CI 1.6-14.7). The OR of presenting subgingival Aggregatibacter actinomycetemcomitans was 8.2 times higher in AAS users (OR = 8.2; p = 0.03; 95 % CI 0.9-70.8). AAS users were 5.6 times more likely to present subgingival Candida spp. than nonusers (OR = 5.6; p = 0.02; 95 % CI 1.1-27.1). AAS users were 14.8 times more likely to present subgingival Candida parapsilosis than nonusers (OR = 14.8; p < 0.0001; 95 % CI 3.1-69.2). The likelihood of AAS users presenting subgingival Candida tropicalis was 4.3 times higher than nonusers (OR = 4.3; p = 0.03; 95 % CI 1.1-16.9). A. actinomycetemcomitans was mostly isolated in individuals with severe periodontitis and was associated with subgingival Porphyromonas gingivalis, P. intermedia, and Candida spp. CONCLUSIONS AAS use may increase the risk for severe periodontitis and may cause a subgingival selection of certain Candida species. Specific periodontopathogens, such as Candida dubliniensis and Candida albicans, seem to be negatively affected by AAS use. The higher risk for disease progression in AAS users may be explained by the significantly higher proportions of A. actinomycetemcomitans, P. gingivalis, P. intermedia, and Candida species as compared to controls. CLINICAL SIGNIFICANCE Data on the influence of AAS on subgingival periodontopathogens and disease progression are scarce. Higher proportions of specific periodontopathogens are plausible in AAS users. AAS users had a higher prevalence of severe periodontitis, gingival inflammation, and clinical attachment loss. Men taking AAS are at greater risk of periodontitis and specific periodontopathogen infection.
Collapse
Affiliation(s)
- María Isabel Brusca
- Department of Microbiology, University Abierta Interamericana, Buenos Aires, Argentina
| | | | | | | | | |
Collapse
|
3
|
Steffens JP, Coimbra LS, Ramalho-Lucas PD, Rossa C, Spolidorio LC. The effect of supra- and subphysiologic testosterone levels on ligature-induced bone loss in rats--a radiographic and histologic pilot study. J Periodontol 2012; 83:1432-9. [PMID: 22309177 DOI: 10.1902/jop.2012.110658] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Testosterone is the primary male sexual hormone, and varying concentrations of the hormone mediated by physiologic, pathologic, or pharmacologic mechanisms may induce large variations in the body. Data regarding the general role of testosterone in mediating inflammation are still inconclusive. Therefore, the purpose of this study is to assess the consequences of supra- and subphysiologic levels of testosterone on ligature-induced bone loss in rats. METHODS Three male adult Holtzman rats were used to observe the course of serum testosterone concentration following orchiectomy (Ocx) and testosterone injections. Another 60 rats were randomly assigned to the following groups: (1) sham-operation controls (n = 10); (2) sham-operation and ligature-induced bone loss (n = 10); (3) orchiectomy without ligature (Ocx; n = 10); (4) Ocx and ligature (n = 10); (5) Ocx plus 250 mg/kg body weight intramuscular testosterone esters injection without ligature (Ocx+T; n = 10); and (6) Ocx, T, and ligature (n = 10). The ligatures were placed 30 days postorchiectomy (or sham-operation) and maintained for 15 days. Thereafter, the rats were sacrificed, and their hemimandibles were used for radiographic evaluation of bone loss along with histologic and histometric analyses of gingival tissue. RESULTS The results indicated a significant increase in bone loss in the Ocx and Ocx+T groups in the presence and absence of inflammation, respectively. In addition, the Ocx and Ocx+T groups presented increased gingival area accompanying ligature-induced bone loss. CONCLUSIONS Both sub- and supraphysiologic testosterone levels may influence bone metabolism, but only subphysiologic levels significantly increase ligature-induced bone loss. Moreover, testosterone has a regulatory effect on the gingival area.
Collapse
Affiliation(s)
- Joao P Steffens
- Department of Physiology and Pathology, School of Dentistry at Araraquara, São Paulo State University, Araraquara, São Paulo, Brazil
| | | | | | | | | |
Collapse
|
4
|
Soolari A, Soolari E, Shumaker ND. Palatal Tissue Enlargement After Subepithelial Connective Tissue Graft Harvest Associated With Anabolic Steroid Abuse. Clin Adv Periodontics 2011; 1:23-28. [PMID: 32698551 DOI: 10.1902/cap.2011.100004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2010] [Accepted: 01/27/2011] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Healing complications associated with androgenic anabolic steroid (AAS) abuse have received minimal attention in the periodontal literature. This case report describes an adverse healing event after palatal subepithelial connective tissue graft (SECTG) harvest associated with AAS abuse. CASE PRESENTATION A 35-year-old white male was treated with an SECTG procedure to address gingival recession on the facial aspect of teeth #24 and #25. Donor tissue was harvested from the left hard palate via a single incision technique. The procedure was completed without complication. One week postoperatively, the patient presented with a large asymptomatic overgrowth of tissue from the palatal harvest site. Over the following 5 weeks of continued observation, the lesion demonstrated progressive, spontaneous resolution. Investigation of possible etiology revealed the subject was a recreational bodybuilder with admitted AAS abuse. CONCLUSIONS Post-surgical healing can be influenced by AAS abuse. Alterations in connective tissue metabolism and fibroblast activity are known sequelae of AAS abuse; however, patients may be reluctant to admit to steroid abuse during the presurgical interview. Surgeons should suspect the possibility of AAS abuse when postoperative complications present in a patient of muscular body type.
Collapse
Affiliation(s)
- Ahmad Soolari
- Private practice, Silver Spring, MD.,Department of Periodontics, Naval Postgraduate Dental School, Bethesda, MD
| | - Ehsan Soolari
- College of Chemical and Life Sciences, University of Maryland, Adelphi, MD
| | - Nicholas D Shumaker
- Currently, private practice, Fort Collins, CO; previously, Naval Health Clinic Quantico, Quantico, VA, and Department of Periodontics, Naval Postgraduate Dental School
| |
Collapse
|
5
|
Ozcelik O, Haytac MC, Seydaoglu G. The Effects of Anabolic Androgenic Steroid Abuse on Gingival Tissues. J Periodontol 2006; 77:1104-9. [PMID: 16805671 DOI: 10.1902/jop.2006.050389] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Anabolic androgenic steroid (AAS) is the familiar name for synthetic derivatives of the male sex hormone, testosterone. A large number of young adults abuse AAS to enhance performance and physical appearance. The aim of this study was to evaluate the effects of AAS abuse on the gingival tissues in a group of bodybuilders and weight lifters. METHODS The test group was composed of 24 athletes aged between 17 and 29 years who had been using AAS for >1 year. All subjects were clinically examined for plaque levels (plaque index), gingival inflammation (gingival index), and gingival enlargement. The results were compared to a control group of 20 bodybuilders who had never used AAS drugs and who matched for age, educational level, and oral habits according to the data obtained from the test group. RESULTS Although there were no statistical differences between the plaque index (P>0.05) and gingival index (P>0.05) scores of the study group and the control group, the AAS abusers had statistically higher scores of gingival thickness, extent of gingival encroachment, and total gingival enlargement scores (P<0.001 each) compared to non-users. CONCLUSIONS The results of this study have revealed that the prolonged use of AAS is closely associated with significant levels of gingival enlargement. Because recreational abuse and abuse in non-competitive sports seem to increase despite legislation, dentists and periodontists should be familiar with the adverse effects of these synthetic derivatives of testosterone on the gingival tissues.
Collapse
Affiliation(s)
- Onur Ozcelik
- Department of Periodontology, Faculty of Dentistry, Cukurova University, Adana, Turkey.
| | | | | |
Collapse
|