1
|
Costa AL, Silva BMA, Soares R, Mota D, Alves V, Mirante A, Ramos JC, Maló de Abreu J, Santos-Rosa M, Caramelo F, Gonçalves T. Type 1 diabetes in children is not a predisposing factor for oral yeast colonization. Med Mycol 2018; 55:358-367. [PMID: 27664993 DOI: 10.1093/mmy/myw092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 08/06/2016] [Indexed: 12/16/2022] Open
Abstract
Type 1 diabetes mellitus (T1D) is considered a risk factor associated with oral yeast infections. The aim of this study was to evaluate the yeast oral carriage (in saliva and mucosal surface) of children with T1D and potential relation with host factors, particularly the subset of CD4+ T cells. Yeasts were quantified and identified in stimulated saliva and in cheek mucosal swabs of 133 diabetic T1D and 72 healthy control subjects. Salivary lymphocytes were quantified using flow cytometry. The presence of yeasts in the oral cavity (60% of total patients) was not affected by diabetes, metabolic control, duration of the disease, salivary flow rate or saliva buffer capacity, by age, sex, place of residence, number of daily meals, consumption of sweets or frequency of tooth brushing. Candida albicans was the most prevalent yeast species, but a higher number of yeast species was isolated in nondiabetics. T1D children with HbA1c ≤ 7.5 (metabolically controlled) presented higher number of CD4+ T salivary subsets when compared with the other groups of children (non-diabetic and nonmetabolically controlled) and also presented the highest number of individuals without oral yeast colonization. In conclusion, T1D does not predisposes for increased oral yeast colonization and a higher number of salivary CD4+T cells seems to result in the absence of oral colonization by yeasts.
Collapse
Affiliation(s)
- Ana L Costa
- FMUC, Faculty of Medicine, University of Coimbra, Portugal
| | - Branca M A Silva
- CNC, Centre for Neurosciences and Cell Biology, University of Coimbra, Portugal
| | - Rui Soares
- FMUC, Faculty of Medicine, University of Coimbra, Portugal.,CNC, Centre for Neurosciences and Cell Biology, University of Coimbra, Portugal
| | - Diana Mota
- FMUC, Faculty of Medicine, University of Coimbra, Portugal
| | - Vera Alves
- FMUC, Faculty of Medicine, University of Coimbra, Portugal
| | | | - João C Ramos
- FMUC, Faculty of Medicine, University of Coimbra, Portugal
| | | | | | - Francisco Caramelo
- FMUC, Faculty of Medicine, University of Coimbra, Portugal.,Laboratory of Biostatistics and Medical Informatics, IBILI
| | - Teresa Gonçalves
- FMUC, Faculty of Medicine, University of Coimbra, Portugal.,CNC, Centre for Neurosciences and Cell Biology, University of Coimbra, Portugal
| |
Collapse
|
2
|
Lourenço AG, Ribeiro AERA, Nakao C, Motta ACF, Antonio LGL, Machado AA, Komesu MC. Oral Candida spp carriage and periodontal diseases in HIV-infected patients in Ribeirão Preto, Brazil. Rev Inst Med Trop Sao Paulo 2017; 59:e29. [PMID: 28591257 PMCID: PMC5459536 DOI: 10.1590/s1678-9946201759029] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 03/31/2017] [Indexed: 11/21/2022] Open
Abstract
The majority of HIV-infected patients develop Candida spp-associated clinical oral lesions. Studies have shown that asymptomatic oral colonization of Candida spp may lead to oral lesions or become a source of disseminated infections. The aim of this study was to verify the effects of periodontal conditions on Candida spp prevalence and Candida spp carriage in the oral cavity of HIV-infected patients compared to non-infected patients. Twenty-five patients not infected with HIV and 48 HIV-infected patients were classified according to periodontal conditions as being periodontal healthy or with periodontal disease. Candida spp carriage and classification were performed in oral rinse samples. Viral load and CD4+ T lymphocyte (CD4+L) counts were performed in blood samples from HIV-infected patients. No differences in Candida spp prevalence related to HIV status or periodontal condition were detected. However, Candida spp carriage was increased in periodontally affected HIV-infected patients when compared to periodontally healthy HIV-infected patients (p= 0.04). Periodontally healthy HIV-infected patients presented Candida spp carriage in similar levels as healthy or periodontally affected non-HIV-infected patients. Candida spp carriage was correlated with CD4+L counting in HIV-infected patients. We concluded that periodontal disease is associated with increased Candida spp carriage in HIV-infected patients and may be a predisposing factor to clinical manifestations of candidiasis.
Collapse
Affiliation(s)
- Alan Grupioni Lourenço
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Morfologia, Fisiologia e Patologia Básica, Ribeirão Preto, São Paulo, Brazil
| | - Ana Elisa Rodrigues Alves Ribeiro
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Morfologia, Fisiologia e Patologia Básica, Ribeirão Preto, São Paulo, Brazil
| | - Cristiano Nakao
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Morfologia, Fisiologia e Patologia Básica, Ribeirão Preto, São Paulo, Brazil
| | - Ana Carolina Fragoso Motta
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Estomatologia, Saúde Coletiva e Odontologia Legal, Ribeirão Preto, São Paulo, Brazil
| | - Luana Grupioni Lourenço Antonio
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Medicina Interna, Ribeirão Preto, São Paulo, Brazil
| | - Alcyone Artioli Machado
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Medicina Interna, Ribeirão Preto, São Paulo, Brazil
| | - Marilena Chinali Komesu
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Morfologia, Fisiologia e Patologia Básica, Ribeirão Preto, São Paulo, Brazil
| |
Collapse
|
3
|
Charone S, Portela MB, Martins KDO, Soares RM, Castro GF. Role of Candida species from HIV infected children in enamel caries lesions: an in vitro study. J Appl Oral Sci 2017; 25:53-60. [PMID: 28198976 PMCID: PMC5289400 DOI: 10.1590/1678-77572016-0021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 09/23/2016] [Indexed: 02/07/2023] Open
Abstract
Objectives This study analyzed the capacity of Candida spp. from dental biofilm of HIV infected (HIV+) children to demineralize primary molar enamel in vitro by Transversal Microhardness (TMH), Polarized Light Microscopy (PLM) and the quantity of calcium ions (Ca2+) released from the enamel. Material and Methods Candida spp. samples were isolated from the supragingival biofilm of HIV+ children. A hundred and forty (140) enamel blocks were randomly assigned to six groups: biofilm formed by C. albicans (Group 1); mixed biofilm formed by C. albicans and C. tropicalis (Group 2); mixed biofilm formed by C. albicans and C. parapsilosis (Group 3); mixed biofilm formed by C. albicans, C. parapsilosis and C. glabrata (Group 4); biofilm formed by C. albicans ATCC (Group 5) and medium without Candida (Group 6). Enamel blocks from each group were removed on days 3, 5, 8 and 15 after biofilm formation to evaluate the TMH and images of enamel were analyzed by PLM. The quantity of Ca2+ released, from Groups 1 and 6, was determined using an Atomic Absorption Spectrophotometer. The SPSS program was used for statistical analysis and the significance level was 5%. Results TMH showed a gradual reduction in enamel hardness (p<0.05) from the 1st to 15th day, but mainly five days after biofilm formation in all groups. The PLM showed superficial lesions indicating an increase in porosity. C. albicans caused the release of Ca2+ into suspension during biofilm formation. Conclusion Candida species from dental biofilm of HIV+ children can cause demineralization of primary enamel in vitro.
Collapse
Affiliation(s)
- Senda Charone
- Universidade Federal do Rio de Janeiro, Faculdade de Odontologia, Departamento de Odontopediatria e Ortodontia, Rio de Janeiro, RJ, Brasil.,Universidade de Brasília, Faculdade de Odontologia, Departamento de Cariologia, Brasília, DF, Brasil
| | - Maristela Barbosa Portela
- Universidade Federal Fluminense, Faculdade de Odontologia, Departamento de Clínica e Odontopediatria, Niterói, RJ, Brasil
| | - Karol de Oliveira Martins
- Universidade Federal Fluminense, Faculdade de Odontologia, Departamento de Clínica e Odontopediatria, Niterói, RJ, Brasil
| | - Rosangela Maria Soares
- Universidade Federal do Rio de Janeiro, Instituto de Microbiologia Paulo de Góes, Departamento de Microbiologia, Rio de Janeiro, RJ, Brasil
| | - Gloria Fernanda Castro
- Universidade Federal do Rio de Janeiro, Faculdade de Odontologia, Departamento de Odontopediatria e Ortodontia, Rio de Janeiro, RJ, Brasil
| |
Collapse
|
4
|
Al-Ahmad A, Auschill TM, Dakhel R, Wittmer A, Pelz K, Heumann C, Hellwig E, Arweiler NB. Prevalence of Candida albicans and Candida dubliniensis in caries-free and caries-active children in relation to the oral microbiota-a clinical study. Clin Oral Investig 2015; 20:1963-1971. [PMID: 26696116 DOI: 10.1007/s00784-015-1696-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 12/14/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The correlation between caries and the oral prevalence of Candida spp. in children is contradictory in literature. Thereby, authors focused on Candida albicans as the most isolated Candida species from the oral cavity. Therefore, the aim of the present study was to compare caries-free and caries-bearing children regarding their oral carriage of Candida spp. MATERIAL AND METHODS Twenty-six caries-free (CF group) and 26 caries-active children (CA group) were included into this study. Three different types of specimens were assessed, saliva and plaque, and in the case of caries, infected dentine samples were microbiologically analyzed for aerobic and anaerobic microorganisms and their counts. Special attention was given to the differentiation between C. albicans and Candida dubliniensis. Additionally, different biochemical tests, VITEK 2 (VITEK®2, bioMérieux, Marcy-l'Etoile, France) and 16S and 18S ribosomal DNA (rDNA) sequencing, were applied for identification. RESULTS The detection of C. albicans did not differ between the CF and CA groups. C. dubliniensis was never detected in any specimen of the CF group, but occurred in one quarter of the CA group (27 % in plaque, 23 % in saliva), thus leading to a statistically significant difference between the two groups (p < 0.05). In six of these cases, C. dubliniensis was detected concomitantly in saliva and plaque and once only in plaque. CA group harbored statistically more Streptococcus mutans than the control group revealing a correlation between S. mutans and C. dubliniensis regarding the caries group. CONCLUSIONS This is the first study reporting a frequent detection of C. dubliniensis in caries-active children, which could have been underestimated so far due to difficulties in differentiation between this yeast species and C. albicans. CLINICAL RELEVANCE Microbiological diagnostic-especially of oral Candida species-is an important determinant for identifying etiological factors of dental caries in children.
Collapse
Affiliation(s)
- A Al-Ahmad
- Department of Operative Dentistry and Periodontology, Center for Dental Medicine, Albert-Ludwigs-University, Freiburg, Germany
| | - T M Auschill
- Department of Periodontology, Philipps-University, Marburg, Germany
| | - R Dakhel
- Department of Operative Dentistry and Periodontology, Center for Dental Medicine, Albert-Ludwigs-University, Freiburg, Germany
| | - A Wittmer
- Institute of Medical Microbiology and Hygiene, Albert-Ludwigs-University, Freiburg, Germany
| | - K Pelz
- Institute of Medical Microbiology and Hygiene, Albert-Ludwigs-University, Freiburg, Germany
| | - C Heumann
- Department of Statistics, Ludwig-Maximilians-University, Munich, Germany
| | - E Hellwig
- Department of Operative Dentistry and Periodontology, Center for Dental Medicine, Albert-Ludwigs-University, Freiburg, Germany
| | - N B Arweiler
- Department of Periodontology, Philipps-University, Marburg, Germany.
| |
Collapse
|
5
|
Blignaut E, van Heerden WFP. Molecular and Histological Association Between Candida albicans from Oral Soft Tissue and Carious Dentine of HIV-Positive Children. Mycopathologia 2015; 180:193-201. [PMID: 26153022 DOI: 10.1007/s11046-015-9912-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 06/13/2015] [Indexed: 10/23/2022]
Abstract
Candida albicans and caries are frequently investigated among healthy and immunosuppressed individuals. The objective of this study was to demonstrate the presence of C. albicans on both oral soft and hard tissue and to investigate, at molecular level, the genetic subtype of the organism from the two oral sites. Tongue swabs and dentine scrapings from 362 HIV-positive children, referred for the extraction of carious primary teeth, were cultured on CHROMagar and identified to species level with ID32C. Histological staining of extracted carious teeth was also done. In patients with positive C. albicans cultures from both the tongue and carious dentine, DNA fingerprinting of such paired isolates was performed, using Southern blot hybridisation with the Ca3 probe. Yeasts were cultured from the tongue of 151 (41.7 %) individuals and 57 (37.7 %) simultaneously yielded positive C. albicans cultures from carious dentine. Nine different yeast spp. were identified from the tongue using the ID32C commercial system, but C. albicans was the only species recovered from carious dentine and histological investigation demonstrated fungal elements penetrated into the dentine and not limited to superficial debris on the floor of the cavity. Twelve of 13 paired isolates of C. albicans revealed identical fingerprinting patterns. The findings from this study demonstrated that in a particular individual, the same genetic subtype of C. albicans was capable of colonising both oral soft tissue and carious dentine. This renders carious teeth a constant source, or reservoir, of potentially infectious agents and, particularly among immunosuppressed individuals, should therefore not be left unattended.
Collapse
Affiliation(s)
- Elaine Blignaut
- Department of Oral Pathology and Oral Biology, Faculty of Health Sciences, School of Dentistry, University of Pretoria, P O Box 1266, Pretoria, 0001, South Africa,
| | | |
Collapse
|
6
|
Klinke T, Urban M, Lück C, Hannig C, Kuhn M, Krämer N. Changes in Candida spp., Mutans Streptococci and Lactobacilli following Treatment of Early Childhood Caries: A 1-Year Follow-Up. Caries Res 2013; 48:24-31. [DOI: 10.1159/000351673] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Accepted: 04/21/2013] [Indexed: 11/19/2022] Open
|
7
|
Santiwongkarn P, Kachonboon S, Thanyasrisung P, Matangkasombut O. Prevalence of oral Candida carriage in Thai adolescents. ACTA ACUST UNITED AC 2011; 3:51-5. [DOI: 10.1111/j.2041-1626.2011.0089.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
8
|
Sardi JCO, Almeida AMF, Mendes Giannini MJS. New antimicrobial therapies used against fungi present in subgingival sites--a brief review. Arch Oral Biol 2011; 56:951-9. [PMID: 21676377 DOI: 10.1016/j.archoralbio.2011.03.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 03/16/2011] [Accepted: 03/17/2011] [Indexed: 01/14/2023]
Abstract
Although the main reservoir of Candida spp. is believed to be the buccal mucosa, these microorganisms can coaggregate with bacteria in subgingival biofilm and adhere to epithelial cells. The treatment of periodontal disease includes scaling and root planning (SRP) associated with proper oral hygiene. However, some patients may have negative responses to different therapeutic procedures, with a continuous loss of insertion, so the use of antimicrobials is needed as an adjuvant to SRP treatment. The use of a broad-spectrum antibiotic, such as tetracycline and metronidazole, as an aid in periodontal treatment has also been a factor for the development of superinfections by resistant bacteria and Candida species, even in patients with HIV. In the dental practice, the most commonly used antifungals are nystatin and fluconazole. However, the introduction of new drugs like the next generation of azoles is essential before the onset of emergent species in periodontal disease. Plants are good options for obtaining a wide variety of drugs. This alternative could benefit a large population that uses plants as a first treatment option. Plants have been used in medicine for a long time and are extensively used in folk medicine, because they represent an economic alternative, are easily accessible and are applicable to various diseases. Herein, we briefly review the literature pertaining the presence of Candida sp. in periodontal pockets, the conventional antifungal resistance and new therapies that include natural antifungal agents are reviewed.
Collapse
Affiliation(s)
- Janaina Cássia Orlandi Sardi
- Faculty of Pharmaceutical Sciences of Araraquara, Department of Clinical Analysis, Laboratory of Clinical Mycology, Univ Estadual Paulista, UNESP, Araraquara, SP, Brazil
| | | | | |
Collapse
|
9
|
das Chagas MS, Portela MB, Cerqueira DF, de Souza IPR, Soares RM, Castro GF. Reduction of Candida species colonization in the oral cavity of children infected with human immunodeficiency virus after dental treatment. ACTA ACUST UNITED AC 2009; 108:383-8. [DOI: 10.1016/j.tripleo.2009.04.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2008] [Revised: 04/14/2009] [Accepted: 04/20/2009] [Indexed: 01/12/2023]
|
10
|
Sissons CH, Anderson SA, Wong L, Coleman MJ, White DC. Microbiota of plaque microcosm biofilms: effect of three times daily sucrose pulses in different simulated oral environments. Caries Res 2007; 41:413-22. [PMID: 17713343 DOI: 10.1159/000104801] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2006] [Accepted: 12/01/2006] [Indexed: 11/19/2022] Open
Abstract
AIM To explore the Ecological Plaque Hypothesis for dental caries. To test modification of the microbiota of dental plaque microcosm biofilms by sucrose pulsing during growth in two different simulated oral fluids, and with a urea-induced plaque pH elevation. METHODS Plaque microcosm biofilms were cultured in an 'artificial mouth' with and without 6-min 5% w/v sucrose pulses every 8 h in an environment of continuously supplied saliva-like defined medium with mucin (DMM), or basal medium mucin (BMM, a high-peptone-yeast extract oral fluid analogue), and also in DMM + 10 mmol/l urea, with sucrose pulsing. Forty plaque species were quantified by checkerboard DNA:DNA hybridization analysis. RESULTS Sucrose pulsing extended rapid plaque growth in DMM and BMM, inducing major microbiota changes in DMM but not in BMM. In DMM, some streptococci and lactobacilli were unaffected while others implicated in caries, together with Candida albicans and Capnocytophaga gingivalis, increased. Aerobic, microaerophilic and major anaerobic species decreased. Elevation of the pH(max) from 6.4 to 7.0 had almost no effect on the microbiota. BMM plaques were distinct from DMM plaques with particularly low levels of Candida albicans and Actinomyces. CONCLUSIONS Modest sucrose exposure in a saliva-like environment causes profound changes in the developmental self-organization of plaque microcosms, supporting the Ecological Plaque Hypothesis. Nevertheless, there is significant stability in microbial composition with varying pH near neutrality. Increases in levels of specific bacteria in response to sucrose could be characteristic of organisms particularly important in caries.
Collapse
Affiliation(s)
- C H Sissons
- Dental Research Group, Department of Pathology and Molecular Medicine, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand.
| | | | | | | | | |
Collapse
|
11
|
Presence of mutans streptococci and Candida spp. in dental plaque/dentine of carious teeth and early childhood caries. Arch Oral Biol 2006; 51:1024-8. [PMID: 16890907 DOI: 10.1016/j.archoralbio.2006.06.001] [Citation(s) in RCA: 155] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2006] [Revised: 05/30/2006] [Accepted: 06/05/2006] [Indexed: 11/19/2022]
Abstract
This study determined the presence of mutans streptococci and Candida spp. in supragingival dental plaque and infected dentine of caries-free children, with early childhood caries and caries. Pooled samples of dental plaque and infected dentine were collected from 56 children aged 1-5 years, which were divided into 3 groups: early childhood caries (ECC); caries and caries-free. Infected dentine was collected in ECC and caries groups to compare the frequency of these microorganisms in the collected sites. The samples were inoculated in SB20 and SA medium, for mutans streptococci and Candida spp., respectively, and incubated at 37 degrees C for 48 h. Colony growth was verified and the identification was performed by biochemical tests and CHROMagar Candida. Fisher's test or chi-square (chi(2)) were applied (p=0.05). The more prevalent species were S. mutans and Candida albicans in ECC (85.4% and 60.4%, respectively), independently of the sample site. S. mutans only was significantly associated with carious teeth, whether in early childhood caries or not. However, the frequency of C. albicans in ECC was higher when compared to caries and caries-free groups. There is a significant association between the presence of C. albicans and early childhood caries.
Collapse
|
12
|
Qi QG, Hu T, Zhou XD. Frequency, species and molecular characterization of oral Candida in hosts of different age in China. J Oral Pathol Med 2005; 34:352-6. [PMID: 15946183 DOI: 10.1111/j.1600-0714.2005.00326.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Research indicates that host age is a determining factor in yeast carriage. From the neonatal period, humans go through several dentition periods, and the emergence and substitution of teeth and changes in living habits greatly change the environment of the oral cavity, and therefore influence colonization by oral commensal organisms, certainly including Candida spp. No previous study of Candida carriage by different age groups divided by dentition has been reported. This study supplies data on the geographical specificity of C. albicans genotypic subgroup distribution. METHODS All test individuals came from a single geographical locale over a short period. Following mucosal swab sampling, CHROMagar Candida-yeast differential media were used to determine the frequency of carriage and species. All C. albicans strains were confirmed by PCR and PCR using primers reported to span a transposable intron region in the 25S rRNA gene was used to determine genotypic subgroups. RESULTS The results demonstrate that for the tested population, the frequency of Candida species and the distribution of C. albicans genotypic subgroups varied with age group. With increasing age, the frequency of C. albicans decreases, non-C. albicans yeasts increases; Genotypic subgroup A is the dominating strain in the oral cavities of healthy young individuals. CONCLUSIONS The influence of dentition substitution on oral yeast carriage was minor.
Collapse
Affiliation(s)
- Q G Qi
- West China College of Stomatology, Sichuan University, Chengdu City, China
| | | | | |
Collapse
|