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.
Highlights
Oral candidiasis is a common chronic condition that affects a large proportion of the population, especially denture wearers
The treatment of choice for chronic atrophic candidiasis (CAC) is topical antifungal therapy, systemic therapy may be required in some cases
The most commonly used antifungal agents for the treatment of CAC are polyene antifungals, which alter the permeability of the fungal cytoplasmic membrane, azole antifungals, which bind to the membrane and destroy its constituent components, rendering it nonfunctional, and DNA analogs, which interfere with fungal nucleic acid synthesis (Skupien et al, 2013; Lalla and Dongari-Bagtzoglou, 2014; Tay et al, 2014)
Summary
Oral candidiasis is a common chronic condition that affects a large proportion of the population, especially denture wearers. Chronic atrophic candidiasis (CAC), known as denture stomatitis, is the most common manifestation of Candida infection and affects more than 65% of individuals wearing maxillary partial dentures (Gonçalves et al, 2013; Chambo-Filho et al, 2014; Santos et al, 2016; Punnia-Moorthy, 2019). The diagnosis of CAC is established by clinical examination, but the use of microbiological methods as a complementary diagnostic tool, such as the oral smear method, is advisable (Lund et al, 2010). The treatment of choice for CAC is topical antifungal therapy, systemic therapy may be required in some cases. Fluconazole, administered orally or intravenously, can provide a viable alternative, especially in cases of disseminated candidiasis, due to its high efficacy and low toxicity. Miconazole is available in patch form (Kossioni, 2011)
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