Prevalence of Denture-Related Stomatitis in Edentulous Patients at a Tertiary Dental Teaching Hospital

Comparative efficacy of photobiomodulation on osseointegration in dental implants: A systematic review and meta-analysis

AIM

This study aimed to assess the effectiveness of photobiomodulation therapy (PBM) in enhancing bone integration with dental implants.

METHOD

PubMed, ScienceDirect, the Cochrane Library, Scopus, and Google Scholar were searched. Studies assessing PBM effectiveness with defined intervention/control groups were included, while those lacking specified laser types, involving severe maxillofacial defects or surgery, and not reporting outcomes related to dental implant osseointegration post-PBM therapy were excluded. The studies' risk of bias was assessed using Robvis for randomized controlled trials (RCTs) and ROBINS-I for non-RCTs. The meta-analysis was conducted utilizing a random-effects model at a significance level of 0.01.

RESULTS

The study reviewed 26 papers involving 571 patients undergoing dental implant procedures with PBM/Low-Level Laser Therapy (LLLT) or placebo/control. Implant stability quotients (ISQ) analysis showed a non-significant difference (p = 0.06, mean difference: 1.02, 95 % CI: 0.28 to 1.75, I2=28 %), while the Periotest method indicated significant improvement in stability (p < 0.01, mean difference: -0.51, 95 % CI: -0.78 to -0.24, I2=71 %). PBM resulted in a significant bone density increase (p < 0.01, mean difference: 26, 95 % CI: 6.93 to 45.06, I2=91 %), but marginal bone loss showed no significant difference (p = 0.11, mean difference: 0.00, 95 % CI: -0.06 to 0.05, I2=45 %). Implant survival rate did not significantly differ (p = 0.73, mean difference: 1.56, 95 % CI: 0.38 to 6.46, I2=0 %). Most studies raised concerns regarding randomization.

CONCLUSION

PBM could improve implant stability, as assessed with Periotest, and increase bone density, enhancing osseointegration. However, implant stability assessed with ISQ, marginal bone loss, and implant survival rate were comparable between the study groups.

A Systematic Review of Denture Stomatitis: Predisposing Factors, Clinical Features, Etiology, and Global Candida spp. Distribution

Denture stomatitis (DS) is a very common disease in wearers of removable complete and partial dentures with a worldwide prevalence in the range of 20-67%. Both industrially developed and impoverished nations are affected by the illness. DS is often associated with ill-fitting dentures or a fungal infection with Candida spp. Candida is normally found in the oral cavity microbiota, but it can be harmful to the health of elderly people with underlying diseases. Therefore, the purpose of the present study is to offer the most recent information about the epidemiology, etiology, and global distribution of Candida species associated with DS through a systematic review. Several databases, including Medline, Web of Science, and Scopus, were used to conduct an extensive search of the literature published in the previous 20 years. The selection of studies was performed by two authors. The extracted data were as follows: author, year of publication, country, sample, frequency of DS, method of diagnosing stomatitis, species of Candida, risk factors, and etiology of the disease. The JBI Critical appraisal tools were used to assess the quality of the studies. Eventually, twenty-eight studies were included in the systematic review. Twenty-one studies investigated DS, while seven studies examined Candida colonization in patients using removable dentures. The results show that the main causes of DS include the type of dentures, continuous wearing of dentures, and the formation of a Candida biofilm, which is facilitated by poor dental hygiene. Additionally, previous studies have pinpointed the significance of the salivary flow, saliva composition, and salivary pH. The findings of the current review indicate that it is crucial to monitor denture wearers for the appearance of DS, especially the patients whose immunity has been impaired due to a systemic condition. Finally, frequent follow-ups should include a clinical examination and microbial swabs of the palatal mucosa and the mucosal surface of the denture.

Influence of Five Different Commercially Available Mouthwashes on the Growth of Candida albicans Adhered to Customized Prefabricated Heat-Cured Denture Base Acrylic Resin Sheets: An In Vitro Study

Background The purpose of this in vitro investigation was to evaluate the impact of five distinct commercial mouthwashes on the development of Candida albicans that had been adhered to heat-cured acrylic resin sheets. Methods This in vitro investigation was carried out at the MES Medical College's Microbiology Department in Perinthalmanna, Kerala, India. A total of 72 heat-cured acrylic resin sheets, size 10 × 10 × 2 mm, were fabricated. After disinfection, all 72 acrylic sheets were placed in a flask containing a suspension of the standard strain of Candida species (American Type Culture Collection) and incubated at 37ºC for 24 hours. Then, the acrylic sheets were randomly divided into six groups, with each group containing 12 acrylic sheets. Group 1 was the control group to which no mouthwash was added. In group 2, Colgate Plax was added. In group 3, Hiora Himalaya was added. In group 4, Oral B was added. In group 5, Listerine was added. In group 6, Pepsodent was added. Colony-forming units (CFUs) were assessed using a colony counter every six, 24, 48, and 120 hours. After obtaining the pH and CFU of all 72 specimens, software known as the Statistical Package for Social Sciences (SPSS) (IBM Corp., Armonk, NY) was used to analyze the data. Results Candida albicans adhered to heat-cured denture base acrylic resin sheets differed significantly in response to commercially available mouthwashes (Oral B, Colgate Plax, and Pepsodent) and non-commercial mouthwashes (Hiora Himalaya and Listerine) that contained cetylpyridinium chloride. Conclusions Compared to other mouthwashes that do not contain cetylpyridinium chloride (Listerine and Hiora Himalaya), mouthwashes with cetylpyridinium chloride as the active ingredient (Oral B, Pepsodent, and Colgate Plax) have shown good antifungal properties against the adhering Candida albicans on denture base resin.

Factors affecting the healing of decubital lesions in patients wearing newly made dentures

Background/purpose

Decubital lesions or traumatic ulcers caused by dentures usually appear one or two day(s) after new dentures placement due to mismatch of the microrelief of the tissue and the microrelief of the gingival surface of the prosthesis. The study aimed to analyze factors that could influence the healing of ulcers during a one-week period after the placement of new partial and complete dentures.

Materials and methods

The prospective cohort study included 60 patients with new denture-induced traumatic ulcers. Traumatic ulcers were treated with denture adjustment, or combination of adjustment with 0.2% or 0.3% hyaluronic acid gels respectively for seven days. Healing of ulcers were observed through measurement of perimeter, area, maximum and minimum diameters on digital photographs. Multivariate logistic regression was used to predict other factors that could affect healing process.

Results

Perimeter, area, maximum and minimum diameters of denture-related ulcers were significant decreased after application of gels on the fifth and seventh day. The fifth day ulcers were not healed if dentures were only adjusted, while healed lesion was 40% for the other two groups. On the seventh day, the percent of healed lesion in the group with dentures adjustment was 20%, while it was increased to 75% healed lesions for combination of denture adjustment and hyaluronic acid gels. Anticoagulant/anti-aggregation drugs also had positive impact on ulcer healing; antihypertensives that included diuretics slowed ulcer healing, other monitored factors in the study did not show a significant impact.

Conclusion

Hyaluronic acid in combination with the dentures adjustment for seven days leads to higher healing rate, and reduction in size of ulcers that did not heal until this time point.

Management of Chronic Atrophic Candidiasis (Denture Stomatitis)-A Narrative Review

One of the most common oral diseases affecting people wearing dentures is chronic atrophic candidiasis or denture stomatitis (DS). The aim of the paper is to provide an update on the pathogenesis, presentation, and management of DS in general dental practice settings. A comprehensive review of the literature published in the last ten years was undertaken using multiple databases, including PubMed via MEDLINE, EMBASE, and Scopus. The eligible articles were analyzed to identify evidence-based strategies for the management of DS. Despite its multifactorial nature, the leading cause of DS is the development of oral Candida albicans biofilm, which is facilitated by poor oral and denture hygiene, long-term denture wear, ill-fitting dentures, and the porosity of the acrylic resin in the dentures. DS affects between 17 and 75% of the population wearing dentures, with a slight predominance in elderly females. The mucosal denture surfaces and posterior tongue are the common sites of DS, and the affected areas exhibit erythema, the swelling of the palatal mucosa and edema. Oral and denture hygiene protocols, adjusting or re-fabricating poorly adapting dentures, smoking cessation, avoiding nocturnal denture wear, and the administration of topical or systemic antifungals are the mainstay of management. Alternate treatments such as microwave disinfection, phytomedicine, photodynamic therapy, and incorporation of antifungals and nanoparticles into denture resins are being evaluated for the treatment of DS but require further evidence before routine use in clinical practice. In summary, DS is the most common oral inflammatory lesion experienced by denture wearers. Most patients with DS can be managed in general dental practice settings. Effective management by general dental practitioners may be supported by a thorough understanding of the pathogenesis, the recognition of the clinical presentation, and an awareness of contemporary treatment strategies.

Host's Immunity and Candida Species Associated with Denture Stomatitis: A Narrative Review

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.