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Campos EN, Clemente LM, Pizziolo PG, Oliveira VDC, Macedo AP, Watanabe E, Silva-Lovato CH, Ribeiro AB. Relation between the risk factors for the severity of denture stomatitis and quality of life of complete edentulous individuals: a cross-sectional study. J Appl Oral Sci 2023; 31:e20230192. [PMID: 38126577 PMCID: PMC10786452 DOI: 10.1590/1678-7757-2023-0192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/30/2023] [Accepted: 10/23/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE To assess the association between risk factors for developing denture stomatitis (DS) and oral health-related quality of life (OHRQoL) in complete denture wearers. METHODOLOGY Participants of both sexes, wearing complete dentures, were classified using the modified Newton classification for the absence or the severity of DS and allocated to groups Normal or zero, IA, IB, II, and III. Lifestyle, oral and denture history, and medication use were assessed using specific questionnaires; clinical parameters such as anatomical characteristics of support were evaluated with the Kapur classification; salivary flow (SF) was calculated by the volume of unstimulated saliva per minute; and microbial load was determined by counting colony forming units (CFU) of target microorganisms present in the biofilm collected from dentures and palate. OHIP-EDENT assessed the OHRQoL. Kendall's tau_b and Spearman tests were applied with a significance level of 5%. RESULTS 184 patients (143 female and 41 male) aged 65.5 ± 6.8 years were evaluated. Positive correlations were found for sex (women; p=0.013, r=0.16), individuals who started to consume alcoholic beverages as a young adult (18-27 years) (p=0.008, r=0.22), CFU of Candida spp. (p<0.001, r=0.27 denture; p<0.001, r=0.31 palate); Candida albicans (p=0.004, r=0.22 denture; p=0.003, r=0.25 palate), and Candida glabrata (p=0.004, r=0.22 denture; p=0.001, r=0.27 palate). Moreover, negative correlations with DS were found for CFU of Staphylococcus spp. (p=0.004, r=-0.20 palate) and enterobacteria (p=0.002, r=-0.24 palate), as well as a negative correlation between SF (p=0.009, r=-0.193) and DS. The CFU of Staphylococcus spp. and enterobacteria on the palate significantly correlated with OHRQoL. CONCLUSION Being female, consuming alcoholic beverages as a young adult, CFU of Candida spp., Candida albicans, Candida glabrata, and salivary flow may be the most significant risk factors for DS. The microbial load of Staphylococcus spp. and enterobacteria seems to influence the quality of life for complete denture wearers.
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Affiliation(s)
- Eleonora Nardi Campos
- Universidade de São Paulo. Faculdade de Odontologia de Ribeirão Preto. Departamento de Materiais Dentários e Prótese. Ribeirão Preto, São Paulo
| | - Lorena Mosconi Clemente
- Universidade de São Paulo. Faculdade de Odontologia de Ribeirão Preto. Departamento de Materiais Dentários e Prótese. Ribeirão Preto, São Paulo
| | - Pillar Gonçalves Pizziolo
- Universidade de São Paulo. Faculdade de Odontologia de Ribeirão Preto. Departamento de Materiais Dentários e Prótese. Ribeirão Preto, São Paulo
| | - Viviane de Cássia Oliveira
- Universidade de São Paulo. Faculdade de Odontologia de Ribeirão Preto. Departamento de Materiais Dentários e Prótese. Ribeirão Preto, São Paulo
| | - Ana Paula Macedo
- Universidade de São Paulo. Faculdade de Odontologia de Ribeirão Preto. Departamento de Materiais Dentários e Prótese. Ribeirão Preto, São Paulo
| | - Evandro Watanabe
- Universidade de São Paulo. Faculdade de Odontologia de Ribeirão Preto. Departamento de Dentística Restauradora. Ribeirão Preto, São Paulo
| | - Cláudia Helena Silva-Lovato
- Universidade de São Paulo. Faculdade de Odontologia de Ribeirão Preto. Departamento de Materiais Dentários e Prótese. Ribeirão Preto, São Paulo
| | - Adriana Barbosa Ribeiro
- Universidade de São Paulo. Faculdade de Odontologia de Ribeirão Preto. Departamento de Materiais Dentários e Prótese. Ribeirão Preto, São Paulo
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Clemente LM, Ribeiro AB, Fortes CV, Ribeiro AB, Oliveira VDC, Macedo AP, Salgado HC, da Silva CHL. Risk factors and immunological biomarkers in denture stomatitis: An observational cross-sectional study. Arch Oral Biol 2023; 155:105799. [PMID: 37672969 DOI: 10.1016/j.archoralbio.2023.105799] [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: 07/07/2023] [Revised: 08/15/2023] [Accepted: 08/27/2023] [Indexed: 09/08/2023]
Abstract
OBJECTIVE Assess risk factors, local and systemic immunological biomarkers in healthy individuals and with Denture Stomatitis (DS). DESIGN For this observational transversal study, 27 participants without DS (Group 0), 24 with moderate DS (Group 1), and 25 with severe DS (Group 2) were assessed for sociodemographic, behavioral, and clinical parameters, microbial load of Candida spp., Staphylococcus spp., Streptococcus mutans, Pseudomonas spp., and enterobacteria, and cytokine and C-reactive protein levels. ANOVA, Fisher's exact, Kruskal-Wallis, Mann-Whitney, Wilcoxon and Pearson's chi-square tests were used for data analysis (α = 0.05). RESULTS Group 1 had a significantly higher mean age compared to the other groups (P = 0.018), but no correlation was identified between age and DS (P = 0.830; r = 0.025). No significant differences were found among the groups for other sociodemographic and behavioral characteristics. Group 1 had significantly older upper and lower dentures; however, no correlation was identified between age of upper (P = 0.522; r = 0.075) and lower (P = 0.143; r = 0.195) dentures and DS. The microbial load of Candida albicans on the dentures (P = 0.035) and Candida spp. on the palate (P = 0.008) of the groups 1 and 2 was higher than group 0. Group 1 and 2 had higher Candida spp. counts on denture (P = 0.003) than group 0. There was no difference among groups for bacterial analyzed. Group 1 showed higher and Group 2 intermediate salivary levels of IL-6 compared to Group 0. There was no difference in the C-reactive protein levels among groups. CONCLUSIONS Microbial load of Candida spp. is the factor with the strongest relationship with DS, with capacity for local signaling through IL-6.
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Affiliation(s)
- Lorena Mosconi Clemente
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirao Preto, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Adriana Barbosa Ribeiro
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Caroline Vieira Fortes
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirao Preto, University of São Paulo (USP), Ribeirão Preto, Brazil
| | | | - Viviane de Cássia Oliveira
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Ana Paula Macedo
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Hélio César Salgado
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Cláudia Helena Lovato da Silva
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil.
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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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Liang X, Chou OHI, Cheung BMY. The association between denture use and cardiovascular diseases. The United States National Health and Nutrition Examination Survey 2009-2018. Front Cardiovasc Med 2023; 9:1000478. [PMID: 36704477 PMCID: PMC9871755 DOI: 10.3389/fcvm.2022.1000478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 12/21/2022] [Indexed: 01/11/2023] Open
Abstract
Introduction Poor dental health is associated with cardiovascular diseases (CVD). However, the relationship between CVD and denture use is currently unknown. This study aimed to investigate whether denture use is associated with CVD among American adults. Methods 10,246 non-pregnant subjects aged 30-59 years from five cycles (2009-2018) of the United States National Health and Nutrition Examination Survey (NHANES) were included in this study. Participants who were observed by a dental examiner wearing denture/partial denture/plates were defined as denture users. CVD was defined as self-reported coronary heart disease, myocardial infarction, angina pectoris, stroke, and congestive heart failure. The association between denture use and CVD was analyzed using logistic regression with adjustment for potential cofounders. Results 4.4% (95% CI, 3.9-5.0) participants had CVD, and 3.5% (95% CI, 2.8-4.5) participants were denture users. Denture use was associated with CVD [OR = 4.26, 95% CI (2.90-6.28), P < 0.01], which remained significant [adjusted OR = 1.82, 95% CI (1.15-2.88), P < 0.01] after adjustments for sociodemographic characteristics, smoking, alcohol use, drug addiction, body mass index (BMI), and abnormal medical conditions including gum problem, hypertension, diabetes, and hyperlipidemia. Women with dentures had significantly higher odds of CVD [adjusted OR = 2.13, 95% CI (1.10-4.11), P = 0.025]. Conclusion In this nationally representative survey, denture use was associated with CVD. Denture use may be an unconventional risk factor for assessing CVD risks, especially in women. Future studies are required to investigate whether CVD and denture use is causally related.
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Affiliation(s)
- Xiaopeng Liang
- Division of Clinical Pharmacology and Therapeutics, Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Oscar Hou In Chou
- Division of Clinical Pharmacology and Therapeutics, Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Bernard M. Y. Cheung
- Division of Clinical Pharmacology and Therapeutics, Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China,State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Pokfulam, Hong Kong SAR, China,Institute of Cardiovascular Science and Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China,*Correspondence: Bernard M. Y. Cheung,
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Ribeiro AB, Ribeiro AB, de Araújo CB, Fortes CV, Clemente LM, Paranhos HDFO, Watanabe E, Salgado HC, Silva-Lovato CH. Effect of a Hygiene Protocol on Denture-Related Stomatitis Remission, Local Inflammatory Factors, and Hemodynamic Responses by Arterial Pressure. Antibiotics (Basel) 2022; 11:antibiotics11101320. [PMID: 36289978 PMCID: PMC9598829 DOI: 10.3390/antibiotics11101320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/16/2022] [Accepted: 09/24/2022] [Indexed: 11/17/2022] Open
Abstract
Denture-related stomatitis (DRS) is frequent oral inflammation in complete denture wearers. This study evaluated the effect of a hygiene protocol on DRS remission, local inflammatory factors, and hemodynamic responses. Thirty-three individuals were enrolled in the study. The outcomes were measured before and after 10 days of a hygiene protocol treatment consisting of brushing the palate with a soft brush and water and denture brushing with a denture-specific brush and mild soap, as well as immersion of the denture for 20 min in a 0.25% sodium hypochlorite solution. Data were analyzed by paired Wilcoxon for biofilm removal and CFU count of microorganisms. The paired T test was used to assess salivary MUC 1, cytokines, and arterial pressure (p < 0.05). A significant difference was found in the DRS degree (p < 0.001), biofilm (p < 0.001), microbial load of Candida spp. (p < 0.001), Gram-negative (p < 0.004), Staphylococcus spp. (p < 0.001), and S. mutans (p < 0.001) of the denture, and S. mutans (p < 0.001) of the palate after use of the protocol. The salivary flow (p = 0.2) and pH (p = 0.97) did not change; there was an increase of MUC 1 (p = 0.049) and a decrease in IL-6 (p = 0.038), IL-2 (p = 0.04), IL-10 (p = 0.041), and IFNγ (p = 0.04). There was also a decrease in systolic (p = 0.012) and mean arterial pressure (p = 0.02). The current hygiene protocol reduced the inflammation degree of DRS and promoted an improvement of local inflammatory factors and a reduction in the systolic arterial pressure of the patients.
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Affiliation(s)
- Adriana Barbosa Ribeiro
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Aline Barbosa Ribeiro
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Camila Borba de Araújo
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Caroline Vieira Fortes
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Lorena Mosconi Clemente
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Helena de Freitas Oliveira Paranhos
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Evandro Watanabe
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Helio Cesar Salgado
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Cláudia Helena Silva-Lovato
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
- Correspondence: ; Tel.: +55-16-3315-4006
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Dakka A, Nazir Z, Shamim H, Jean M, Umair M, Muddaloor P, Farinango M, Ansary A, Khan S. Ill Effects and Complications Associated to Removable Dentures With Improper Use and Poor Oral Hygiene: A Systematic Review. Cureus 2022; 14:e28144. [PMID: 36148203 PMCID: PMC9482451 DOI: 10.7759/cureus.28144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2022] [Indexed: 11/05/2022] Open
Abstract
The importance of oral care and its relationship with an individual's well-being has been identified over the past few decades. As there is a drastic increase in the aging population, so did the use of removable dentures more than ever before. The use of dentures among the elderly provides functional advantages and esthetic benefits. However, improper use and poor oral hygiene with removable dentures come with complications, including denture stomatitis, ulcerations, pneumonia, and many more. The study aims to determine the complications associated with inappropriate use and poor oral care and bring forth evidence-based dentist-recommended guidelines for denture maintenance. Articles were systematically screened in PubMed/Medline (Medical Literature Analysis and Retrieval System Online), PubMed Central (PMC), and Cochrane Library using keywords. Medical Subject Heading (MeSH) was also utilized to identify relevant articles. Inclusion and exclusion criteria were applied, duplicate articles were discarded, and then the articles were reviewed by title and abstract screening. The remaining articles went through a detailed full-text review. A quality appraisal check was conducted for each unique type of research publication, after which a total of 22 articles were finalized. In this study, we have seen pathological biofilm formation on dentures, life-threatening pneumonia, denture stomatitis, and accidental ingestion/aspiration of dentures amongst the elderly population. The study also identified members with low literacy rates, minorities, and low-income families seem to be at higher risk of poor oral care and denture hygiene. We identified that most of these complications could be prevented with proper guidance and education. In the future, a further detailed study is important as no clear consensus exists in terms of best practices of denture cleaning methods. In addition, measures should be initiated to encourage regular dentist appointments and increase accessibility among members of low socioeconomic status and minorities.
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Affiliation(s)
- Amulya Dakka
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Zahra Nazir
- Internal Medicine Clinical Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Humaira Shamim
- Dermatology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Marie Jean
- Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Muaaz Umair
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Pratyusha Muddaloor
- General Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Michelle Farinango
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Akhil Ansary
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
- Clinical Sciences, St. Martinus University Faculty of Medicine, Willemstad, CUW
| | - Safeera Khan
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Le Bars P, Kouadio AA, Bandiaky ON, Le Guéhennec L, de La Cochetière MF. Host's Immunity and Candida Species Associated with Denture Stomatitis: A Narrative Review. Microorganisms 2022; 10:microorganisms10071437. [PMID: 35889156 PMCID: PMC9323190 DOI: 10.3390/microorganisms10071437] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 02/04/2023] Open
Abstract
Denture-related Candida stomatitis, which has been described clinically in the literature, is either localized or generalized inflammation of the oral mucosa in connection with a removable prosthesis. During this inflammatory process, the mycobacterial biofilm and the host’s immune response play an essential role. Among microorganisms of this mixed biofilm, the Candida species proliferates easily and changes from a commensal to an opportunistic pathogen. In this situation, the relationship between the Candida spp. and the host is influenced by the presence of the denture and conditioned both by the immune response and the oral microbiota. Specifically, this fungus is able to hijack the innate immune system of its host to cause infection. Additionally, older edentulous wearers of dentures may experience an imbalanced and decreased oral microbiome diversity. Under these conditions, the immune deficiency of these aging patients often promotes the spread of commensals and pathogens. The present narrative review aimed to analyze the innate and adaptive immune responses of patients with denture stomatitis and more particularly the involvement of Candida albicans sp. associated with this pathology.
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Affiliation(s)
- Pierre Le Bars
- Department of Prosthetic Dentistry, Faculty of Dentistry, Nantes University, 1 Place Alexis Ricordeau, 44042 Nantes, France; (A.A.K.); (O.N.B.); (L.L.G.)
- Correspondence: authors:
| | - Alain Ayepa Kouadio
- Department of Prosthetic Dentistry, Faculty of Dentistry, Nantes University, 1 Place Alexis Ricordeau, 44042 Nantes, France; (A.A.K.); (O.N.B.); (L.L.G.)
- Department of Prosthetic Dentistry, Faculty of Dentistry, CHU, Abidjan P.O. Box 612, Côte d’Ivoire
| | - Octave Nadile Bandiaky
- Department of Prosthetic Dentistry, Faculty of Dentistry, Nantes University, 1 Place Alexis Ricordeau, 44042 Nantes, France; (A.A.K.); (O.N.B.); (L.L.G.)
| | - Laurent Le Guéhennec
- Department of Prosthetic Dentistry, Faculty of Dentistry, Nantes University, 1 Place Alexis Ricordeau, 44042 Nantes, France; (A.A.K.); (O.N.B.); (L.L.G.)
| | - Marie-France de La Cochetière
- EA 3826 Thérapeutiques Cliniques Et expérimentales des Infections, Faculté de Médecine, CHU Hôtel-Dieu, Université de Nantes, 1, rue G. Veil, 44000 Nantes, France;
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Barbosa Ribeiro A, Borba Araújo C, Vieira Fortes C, Lucarini Bueno F, de Cássia Oliveira V, Macedo AP, de Freitas Oliveira Paranhos H, Watanabe E, De Wever B, Helena Silva-Lovato C. Effect of Denture Hygiene Protocols on Patient Satisfaction, Oral Health-Related Quality Of Life, and Salivary Parameters: A Randomized Clinical Trial. J Prosthodont 2022; 31:e12-e19. [PMID: 35150590 DOI: 10.1111/jopr.13494] [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: 06/22/2021] [Accepted: 02/08/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This randomized controlled trial compared four denture hygiene protocols in terms of patient satisfaction, oral health-related quality of life (OHRQoL), and salivary parameters in complete denture wearers with denture stomatitis. MATERIAL AND METHODS For this randomized, double-blind controlled clinical trial, 108 participants were assigned to soak their dentures in one of the following solutions: (1) 0.25% sodium hypochlorite (positive control), (2) 0.15% Triclosan, (3) denture disinfecting tablets, or (4) denture disinfecting tablets plus palatine mucosa brushing solution. The outcomes of patient satisfaction, OHRQoL, and salivary parameters (salivary flow rate and pH) were measured at baseline and after 10 days. Results were compared by Kruskal-Wallis, between-group by the Dunn test, and Wilcoxon tests between times (α = 0.05). RESULTS After the hygiene protocols, and when compared with baseline, the overall patient satisfaction, maxillary denture satisfaction, maxillary denture comfort, and maxillary denture retention were ameliorated. A significant improvement was noted in OHRQoL in 3 of 4 domains evaluated (orofacial pain and discomfort, masticatory discomfort and disability, and psychological disability and discomfort). The salivary flow rate (unstimulated and stimulated); and pH were not significantly affected at the times evaluated. CONCLUSIONS Complete denture wearers may feel more satisfied with their complete dentures when treated for denture stomatitis. The tested treatments lead to similar improvement in terms of patient satisfaction and OHRQoL. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Adriana Barbosa Ribeiro
- Department of Dental Materials and Prothesis; School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Camila Borba Araújo
- Department of Dental Materials and Prothesis; School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Caroline Vieira Fortes
- Department of Dental Materials and Prothesis; School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Frank Lucarini Bueno
- Department of Dental Materials and Prothesis; School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Viviane de Cássia Oliveira
- Department of Dental Materials and Prothesis; School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Ana Paula Macedo
- Department of Dental Materials and Prothesis; School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Helena de Freitas Oliveira Paranhos
- Department of Dental Materials and Prothesis; School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Evandro Watanabe
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Bart De Wever
- Chief Scientific Officer, bonyf AG, Vaduz, Liechtenstein
| | - Cláudia Helena Silva-Lovato
- Department of Dental Materials and Prothesis; School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil
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Development of a United Kingdom-centric cost-effectiveness model for denture cleaning strategies. J Prosthet Dent 2021; 127:266.e1-266.e7. [PMID: 34895901 DOI: 10.1016/j.prosdent.2021.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 10/22/2021] [Accepted: 10/22/2021] [Indexed: 11/24/2022]
Abstract
STATEMENT OF PROBLEM Denture stomatitis is a prevalent condition in denture wearers. Economic evaluations of health care can help stakeholders, including patients, make better decisions about treatments for a given condition. Economic models to assess the costs and benefits of different options for managing denture stomatitis are lacking. PURPOSE The purpose of this study was to explore the feasibility of developing a cost-effectiveness model to assess denture cleaning strategies aimed at preventing denture stomatitis from a denture-wearer perspective in the United Kingdom. MATERIAL AND METHODS A model was developed to identify and estimate the costs and effects associated with 3 denture cleaning strategies. These were low care (LC)-cleaning by brushing and soaking overnight in water; medium care (MC)-brushing with toothpaste and soaking overnight in water; and optimum care (OC)-brushing and soaking overnight in water and antimicrobial denture cleanser. Costs, outcome measures (denture stomatitis-free days), and probabilities (incidence of stomatitis, unscheduled dentist visits, prescription charges, self-medication) associated with each strategy were defined. A sensitivity analysis was used to identify key drivers and test the robustness of the model. RESULTS The model showed that the total costs for 2015 ranged from £1.07 (LC) to £18.42 (OC). Costs associated with LC were derived from unscheduled dentist visits and use of medication and/or prescription charges. Incremental costs per denture stomatitis-free day were £0.64 (MC) and £1.81 (OC) compared with LC. A sensitivity analysis showed that varying either or both key parameters (baseline incidence of denture stomatitis and relative effectiveness of MC and OC strategies) had a substantial effect. Incremental cost-effectiveness ratios ranged from £4.11 to £7.39 (worst-case scenario) and from £0.21 to £0.61 (best-case scenario). CONCLUSIONS A model was developed to assess the relative cost-effectiveness of different denture cleaning strategies to help improve denture hygiene. An important finding of the study was the lack of evidence on the relative effectiveness of different cleaning strategies, meaning that several assumptions had to be incorporated into the model. The model output would therefore likely be considerably improved and more robust if these evidence gaps were filled.
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In Vitro Biofilm Formation on Aryl Ketone Polymer (AKP), A New Denture Material, Compared with That on Three Traditional Dental Denture Materials. Int J Dent 2021; 2021:4713510. [PMID: 34737774 PMCID: PMC8563116 DOI: 10.1155/2021/4713510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 09/28/2021] [Accepted: 10/01/2021] [Indexed: 12/27/2022] Open
Abstract
Control of denture plaque biofilms is a practical approach to preventing persistent oral infections such as denture stomatitis. Objectives. This study compared in vitro biofilm attachment and growth on a new denture material, Ultaire® AKP, with that on traditional denture materials including cobalt chrome (CoCr), polymethyl methacrylate (PMMA), and polyoxymethylene (POM). Methods. Microbial biofilms were grown with cultures of Candida albicans, Streptococcus mutans UA159, or a mixed Streptococcus spp. (S. mutans 700610/Streptococcus sanguinis BAA-1455) for 6 hours in a static protocol or 24 hours in a dynamic protocol for each material. Adherent biofilm cells were removed, and viable colony-forming units (CFUs) were enumerated. Confocal microscopy of the 24-hour Streptococcus spp. biofilms was used to determine biofilm mass and roughness coefficients. Results. The rank order of C. albicans attachment after 6 hours was CoCr > PMMA ∗ > Ultaire® AKP ∗ ( ∗ vs CoCr, p ≤ 0.05), and that for 24-hour biofilm growth was CoCr > Ultaire® AKP ∗ > PMMA ∗ ( ∗ vs CoCr, p ≤ 0.05). The rank order of S. mutans biofilm attachment was CoCr > POM > Ultaire® AKP ∗ > PMMA ∗ ( ∗ vs CoCr, p ≤ 0.05), and that for the 24-hour Streptococcus spp. biofilm growth was POM > Ultaire® AKP > PMMA > CoCr ∗ ( ∗ vs POM, p ≤ 0.05). Confocal images revealed structural differences in Streptococcus spp. biofilms on CoCr compared with the other test materials. Significantly lower roughness coefficients of Streptococcus spp. biofilms on Ultaire® AKP were noted, suggesting that these biofilms were less differentiated. Ultaire® AKP promoted significantly less C. albicans and S. mutans biofilm attachment than CoCr at 6 hours and C. albicans growth at 24 hours. Streptococcus spp. biofilms on Ultaire® AKP were less differentiated than those on other test materials. Conclusion. In addition to its material strength, Ultaire® AKP represents an attractive option for denture material in removable partial dentures.
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Araujo CB, Ribeiro AB, Fortes CV, Bueno FL, De Wever B, Oliveira VC, Macedo AP, Paranhos HFO, da Silva CHL. Effect of local hygiene protocols on denture-related stomatitis, biofilm, microbial load, and odor: A randomized controlled trial. J Prosthet Dent 2021; 128:664-673. [PMID: 33736863 DOI: 10.1016/j.prosdent.2020.12.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 12/18/2020] [Accepted: 12/18/2020] [Indexed: 12/20/2022]
Abstract
STATEMENT OF PROBLEM Denture stomatitis affects complete denture wearers and is frequently treated with antifungals drugs, as well as treating the denture with sodium hypochlorite. Whether the limitations of these treatments can be overcome with local hygiene protocols that do not damage the denture materials or adversely affect the patient is unclear. PURPOSE The purpose of this randomized controlled trial was to evaluate the effect of denture hygiene protocols on complete denture wearers with denture stomatitis. MATERIAL AND METHODS For this randomized, double-blind controlled clinical trial, 108 participants were assigned to parallel groups: 0.25% sodium hypochlorite (positive control) 0.15% Triclosan, denture cleaning tablets, or denture cleaning tablets plus gingival cleaning tablets. The participants were instructed to brush the dentures and the palate and immerse the denture in the solutions. The outcomes of denture stomatitis remission, biofilm removal, decrease of microbial load (colony-forming units), and odor level of the mouth and denture were measured at baseline and after 10 days. Descriptive analyses were used for sociodemographic characterization of the participants; the Pearson chi-square test was used to compare participant frequency with different degrees of denture stomatitis. The data were not normally distributed (Shapiro-Wilks test) or homogeneous (Levene test). So, the Kruskal-Wallis and Dunn post hoc tests and Wilcoxon test were used to compare the effects of solutions and time on the variables (α=.05). RESULTS The frequency of the highest to lowest denture stomatitis scores was significantly different for the 0.15% Triclosan and denture cleaning tablets groups. No significant difference was found among the groups in terms of denture stomatitis scores, biofilm, or colony-forming unit count of Candida spp. or C. albicans and S. mutans; a significant reduction was found in these parameters. The 0.25% sodium hypochlorite and 0.15% Triclosan treatments caused a significant reduction in Gram-negative microorganisms; these 2 protocols, and the denture cleaning tablets showed a significant reduction in Staphylococcus spp.; all protocols had similar effects. Only the S. mutans count of the palate decreased after 10 days. The odor level of the mouth and the denture was not significantly different (P=.778). CONCLUSIONS The evaluated protocols can be recommended for the hygiene of complete dentures, since they were effective for all the variables studied.
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Affiliation(s)
- Camila B Araujo
- Master student, Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Adriana B Ribeiro
- Collaboration Professor, Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Caroline V Fortes
- Master student, Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Frank L Bueno
- Doctoral student, Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Bart De Wever
- Chief Scientific Officer, bonyf AG, Vaduz, Liechtenstein
| | - Viviane C Oliveira
- Specialized Laboratory Technician, Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Ana P Macedo
- Specialized Laboratory Technician, Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Helena F O Paranhos
- Titular professor, Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Claudia Helena Lovato da Silva
- Titular professor, Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil.
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Abstract
With the projected increase to 1.3 billion people aged 65 years or older by 2040, healthcare professionals are faced with significant challenges in managing this population of patients. In the oral cavity, oral mucosal disease is a significant problem found in older populations. Several facial pain conditions are more likely to be seen in this cohort of patients. Although management of this group of patients may not always be appropriate in general practice, an awareness of the range of oral medicine conditions that may be encountered in older patients is essential to allow prompt referral and treatment.
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Affiliation(s)
- Jayne Patterson
- DCT2 Oral Surgery & Oral Medicine, School of Dentistry, Belfast
| | - Amanda Willis
- Senior Clinical Lecturer/Consultant in Oral Medicine, Department of Oral Medicine, School of Dentistry, Queens University Belfast and Belfast Health and Social Care Trust
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13
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Reinhardt LC, Nascente PS, Ribeiro JS, Guimarães VBS, Etges A, Lund RG. Sensitivity to antifungals by Candida spp samples isolated from cases of chronic atrophic candidiasis (CAC). BRAZ J BIOL 2020; 80:266-272. [PMID: 31291399 DOI: 10.1590/1519-6984.190454] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 09/10/2018] [Indexed: 01/23/2023] Open
Abstract
The treatment of choice for chronic atrophic candidiasis (CAC), also known as denture stomatitis, is topical antifungal therapy. This study aimed to isolate, identify, and assess the antifungal susceptibility of Candida species from mucosal sites in denture wearers with a diagnosis of CAC and determine the prevalence of associated variables. The sample consisted of 44 patients wearing complete or partial dentures who had a clinical diagnosis of CAC. Using sterile cotton swabs, specimens were collected from the oral mucosa of all patients and grown at 30ºC for 48 h in CHROMagar Candida, as a means of isolating and screening the species. The complementary identification of the species was performed using the VITEK 2 automated system (BioMérieux), as well as the determination of their susceptibility to antifungal agents. Data were analyzed using the chi-square test. STATA 13.1 was used for statistical analysis (α = 5%). Of 44 patients with CAC, 33 (75%) had lesions classified as Newton type II. Yeasts were isolated in 38 cases. The most prevalent species was Candida albicans. None of the isolates were resistant to the antifungals tested. Our findings suggest that current indications for antifungal agents are appropriate. Also, antifungal susceptibility testing and proper fungal identification can help dentists to determine the optimal course of treatment for CAC.
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Affiliation(s)
- L C Reinhardt
- Programa de Pós-graduação em Odontologia - PPGO, Laboratório de Microbiologia Oral, Faculdade de Odontologia, Universidade Federal de Pelotas - UFPel, Rua Gonçalves Chaves, 457, Sala 702/3, CEP , Pelotas, RS, Brasil
| | - P S Nascente
- Programa de Pós-graduação em Bioquímica e Bioprospecção - PPGBBio, Departamento de Microbiologia e Parasitologia, Laboratório de Micologia, Universidade Federal de Pelotas - UFPel, Campus Universitário Capão do Leão, s/n, , Capão do Leão, RS, Brasil
| | - J S Ribeiro
- Programa de Pós-graduação em Odontologia - PPGO, Laboratório de Microbiologia Oral, Faculdade de Odontologia, Universidade Federal de Pelotas - UFPel, Rua Gonçalves Chaves, 457, Sala 702/3, CEP , Pelotas, RS, Brasil
| | - V B S Guimarães
- Programa de Pós-graduação em Odontologia - PPGO, Laboratório de Microbiologia Oral, Faculdade de Odontologia, Universidade Federal de Pelotas - UFPel, Rua Gonçalves Chaves, 457, Sala 702/3, CEP , Pelotas, RS, Brasil
| | - A Etges
- Centro de Diagnóstico e Doenças da Boca - CDDB, Faculdade de Odontologia, Universidade Federal de Pelotas - UFPel, Rua Gonçalves Chaves, 457, Sala 607, CEP , Pelotas, RS, Brasil
| | - R G Lund
- Programa de Pós-graduação em Odontologia - PPGO, Laboratório de Microbiologia Oral, Faculdade de Odontologia, Universidade Federal de Pelotas - UFPel, Rua Gonçalves Chaves, 457, Sala 702/3, CEP , Pelotas, RS, Brasil.,Programa de Pós-graduação em Bioquímica e Bioprospecção - PPGBBio, Departamento de Microbiologia e Parasitologia, Laboratório de Micologia, Universidade Federal de Pelotas - UFPel, Campus Universitário Capão do Leão, s/n, , Capão do Leão, RS, Brasil
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14
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Ribeiro AB, de Araújo CB, Silva LEV, Fazan-Junior R, Salgado HC, Ribeiro AB, Fortes CV, Bueno FL, de Oliveira VC, de F O Paranhos H, Watanabe E, da Silva-Lovato CH. Hygiene protocols for the treatment of denture-related stomatitis: local and systemic parameters analysis - a randomized, double-blind trial protocol. Trials 2019; 20:661. [PMID: 31783777 PMCID: PMC6884795 DOI: 10.1186/s13063-019-3854-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 10/25/2019] [Indexed: 12/15/2022] Open
Abstract
Background Denture-related stomatitis (DS) is chronic multifactorial inflammation, strongly related to the presence of the biofilm that is the complex structure formed by microorganisms held together by a mucus-like matrix of carbohydrate that adheres to different surfaces, including the denture surface. DS has recently been correlated with deleterious cardiovascular alterations. The potential effect of hygiene protocols in the control of DS and randomized clinical trials that address this oral condition with cardiovascular complications are important in clinical decision-making. Material/design A clinical trial, randomized, double-blind, and with parallel groups, will be conducted in Brazil The sample will consist of 100 patients without teeth in both arches, users of at least maxillary complete dentures, and diagnosed with DS, who will be allocated to groups (n = 25 per group) according to the different hygiene protocols: (1) brushing of the palate and immersion of the prosthesis in 0.25% sodium hypochlorite solution (positive control); (2) brushing of the palate and immersion of the prosthesis in 0.15% triclosan solution; (3) brushing of the palate and immersion of the prosthesis in lactose monohydrate; or (4) brushing the palate with citric acid and immersing the prosthesis in lactose monohydrate. The response variables will be heart rate variability and alteration of blood pressure (systemic level), remission of DS, removal of biofilm, reduction of microbial load (colony-forming units (CFU)), mouth and prosthesis odor level, expression of MUC1, proinflammatory cytokines, C-reactive protein (CRP), viscosity, pH and salivary flow (locally); patient-centred qualitative analysis will also be undertaken. Measurements will be performed at baseline and 10 days after the interventions. The results obtained will be statistically analyzed as pertinent, with a level of significance of 0.05. Discussion This study will provide a guideline for clinical practice regarding the use of hygiene protocols in the treatment of oral diseases (DS) mediated by biofilm. Also, it may provide evidence of correlation of oral manifestation with cardiac risk. Trial registration Brazilian Registry of Clinical Trials, RBR-4hhwjb. Registered on 9 November 2018.
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Affiliation(s)
- Adriana B Ribeiro
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Camila B de Araújo
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Luiz Eduardo V Silva
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Rubens Fazan-Junior
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Helio C Salgado
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Aline B Ribeiro
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Caroline V Fortes
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Frank L Bueno
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Viviane C de Oliveira
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Helena de F O Paranhos
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Evandro Watanabe
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Cláudia H da Silva-Lovato
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil.
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15
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Khiyani MF, Ahmadi M, Barbeau J, Feine JS, de Souza RF, Siqueira WL, Emami E. Salivary Biomarkers in Denture Stomatitis: A Systematic Review. JDR Clin Trans Res 2019; 4:312-322. [PMID: 30931724 DOI: 10.1177/2380084419830941] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Denture stomatitis (DS) is an oral biofilm-associated inflammation of the denture-bearing mucosa. The objective of this review was to identify and evaluate the quality of evidence on the association between the levels of salivary biomarkers and DS among adults with and without palatal DS. MATERIALS AND METHODS Following the PRISMA guidelines, Medline, PubMed, EMBASE, and the Cochrane Central Register for Controlled Trials were searched for eligible studies from the beginning of the archives until December 2018. Experimental and observational studies with adult participants were included that had a control group or subgroup analysis and provided data on salivary biomarkers and DS. Articles in languages other than English or French were excluded. The level of evidence and grades of recommendation were established with the 2011 scale of the Oxford Centre for Evidence-Based Medicine. Additionally, the assessment of methodological quality was conducted with the STROBE statement (Strengthening the Reporting of Observational Studies in Epidemiology) and graded according to the Olmos scale. RESULTS From 1,008 citations, 9 studies were included in the systematic review (8 observational, 1 clinical trial). Seven studies suggested a statistically significant difference in the levels of salivary cytokines (IL-6, CCL3, TGF-β, CXCL8, GM-CSF, and TNF-α) between participants with DS and controls (P < 0.05). In contrast, 2 studies concluded that the difference in the levels of several salivary cytokines (IL2, IL12, IFN-g, IL-4, IL-8, IL-10, IL-17, TNF-α, and ICAM-1) between the groups was not statistically significant. The level of evidence for the majority of studies was 3, while the grade of recommendation for all the studies was B, interpreted as "favorable." In terms of methodological quality, most studies met 50% to 80% of STROBE criteria and were graded B. CONCLUSION Palatal inflammation in DS is significantly associated with the levels of salivary cytokines. KNOWLEDGE TRANSFER STATEMENT The results of this study identified altered levels of specific salivary biomarkers associated with denture stomatitis, which may aid in the early diagnosis and treatment of this disease.
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Affiliation(s)
- M F Khiyani
- Faculty of Dental Medicine, Université de Montréal, Montreal, QC, Canada
| | - M Ahmadi
- Faculty of Dental Medicine, Université de Montréal, Montreal, QC, Canada
| | - J Barbeau
- Faculty of Dental Medicine, Université de Montréal, Montreal, QC, Canada
| | - J S Feine
- Faculty of Dentistry, McGill University, Montréal, QC, Canada
| | - R F de Souza
- Faculty of Dentistry, McGill University, Montréal, QC, Canada
| | - W L Siqueira
- Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
| | - E Emami
- Faculty of Dental Medicine, Université de Montréal, Montreal, QC, Canada.,Faculty of Dentistry, McGill University, Montréal, QC, Canada
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Reinhardt LC, Nascente PDS, Ribeiro JS, Etges A, Lund RG. A single-center 18-year experience with oral candidiasis in Brazil: a retrospective study of 1,534 cases. Braz Oral Res 2018; 32:e92. [PMID: 30231172 DOI: 10.1590/1807-3107bor-2018.vol32.0092] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 07/25/2018] [Indexed: 11/22/2022] Open
Abstract
Despite the large number of published studies about oral candidiasis and associated risk factors, reports of large single-center retrospective studies on the prevalence of oral candidiasis, risk factors, and the oral candidiasis types diagnosed more frequently in oral diagnostic reference centers are scarce. The objective of the present study was to retrospectively survey the demographic and clinical profiles of 1,534 patients diagnosed with candidiasis and treated at the Center for Diagnosis of Oral Diseases (CDOD), Pelotas Dental School, Federal University of Pelotas between 1997 and 2014. Using a retrospective, cross-sectional, epidemiological design, data on race, gender, age, systemic diseases, oral candidiasis type and location, symptoms, and harmful habits such as smoking and alcohol consumption were collected. The statistical analysis was performed using STATA version 13.1. Risk factors for chronic atrophic candidiasis (CAC) were evaluated using Poisson regression with robust variance (p ≤ 0.05). The majority of patients with oral candidiasis seen at the CDOD over the 18-year period of analysis were Caucasian women, aged 51-60 years, nonsmokers, and nondrinkers, with no systemic disease, and who wore some form of dental prostheses. CAC was the single most common clinical type of candidiasis detected, and the most frequently affected oral site was the palate. These data from a large single-center in Brazil agree with previous evidence about the clinical and demographic profiles of patients with oral candidiasis.
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Affiliation(s)
- Leandro Calcagno Reinhardt
- Post-Graduate Program in Dentistry, School of Dentistry, Universidade Federal de Pelotas - UFPel, Pelotas, RS, Brazil
| | - Patricia da Silva Nascente
- Department of Microbiology and Parasitology, Institute of Biology, Universidade Federal de Pelotas - UFPel, Capão do Leão, RS, Brazil
| | - Juliana Silva Ribeiro
- Post-Graduate Program in Dentistry, School of Dentistry, Universidade Federal de Pelotas - UFPel, Pelotas, RS, Brazil
| | - Adriana Etges
- Post-Graduate Program in Dentistry, School of Dentistry, Universidade Federal de Pelotas - UFPel, Pelotas, RS, Brazil
| | - Rafael Guerra Lund
- Post-Graduate Program in Dentistry, School of Dentistry, Universidade Federal de Pelotas - UFPel, Pelotas, RS, Brazil
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17
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Osmenda G, Maciąg J, Wilk G, Maciąg A, Nowakowski D, Loster J, Dembowska E, Robertson D, Guzik T, Cześnikiewicz-Guzik M. Treatment of denture-related stomatitis improves endothelial function assessed by flow-mediated vascular dilation. Arch Med Sci 2017; 13:66-74. [PMID: 28144257 PMCID: PMC5206372 DOI: 10.5114/aoms.2017.64715] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 12/01/2015] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION The presence of oral inflammation has recently been linked with the pathogenesis of cardiovascular diseases. While numerous studies have described links between periodontitis and endothelial dysfunction, little is known about the influence of denture-related stomatitis (DRS) on cardiovascular risk. Therefore, the aim of this study was to determine whether the treatment of DRS can lead to improvement of the clinical measures of vascular dysfunction. MATERIAL AND METHODS The DRS patients were treated with a local oral antifungal agent for 3 weeks. Blood pressure, flow-mediated dilatation (FMD) and nitroglycerine-mediated vascular dilatation (NMD) were measured during three study visits: before treatment, one day and two months after conclusion of antifungal therapy. RESULTS Flow-mediated dilatation measurements showed significant improvement of endothelial function 2 months after treatment (FMD median 5%, 95 CI: 3-8.3 vs. 11%, 95% CI: 8.8-14.4; p < 0.01), while there was no difference in control, endothelium-independent vasorelaxations (NMD; median = 15.3%, 95% CI: 10.8-19.3 vs. 12.7%, 95% CI: 10.6-15; p = 0.3). Other cardiovascular parameters such as systolic (median = 125 mm Hg; 95% CI: 116-129 vs. 120 mm Hg, 95% CI: 116-126; p = 0.1) as well as diastolic blood pressure and heart rate (median = 65.5 bpm, 95% CI: 56.7-77.7 vs. 71 bpm, 95% CI: 66.7-75; p = 0.5) did not change during or after the treatment. CONCLUSIONS Treatment of DRS is associated with improvement of endothelial function. Since endothelial dysfunction is known to precede the development of severe cardiovascular disorders such as atherosclerosis and hypertension, patients should be more carefully screened for DRS in general dental practice, and immediate DRS treatment should be advised.
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Affiliation(s)
- Grzegorz Osmenda
- Department of Internal and Agricultural Medicine, Jagiellonian University Collegium Medicum, Krakow, Poland
| | - Joanna Maciąg
- Department of Dental Prophylaxis and Experimental Dentistry, Dental School, Jagiellonian University, Krakow, Poland
| | - Grzegorz Wilk
- Department of Internal and Agricultural Medicine, Jagiellonian University Collegium Medicum, Krakow, Poland
| | - Anna Maciąg
- Zbigniew Żak Voivodeship Dental Clinic, Krakow, Poland
| | - Daniel Nowakowski
- Department of Dental Prophylaxis and Experimental Dentistry, Dental School, Jagiellonian University, Krakow, Poland
| | - Jolanta Loster
- Department of Prosthodontics, Dental School, Jagiellonian University, Krakow, Poland
| | - Elżbieta Dembowska
- Department of Periodontology, Dental School, Pomeranian Medical University, Szczecin, Poland
| | - Douglas Robertson
- Oral Sciences Research Group, Glasgow Dental School, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Tomasz Guzik
- Department of Internal and Agricultural Medicine, Jagiellonian University Collegium Medicum, Krakow, Poland
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Marta Cześnikiewicz-Guzik
- Department of Dental Prophylaxis and Experimental Dentistry, Dental School, Jagiellonian University, Krakow, Poland
- Oral Sciences Research Group, Glasgow Dental School, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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18
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Maciąg J, Mikołajczyk T, Matusik P, Nosalski R, Sagan A, Maciąg A, Nowakowski D, Wilk G, Osmenda G, Guzik T, Cześnikiewicz-Guzik M. Systemic T Cells and Monocyte Characteristics in Patients with Denture Stomatitis. J Prosthodont 2016; 26:19-28. [PMID: 26883670 DOI: 10.1111/jopr.12447] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2015] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Chronic inflammatory disorders of the oral cavity, such as periodontitis, were recently linked to systemic immune activation. Since fungal oral infections have not yet been studied in this respect, the aim of our study is to determine whether the local inflammation caused by oral fungal infection of the palatal tissue (denture stomatitis-DS) is associated with the systemic inflammatory response. This question is becoming essential as the population ages. MATERIALS AND METHODS Peripheral blood of DS patients (n = 20) and control patients (n = 24) was assessed with flow cytometry to determine lymphocyte and monocyte profiles. Intracellular cytometric analysis was carried out to establish cytokine production by T cells. DS was diagnosed based on clinical symptoms of DS such as swelling and redness of oral mucosa, confirmed by microbiological swabs for fungal colonization with Candida species. The control group was recruited from denture users without clinical and microbiological signs of oral infections. RESULTS Percentages of peripheral lymphocytes, T cells, monocytes, and their subpopulations were similar in both studied groups. The exception was median percentages of CD25+ T cell subsets, which were significantly lower in DS patients than in control subjects. This reduction was observed in both CD4 T cell subset (16.7% and 28.1%; p = 0.0006) and CD8 T cell subset (4.6% and 7.0%; p = 0.007) CONCLUSIONS: While DS and associated local fungal infection do not overtly affect activation of monocytes or lymphocytes, the number of CD 25+ T cells is significantly lower in the DS patients, possibly indicating limited potential for the infection clearance in denture-using aging patients.
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Affiliation(s)
- Joanna Maciąg
- Institute of Dentistry, Department of Dental Prophylaxis and Experimental Dentistry, Jagiellonian University Medical College, Cracow, Poland
| | - Tomasz Mikołajczyk
- Department of Internal and Agricultural Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Paweł Matusik
- Department of Internal and Agricultural Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Ryszard Nosalski
- Department of Internal and Agricultural Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Agnieszka Sagan
- Department of Internal and Agricultural Medicine, Jagiellonian University Medical College, Cracow, Poland.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Anna Maciąg
- Zbigniew Żak Voivodeship Dental Clinic, Cracow, Poland
| | - Daniel Nowakowski
- Institute of Dentistry, Department of Dental Prophylaxis and Experimental Dentistry, Jagiellonian University Medical College, Cracow, Poland
| | - Grzegorz Wilk
- Department of Internal and Agricultural Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Grzegorz Osmenda
- Department of Internal and Agricultural Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Tomasz Guzik
- Department of Internal and Agricultural Medicine, Jagiellonian University Medical College, Cracow, Poland.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Marta Cześnikiewicz-Guzik
- Institute of Dentistry, Department of Dental Prophylaxis and Experimental Dentistry, Jagiellonian University Medical College, Cracow, Poland.,Infection and Immunity Research Group, Glasgow Dental School, University of Glasgow, Glasgow, UK
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Affiliation(s)
- Tanya Walsh
- School of Dentistry, The University of Manchester; JR Moore Building Oxford Road Manchester UK M13 9PL
| | - Philip Riley
- School of Dentistry, The University of Manchester; Cochrane Oral Health Group; JR Moore Building Oxford Road Manchester UK M13 9PL
| | - Analia Veitz-Keenan
- New York University College of Dentistry; Oral Maxillofacial Pathology, Radiology and Medicine; 345 East 24th Street NYC 1st floor New York USA 10010
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