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Xin YH, Ying TJ, Syeed MS, Veettil SK, Menon RK. Comparative effectiveness of interventions for the treatment of denture stomatitis: A systematic review with network meta-analysis. J Prosthet Dent 2023:S0022-3913(23)00019-7. [PMID: 36863936 DOI: 10.1016/j.prosdent.2023.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 01/07/2023] [Accepted: 01/10/2023] [Indexed: 03/04/2023]
Abstract
STATEMENT OF PROBLEM Symptomatic denture stomatitis (DS) is a painful oral mucosal disorder that can impair quality of life in denture wearers. A complete cure of DS is difficult to achieve, and the most efficacious regimen to treat DS has not yet been conclusively established. PURPOSE The purpose of this network meta-analysis was to assess the comparative efficacy of interventions used for the treatment of DS. MATERIAL AND METHODS A search was conducted for trials published in Medline, Scopus, PubMed, and Cochrane Central Register of Controlled Trials from inception until February 2022 (PROSPERO Reg no: CRD42021271366). Network meta-analysis was performed on data from randomized controlled trials that assessed the comparative efficacy of any form of intervention for the treatment of DS in denture wearers. Agents were ranked according to their effectiveness in the treatment of DS based on outcomes using surface under the cumulative ranking (SUCRA). RESULTS A total of 25 articles were included in the quantitative analysis. Topical antifungal agents (risk ratio [RR]=4.37[95% confidence interval [CI]: 2.15,8.90), topical antimicrobial agents used along with systemic antifungal agents (RR=4.25[95% CI: 1.79,10.33]), systemic antifungal agents (RR=4.25[95% CI: 1.79,10.10]), photodynamic therapy (RR=4.25[95% CI: 1.75,8.98]), and topical plant products (RR=3.40[95% CI: 1.59,7.26]) were found to effectively improve DS. Microwave disinfection concurrently administered with topical antifungal agents (RR=7.38(95% CI: 2.75,19.81), microwave disinfection 7.38[95% CI: 2.75,19.81]), topical antifungal agents (RR=4.88[95% CI: 1.92,12.42]), topical plant products (RR=4.49[95% CI: 1.70,11.82]), systemic antifungal agents together with topical antimicrobial agents (RR=3.85[95% CI: 1.33,11.10]), topical antimicrobial agents (RR=3.39[95% CI: 1.17,9.81]), systemic antifungal agents (RR=3.37[95% CI: 1.21,9.34]), and photodynamic therapy or photochemotherapy (PDT) (RR=2.93[95% CI: 1.01,8.47]) were found to effectively resolve mycological DS. Topical antifungals ranked highest in the SUCRA ranking for clinical improvement, whereas microwave disinfection concurrently administered with topical antifungal agents ranked highest for mycological resolution. None of the agents demonstrated significant side effects except for topical antimicrobial agents which demonstrated altered taste and staining of oral structures. CONCLUSIONS Available evidence suggests that topical antifungals, microwave, and systemic antifungals are effective in the treatment of DS, but confidence in these findings is low because of the limited number of studies and a high risk of bias. Additional clinical trials are needed on photodynamic therapy, topical plant products, and topical antimicrobials.
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Affiliation(s)
- Yew Hui Xin
- Predoctoral student, School of Dentistry, International Medical University, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Tan Joe Ying
- Predoctoral student, School of Dentistry, International Medical University, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - M Sakil Syeed
- PhD Candidate, Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, Utah
| | - Sajesh K Veettil
- Research Associate, Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, Utah
| | - Rohit Kunnath Menon
- Assistant Professor, Department of Prosthodontics, College of Dentistry, Ajman University, Ajman, United Arab Emirates.
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Caldeira FID, Moreno JDA, Gasque KCDS, Haddad MF. Epidemiological factors associated with Candida albicans in patients using complete denture: a scoping review. REVISTA CIÊNCIAS EM SAÚDE 2021. [DOI: 10.21876/rcshci.v11i1.1050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objective: This study undertakes a scoping review of research on epidemiological factors of Candida albicans in patients using complete denture (CD). Methods: PubMed, LILACS, Embase, SciELO, Web of Science, and Scopus databases were used. Searches were conducted in December 2020. Keywords used in this search were Candida albicans, Complete Denture, Mouth, and Microbiology. Results: Initially, 89 articles were identified; 19 of these comprised the final sample after applying the exclusion/inclusion criteria. There was a greater tendency for females to use DC. In addition, among all samples evaluating the incidence of the fungus (n = 2,724), approximately 44.7% (n = 1,218) had C. albicans-associated prosthetic stomatitis. Conclusion: Prosthetic stomatitis is a condition that mainly affects women aged 50–70 years and has a multifactorial predisposition. Also, Newton's classification proposed in 1962 is the most used for the clinical diagnosis of oral candidiasis. The CD's hygiene status is a crucial factor for the progression of candidosis, in the same way that the C. albicans fungus plays an important role in the progression of this pathogenesis in the host.
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Silva D, Gomes A, Ms Lobo J, Almeida V, Almeida IF. Management of skin adverse reactions in oncology. J Oncol Pharm Pract 2020; 26:1703-1714. [PMID: 32635811 DOI: 10.1177/1078155220936341] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Chemo and targeted anticancer therapies present significant skin adverse reactions, which impair the patients' quality of life. Cutaneous toxicities lead to poor treatment adherence, drug cessation, and psychosocial distress. This review aims to summarize the current knowledge concerning the prevention and management of skin toxicity arising from these therapies. A systematic literature search on online databases was conducted. The categorization of the main preventive and treatment measures was performed according to the level of evidence. Management of skin adverse reactions of oncology treatments is very heterogeneous, which can be explained by the lack of sound evidence-based treatments. The most studied adverse effects are papulopustular eruption, xerosis, and hand-foot syndrome. Prevention of xerosis stands out as the strategy most supported by level II studies. With respect to treatment, the use of antibiotics in papulopustular eruption resulting from anti-epidermal growth factor receptor agents is the most evidence-based approach. In general, the number of studies published in the literature classified with a level II of evidence (52%) is similar to the ones classified as level IV (33%), making clear the need of more randomized controlled trials regarding the effectiveness of preventive and treatment measures of skin adverse reactions of chemo and targeted anticancer therapies.
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Affiliation(s)
- Diva Silva
- Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Ana Gomes
- Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - José Ms Lobo
- Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.,UCIBIO/REQUIMTE, MedTech-Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Vera Almeida
- UCIBIO/REQUIMTE, MedTech-Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.,92909CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies, Gandra, Portugal
| | - Isabel F Almeida
- Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.,UCIBIO/REQUIMTE, MedTech-Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
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Chladek G, Pakieła K, Pakieła W, Żmudzki J, Adamiak M, Krawczyk C. Effect of Antibacterial Silver-Releasing Filler on the Physicochemical Properties of Poly(Methyl Methacrylate) Denture Base Material. MATERIALS (BASEL, SWITZERLAND) 2019; 12:E4146. [PMID: 31835665 PMCID: PMC6947518 DOI: 10.3390/ma12244146] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 12/02/2019] [Accepted: 12/09/2019] [Indexed: 12/24/2022]
Abstract
Colonization of polymeric dental prosthetic materials by yeast-like fungi and the association of these microorganisms with complications occurring during prosthetic treatment are important clinical problems. In previously presented research, submicron inorganic particles of silver sodium hydrogen zirconium phosphate (S-P) were introduced into poly(methyl methacrylate) (PMMA) denture base material which allowed for obtaining the antimicrobial effect during a 90 day experiment. The aim of the present study was to investigate the flexural strength, impact strength, hardness, wear resistance, sorption, and solubility during three months of storage in distilled water. With increasing S-P concentration after 2 days of conditioning in distilled water, reduced values of flexural strength (107-72 MPa), impact strength (18.4-5.5 MPa) as well as enhanced solubility (0.95-1.49 µg/mm3) were registered, but they were at acceptable levels, and the sorption was stable. Favorable changes included increased hardness (198-238 MPa), flexural modulus (2.9-3.3 GPa), and decreased volume loss during wear test (2.9-0.2 mm3). The percentage changes of the analyzed properties during the 90 days of storage in distilled water were similar for all materials.
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Affiliation(s)
- Grzegorz Chladek
- Faculty of Mechanical Engineering, Silesian University of Technology, ul. Konarskiego 18a, 44-100 Gliwice, Poland; (K.P.); (W.P.); (J.Ż.); (M.A.)
| | - Katarzyna Pakieła
- Faculty of Mechanical Engineering, Silesian University of Technology, ul. Konarskiego 18a, 44-100 Gliwice, Poland; (K.P.); (W.P.); (J.Ż.); (M.A.)
| | - Wojciech Pakieła
- Faculty of Mechanical Engineering, Silesian University of Technology, ul. Konarskiego 18a, 44-100 Gliwice, Poland; (K.P.); (W.P.); (J.Ż.); (M.A.)
| | - Jarosław Żmudzki
- Faculty of Mechanical Engineering, Silesian University of Technology, ul. Konarskiego 18a, 44-100 Gliwice, Poland; (K.P.); (W.P.); (J.Ż.); (M.A.)
| | - Marcin Adamiak
- Faculty of Mechanical Engineering, Silesian University of Technology, ul. Konarskiego 18a, 44-100 Gliwice, Poland; (K.P.); (W.P.); (J.Ż.); (M.A.)
| | - Cezary Krawczyk
- Department of Dental Technology, Medical College, ul. 3 Maja 63, 41-800 Zabrze, Poland;
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Aitken-Saavedra J, Lund RG, González J, Huenchunao R, Perez-Vallespir I, Morales-Bozo I, Urzúa B, Tarquinio SC, Maturana-Ramírez A, Martos J, Fernandez-Ramires R, Molina-Berríos A. Diversity, frequency and antifungal resistance of Candida species in patients with type 2 diabetes mellitus. Acta Odontol Scand 2018; 76:580-586. [PMID: 30045641 DOI: 10.1080/00016357.2018.1484154] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To determine number, species of Candida and Candida resistance to antifungal therapy according to the metabolic control state and the associated salivary changes in patients with type 2 diabetes mellitus (DM2). MATERIALS AND METHODS Samples of non-stimulated saliva were collected from 52 patients with DM2. Salivary pH was measured and cultured on Sabouraud glucose agar and the values of CFU/ml were calculated. The species were presumptively identified using CHROMagar Candida® plates, and identification was confirmed by polymerase chain reaction (PCR). C. albicans isolates were cultured on SGA tetracycline agar with nystatin and fluconazole diffusion disks to measure susceptibility. RESULTS Sixty six percent of the yeasts isolated were Candida albicans, followed by C. glabrata (20.7%). In patients with decompensated DM2, there was an inverse association between HbA1c value and salivary pH. At higher levels of salivary acidification, a greater diversity and quantity of yeasts of the genus Candida were observed. With nystatin, higher inhibition was observed at lower pH. CONCLUSIONS The antifungal therapies could be more effective if it consider, qualitative salivary characteristics as pH, that could determine the susceptibility of species of Candida to at least to nystatin, which is the most used antifungal for treatment to oral candidiasis in patients with DM2.
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Affiliation(s)
- Juan Aitken-Saavedra
- Department of Oral Pathology and Medicine, School of Dentistry, University of Chile, Santiago, Chile
- Post Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Rafael G. Lund
- Post Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Jaime González
- Department of Oral Pathology and Medicine, School of Dentistry, University of Chile, Santiago, Chile
| | - Romina Huenchunao
- Department of Oral Pathology and Medicine, School of Dentistry, University of Chile, Santiago, Chile
| | - Ilia Perez-Vallespir
- Department of Oral Pathology and Medicine, School of Dentistry, University of Chile, Santiago, Chile
| | - Irene Morales-Bozo
- Faculty of Dentistry, Institute for Research in Dental Sciences, University of Chile, Santiago, Chile
| | - Blanca Urzúa
- Faculty of Dentistry, Institute for Research in Dental Sciences, University of Chile, Santiago, Chile
| | | | - Andrea Maturana-Ramírez
- Department of Oral Pathology and Medicine, School of Dentistry, University of Chile, Santiago, Chile
| | - Josué Martos
- Post Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Ricardo Fernandez-Ramires
- Department of Oral Pathology and Medicine, School of Dentistry, University of Chile, Santiago, Chile
| | - Alfredo Molina-Berríos
- Faculty of Dentistry, Institute for Research in Dental Sciences, University of Chile, Santiago, Chile
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6
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Masetti P, Arbeláez MIA, Pavarina AC, Sanitá PV, Jorge JH. Cytotoxic potential of denture base and reline acrylic resins after immersion in disinfectant solutions. J Prosthet Dent 2018; 120:155.e1-155.e7. [PMID: 29724556 DOI: 10.1016/j.prosdent.2018.01.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 01/09/2018] [Accepted: 01/09/2018] [Indexed: 10/17/2022]
Abstract
STATEMENT OF PROBLEM The daily immersion of dentures in disinfectant solutions can cause the incorporation of toxic substances in the acrylic resins, and studies evaluating the cumulative effect of disinfectant solutions on cell culture are lacking. PURPOSE The purpose of this in vitro study was to evaluate the cytotoxic potential of cell cultures of denture base and reline acrylic resins after immersion in disinfectant solutions. MATERIAL AND METHODS Disk-shaped specimens (14×1.2 mm) were obtained and divided into groups (n=9) according to the disinfectant solutions (distilled water [control], 2% chlorhexidine digluconate, 3.8% sodium perborate, 0.5% sodium hypochlorite, and apple vinegar) and to the storage period (0, 1, 3, and 6 months). Solutions were changed daily. After the different storage periods, specimens were immersed in culture medium for 24 hours, and extracts were obtained. Human keratinocytes were cultivated, and the cellular metabolism was evaluated by using Alamar Blue. Data were submitted to 3-way analysis of variance and Games-Howell post hoc tests (α=.05). RESULTS Both of the acrylic resins tested showed similar biocompatibility properties after immersion in different solutions (P=.400). Immersion in distilled water, 3.8% sodium perborate, and 0.5% sodium hypochlorite did not affect the cellular metabolism of the keratinocytes (P>.05), regardless of the immersion period and the type of acrylic resin (P>.05). Immersion in 2% chlorhexidine digluconate or apple vinegar resulted in high cytotoxicity over time, until the third month (P<.05), after which no changes were observed (P>.05). CONCLUSIONS The type of acrylic resin (base or reline) had no significant effect on the viability of cells. Vinegar and chlorhexidine digluconate solutions increased in cytotoxic effect over time, and were strongly cytotoxic after 6 months of immersion. Sodium perborate and sodium hypochlorite were noncytotoxic in all periods of time tested.
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Affiliation(s)
- Paula Masetti
- Postgraduate student, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | | | - Ana Claudia Pavarina
- Professor, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | - Paula Volpato Sanitá
- Professor, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | - Janaina Habib Jorge
- Professor, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, Brazil
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7
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Silva HPRD, Koppe B, Brew MC, Sória GS, Bavaresco CS. Approach to the most prevalent oral disorders among the elderly: an integrative review focusing on primary health care. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2017. [DOI: 10.1590/1981-22562017020.160199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective: an integrative review of the treatment of oral candidiasis, root caries and xerostomia among the elderly population, focusing on Primary Health Care, was carried out. Method: scientific articles were collected from the MEDLINE/PUBMED database using the keywords "Geriatric dentistry" and "Oral health", crossed with corresponding descriptors, together with specific terms for the pathologies studied, and with “the clinical trial” filter activated. The abstracts of the articles were read by three researchers. Result: oral candidiasis: six randomized clinical trials and one quasi-experimental design study, on the treatment of prosthetic stomatitis by medication and/or the disinfection of dentures by different techniques, were identified; root caries: three randomized clinical trials were included, which tested the use of mouthwash with chlorhexidine solution and oral hygiene instruction associated or otherwise with other drugs; and xerostomia: two articles were analyzed using various medications, and the functional massage of the salivary glands and associated muscles. Conclusion: The results demonstrate a variety of treatment options for the studied clinical situations, although these should be adapted to the characteristics of the services and the population, as standard treatment in Primary Health Care has not been established. Strategies based on soft technologies, such as health education, seem to provide good results. The present study provides additional knowledge for health professionals in search of more resolutive and qualified dental care for the elderly in primary health care.
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Hilgert JB, Giordani JMDA, de Souza RF, Wendland EMDR, D'Avila OP, Hugo FN. Interventions for the Management of Denture Stomatitis: A Systematic Review and Meta-Analysis. J Am Geriatr Soc 2016; 64:2539-2545. [DOI: 10.1111/jgs.14399] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Juliana Balbinot Hilgert
- Postgraduate Program in Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
- Postgraduate Program in Epidemiology; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | | | - Raphael Freitas de Souza
- Department of Dental Materials and Prosthetics; University of São Paulo; Ribeirão Preto Brazil
- Division of Oral Health and Society; McGill University; Montreal Québec Canada
| | | | - Otavio Pereira D'Avila
- Postgraduate Program in Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Fernando Neves Hugo
- Postgraduate Program in Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
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Yarborough A, Cooper L, Duqum I, Mendonça G, McGraw K, Stoner L. Evidence Regarding the Treatment of Denture Stomatitis. J Prosthodont 2016; 25:288-301. [DOI: 10.1111/jopr.12454] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2015] [Indexed: 11/27/2022] Open
Affiliation(s)
- Alexandra Yarborough
- Department of Prosthodontics; University of North Carolina at Chapel Hill School of Dentistry; Chapel Hill NC
| | - Lyndon Cooper
- Department of Oral Biology; University of Illinois at Chicago College of Dentistry; Chicago IL
| | - Ibrahim Duqum
- Department of Prosthodontics; University of North Carolina at Chapel Hill School of Dentistry; Chapel Hill NC
| | - Gustavo Mendonça
- Division of Prosthodontics; University of Michigan School of Dentistry; Ann Arbor MI
| | - Kathleen McGraw
- Health Sciences Library; University of North Carolina; Chapel Hill NC
| | - Lisa Stoner
- Department of Prosthodontics; University of North Carolina at Chapel Hill School of Dentistry; Chapel Hill NC
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Garcia-Cuesta C, Sarrion-Pérez MG, Bagán JV. Current treatment of oral candidiasis: A literature review. J Clin Exp Dent 2014; 6:e576-82. [PMID: 25674329 PMCID: PMC4312689 DOI: 10.4317/jced.51798] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 07/26/2014] [Indexed: 12/29/2022] Open
Abstract
Candidiasis or oral candidosis is one of the most common human opportunistic fungal infections of the oral cavity. This pathology has a wide variety of treatment which has been studied until these days. The present study offers a literature review on the treatment of oral candidiasis, with the purpose of establish which treatment is the most suitable in each case. Searching the 24 latest articles about treatment of candidiasis it concluded that the incidence depends on the type of the candidiasis and the virulence of the infection. Although nystatin and amphotericin b were the most drugs used locally, fluconazole oral suspension is proving to be a very effective drug in the treatment of oral candidiasis. Fluconazole was found to be the drug of choice as a systemic treatment of oral candidiasis. Due to its good antifungal properties, its high acceptance of the patient and its efficacy compared with other antifungal drugs. But this drug is not always effective, so we need to evaluate and distinguish others like itraconazole or ketoconazole, in that cases when Candida strains resist to fluconazole.
Key words:Candidiasis, treatment, miconazole, fluconazole, nystatin.
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Affiliation(s)
| | | | - Jose V Bagán
- Chairman of Oral Medicine. Oral Medicine Unit. Department of Stomatology. University of Valencia. Head of the Department of Stomatology and Maxilofacial Surgery. Valencia University General Hospital
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Emami E, Kabawat M, Rompre PH, Feine JS. Linking evidence to treatment for denture stomatitis: a meta-analysis of randomized controlled trials. J Dent 2013; 42:99-106. [PMID: 24316341 DOI: 10.1016/j.jdent.2013.11.021] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 11/08/2013] [Accepted: 11/29/2013] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The aim of this meta-analysis was to compare the efficacy of antifungal therapy with any other alternative methods used for the treatment of denture stomatitis. DATA SOURCES MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews were searched, complemented by hand searching, until the first week of January 2013. STUDY SELECTION Included studies consisted of randomized clinical trials published in English or French, which compared antifungals with any other alternative or placebo, used for the treatment of denture stomatitis. The remission of clinical signs of denture stomatitis, and the reduction in Candida colony counts were considered as the clinical and microbiological outcomes, respectively. Random effects models were used to conduct the statistical analyses. RESULTS From 233 identified articles, a total of 15 manuscripts on 14 randomized controlled trials were included in systematic review and 8 in the meta-analysis. No statistically significant difference between antifungal treatment and disinfection methods was found for both clinical (OR=0.7; 95% CI: 0.32-1.36; Z=-1.14; p=0.256) and microbiological (OR=0.8; 95% CI: 0.26-2.5; Z=-0.35; p=0.724) outcomes. The meta-analysis showed a statistically significant difference between an antifungal and a placebo for the microbiological outcome (OR=0.32; 95% CI: 0.12-0.89; Z=-2.2; p=0.028), favouring the antifungals. However, there was no statistically significant difference between antifungal and placebo for the clinical outcome (OR=0.2; 95% CI: 0.04-1.04; Z=-1.9; p=0.056). CONCLUSIONS Disinfection agents, antiseptic mouthwashes, natural substances with antimicrobial properties, microwave disinfection and photodynamic therapy could be suggested as an adjunct or alternative to antifungal medications in the treatment of denture stomatitis.
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Affiliation(s)
- Elham Emami
- Département de Dentisterie et de Restauration, Faculté de Médecine Dentaire, Université de Montréal, Montreal, Canada.
| | - Marla Kabawat
- Département de Dentisterie et de Restauration, Faculté de Médecine Dentaire, Université de Montréal, Montreal, Canada
| | - Pierre H Rompre
- Département de Stomatologie, Faculté de Médecine Dentaire, Université de Montréal, Montreal, Canada
| | - Jocelyne S Feine
- Oral Health and Society Research Unit, Faculty of Dentistry; Department of Epidemiology and Biostatistics and Department of Oncology, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
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Sun X, Cao Z, Yeh CK, Sun Y. Antifungal activity, biofilm-controlling effect, and biocompatibility of poly(N-vinyl-2-pyrrolidinone)-grafted denture materials. Colloids Surf B Biointerfaces 2013; 110:96-104. [PMID: 23708753 DOI: 10.1016/j.colsurfb.2013.04.043] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Revised: 04/10/2013] [Accepted: 04/15/2013] [Indexed: 11/18/2022]
Abstract
Colonization and biofilm-formation of Candida species on denture surfaces cause Candida-associated denture stomatitis (CADS), a common, recurring disease affecting up to 67% of denture wearers. We developed poly(N-vinyl-2-pyrrolidinone)-grafted denture materials that can be repeatedly recharged with various antifungal drugs to achieve long-term antifungal and biofilm-controlling effects. The monomer, N-vinyl-2-pyrrolidinone (NVP), was grafted onto poly(methyl methacrylate) denture resins through plasma-initiated grafting polymerization. The physical properties and biocompatibility of the resulting resins were not negatively affected by the presence of up to 7.92% of grafted poly (N-vinyl-2-pyrrolidinone) (PNVP). Miconazole and chlorhexidine digluconate (CD) were used as model antifungal drugs. PNVP grafting significantly increased the drug absorption capability of the resulting denture materials. Further, the new materials showed sustained drug release and provided antifungal effects for weeks (in the case of CD) to months (in the case of miconazole). The drug-depleted resins could be recharged with the same or a different class of antifungal drug to further extend antifungal duration. If needed, drugs on the PNVP-grafted denture materials could be "washed out" (quenched) by treating with PNVP aqueous solutions to stop drug release. These results point to great potentials of the new materials in controlling biofilm-formation in a wide range of device-related applications.
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Affiliation(s)
- Xinbo Sun
- Medetech Development Corporation, 12527 Mukilteo Speedway STE 103, Lynnwood, WA, 98087, United States
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Manfredi M, Polonelli L, Aguirre-Urizar JM, Carrozzo M, McCullough MJ. Urban legends series: oral candidosis. Oral Dis 2012; 19:245-61. [PMID: 22998462 DOI: 10.1111/odi.12013] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Revised: 07/24/2012] [Accepted: 07/24/2012] [Indexed: 01/10/2023]
Abstract
Candida species (spp) are commensal yeast that can only instigate oral infection (oral candidosis - OC) when there is an underlying predisposing condition in the host. We investigated four controversial topics on OC: (i) How can a microbiological determination of OC be made as Candida spp. are commensal yeasts and not all of them form hyphae or pseudohyphae during infection? (ii) Is median rhomboid glossitis (MRG) a manifestation of candidal infection? (iii) Can candidal infection cause palate papillary hyperplasia (PPH)? (iv) What is the best therapeutic treatment for denture-associated erythematous stomatitis (DAES)? Results from extensive literature searches, including a systematic review, suggested the following: (i) the diagnosis of OC merely on the basis of the presence of yeasts is an oversimplification of a complex process. No convincing evidence of a single test or method better able to discriminate the transition from candidal saprophytism to pathogenicity has been reported in the literature; (ii-iii) conclusive evidence of a direct aetiopathogenic relationship between MRG and PPH and candidal infection has not been found; and (iv) only limited evidence is available for any DAES treatment, thus making it impossible to make strong therapeutic recommendations.
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Affiliation(s)
- M Manfredi
- Oral Medicine, Pathology and Laser-assisted Surgery Unit, University of Parma, Parma, Italy
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Ryalat S, Darwish R, Amin W. New form of administering chlorhexidine for treatment of denture-induced stomatitis. Ther Clin Risk Manag 2011; 7:219-25. [PMID: 21753884 PMCID: PMC3132092 DOI: 10.2147/tcrm.s18297] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Indexed: 11/23/2022] Open
Abstract
Background: The purpose of this study was to evaluate the release of chlorhexidine as an antifungal drug from doped self-cured poly (methyl methacrylate) (PMMA) acrylic resin and the effect of the drug released on the growth of Candida albicans. Methods: Release of chlorhexidine was evaluated using liquid chromatography, and the effect of the drug on the growth of C. albicans was investigated microbiologically using a “well” technique on Saboraud culture medium inoculated with a resistant strain of C. albicans. Results: Chlorhexidine leached steadily out of the acrylic resin into distilled water at mouth temperature, and the sustained drug release continued throughout the 28-day test period. The drug released also demonstrated antifungal activity against the resistant strain of C. albicans. Conclusion: The findings of this study support the use of chlorhexidine-impregnated self-cured PMMA chair-side resin as a new dosage form for the treatment of denture-induced stomatitis.
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Affiliation(s)
- Soukaina Ryalat
- Department of Oral Surgery, Jordan University, Amman, Jordan
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Sanitá PV, Vergani CE, Giampaolo ET, Pavarina AC, Machado AL. Growth ofCandidaspecies on complete dentures: effect of microwave disinfection. Mycoses 2009; 52:154-60. [DOI: 10.1111/j.1439-0507.2008.01558.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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16
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Koray M, Ak G, Kurklu E, Isseur H, Tonyen T, Kukeka G, Guy U. LETTERS TO THE EDITOR. Oral Dis 2006. [DOI: 10.1111/j.1601-0825.2006.01276_2.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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