Abstract
We aimed to evaluate the microbial and inflammatory characteristics associated with Denture Stomatitis (DS) analyzing: l) Levels of salivary cytokines and cultivable C. albicans; 2) DNA-DNA checkerboard on biofilm associated with mucosal tissue-bearing denture surfaces, 3) Serum C-reactive protein (CRP) levels. Thirty-two subjects were enrolled in the study with control (n = 17) and DS types II and III (n = 15) subjects. Samples were collected from unstimulated whole saliva, serum and swabs from denture surfaces. Salivary levels of inflammatory mediators and CRP were measured by multiplex. Samples from denture and mucosal surfaces were analyzed by DNA-DNA checkerboard. Saliva from DS subjects showed increase in IL-8 (p = 0.04) and IL-1β (p = 0.04) with trend for increase in IL-1β, TNFα and IL-6 levels. C. albicans higher counts in DS saliva (p = 0.03) showed association with elevated levels of IL-8 (p = 0.03) and IL-1α (p = 0.01). CRP levels were not different among groups (p = 0.74). DNA-DNA checkerboard analyses indicated typical periodontal pathogens below the detection threshold of 104 organisms on both denture and inflamed mucosal surfaces. The data suggest that DS is associated with elevation of salivary IL1 and IL-8 together with increased C. albicans. There was no evidence of systemic inflammation as measured by serum C-reactive protein levels.
Highlights
Candida-associated denture stomatitis (CADS) is characterized by inflammation of the palatal mucosa in contact with the maxillary denture and is the most common form of oral candidal infection with Candida albicans being the principal etiological agent [1,2,3]
We aimed to evaluate the microbial and inflammatory characteristics associated with Denture Stomatitis (DS) analyzing: l) Levels of salivary cytokines and cultivable C. albicans; 2) DNA-DNA checkerboard on biofilm associated with mucosal tissue-bearing denture surfaces; 3) Serum C-reactive protein (CRP) levels
We have recently found regarding C. albicans colonization in denture stomatitis patients, that the denture appears to be the primary source of salivary C. albicans rather than the inflamed mucosa
Summary
Candida-associated denture stomatitis (CADS) is characterized by inflammation of the palatal mucosa in contact with the maxillary denture and is the most common form of oral candidal infection with Candida albicans being the principal etiological agent [1,2,3]. CADS has been reported in 11% - 67% of the otherwise healthy denture wearers [4], and has been classified according to Newton’s work in 1962 [5] into 3 clinical types: Type I— a localized simple inflammation or a pinpoint hyperemia; Type II (mild): an erythematous or generalized simple type presenting as more diffuse erythema, and Type III (severe): a granular or papillary type This condition has been considered to have a multifactorial etiology, which can include factors related to 1) Trauma such as denture wearing; 2) Local trauma resulting from salivary hypofunction [6,7]; 3) Infection with candida species; or 4) Factors related to impaired host defense as in systemic diseases such as HIV infection, leukemia, lymphoma, radiation therapy for head and neck malignancies, chemotherapy, diabetes, hormonal imbalance, anemia, malnutrition, or long-term use of corticosteroid or antibiotics.
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