Denture-related Stomatitis Research Articles

Effect of a Hygiene Protocol on Denture-Related Stomatitis Remission, Local Inflammatory Factors, and Hemodynamic Responses by Arterial Pressure.

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.

Prevention of inflammatory changes in the denture-bearing mucous membrane

Relevance. Advanced clinical and cytological studies have not been conducted yet to examine denture adhesive effect on the prevention of inflammatory changes in the mucous membrane of the prosthetic bed, and thus, the prevention of denture-related stomatitis. Purpose: to assess the clinical and functional condition of the oral mucosa beneath the denture during the adaptation period using a denture adhesive cream to prevent inflammation of the denture bed mucous membrane.Materials and methods. The study clinically and cytologically (washing, scraping) assessed the condition of oral mucosa beneath complete acrylic dentures on days 14-16 and 28-30 of the adaptation period in 15 fully edentulous patients (main group), who used an adhesive cream after they were delivered their dentures, and in 21 fully edentulous patients (control group) who did not use the cream during the denture adaptation period. All the patients were elderly.Results. At different times of the adaptation period, the study more frequently detected inflammatory changes in the denture-bearing mucosa in subjects who did not use the denture adhesive cream. The cytological study confirmed the results of the oral clinical examination, as, at the end of the adaptation period, the number of cellular elements and various microorganisms was significantly lower in the main group than in the controls, which proved the effectiveness of the denture adhesive cream for the prevention of denture stomatitis.Conclusions. Regardless of sex, patients with complete acrylic dentures, who used a denture adhesive cream, had a lower bacterial accumulation on the prosthetic bed and inflammatory changes during the adaptation period, which allowed us to recommend the adhesive cream for the prevention of denture stomatitis.

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

Oral mucosal lesions can be uncomfortable and can result in a poorer oral health related quality of life. This can be seen especially in edentulous patients who are mostly elderly and have comorbid diseases such as Diabetes Mellitus, which can impair their ability to withstand oral infections. In South Africa, one of the most unequal countries in the world, almost 50% of the population is edentulous and this prevalence increases as age increases. The aim of this cross-sectional study was to determine the prevalence of denture-related stomatitis in subjects who presented to a tertiary institution in Cape Town, South Africa for new complete dentures and to determine the risk indicators associated with it. Three hundred and ninety-six folders of participants who received complete dentures during the period 2014–2019 were included in this study. Categorical data was displayed as frequencies and percentages and a multiple adjusted logistic regression was used to determine associations between Candida and certain risk indicators. The prevalence of denture-related stomatitis was 25.76% (n = 102). Almost 75% (n = 225) females and 72.63% (n = 69) males had no denture-related stomatitis. The most common site for candidiasis in this population was the palate and tonsillar area (40.2%, n = 41) and the least common site was the upper ridge (2.94%, n = 3). Candidiasis, in edentulous patients are highly prevalent in this population and more needs to be done to prevent it.

Effect of local hygiene protocols on denture-related stomatitis, biofilm, microbial load, and odor: A randomized controlled trial

Statement of problemDenture 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. PurposeThe purpose of this randomized controlled trial was to evaluate the effect of denture hygiene protocols on complete denture wearers with denture stomatitis. Material and methodsFor 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). ResultsThe 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). ConclusionsThe evaluated protocols can be recommended for the hygiene of complete dentures, since they were effective for all the variables studied.

Correlation between the relative abundance of oral bacteria and Candida albicans in denture and dental plaques

ObjectivesThe opportunistic fungus Candida albicans is a component of denture plaque and is associated with denture-related stomatitis. Inter-kingdom interactions between C. albicans and bacteria exist in such multi-species biofilms, which may affect the microbial composition of the plaque. This study was performed to investigate the bacterial composition of denture plaques, and the correlation between the relative abundance of these bacteria and C. albicans. MethodsThirty denture plaque and 16 dental plaque samples were collected from 18 denture wearers (mean age, 80.3 years). After DNA extraction, a meta 16S rDNA amplicon library was constructed using PCR primers targeting the V3–V4 hypervariable region of bacteria. The amplicon was evaluated by high-throughput sequencing, followed by bacterial population analysis. The concentrations of both C. albicans DNA and total bacterial DNA were determined by real-time PCR. The correlation between the relative abundance of each bacterial genus and C. albicans was analyzed through Spearman's rank correlation. ResultsThe genera Streptococcus, Lactobacillus, Rothia, and Corynebacterium were found to be more abundant in dentures than in dental plaques. The predominant bacteria in healthcare-associated pneumonia also inhabited denture surfaces. C. albicans was positively correlated with three acidogenic bacteria and negatively correlated with Leptotrichia and pathogens associated with periodontitis and endocarditis. ConclusionsDentures may be significant reservoirs of pathogens causing aspiration pneumonia. Bacteria showing negative correlation with C. albicans, such as Leptotrichia, may be useful for controlling the growth of C. albicans in antifungal therapies.

Patient attitude and habits regarding removable denture home hygiene and correlation with prosthesis cleanliness: A cross-sectional study of elderly Italians

Statement of problemWith the aging population, an increasing number of patients will require removable dental prostheses. Despite the recent public efforts to improve oral healthcare, knowledge of hygiene procedures for removable dental prostheses is sparse. PurposeThe purpose of this cross-sectional study was to determine, through questionnaires, the level of awareness and education of home hygiene procedures among elderly Italian individuals wearing removable dental prostheses and to correlate self-reported hygiene habits and prosthesis cleanliness, as determined by a clinical examination. Material and methodsA cross-sectional study was performed by questionnaires administered by a dental hygienist to patients attending the dental clinics (prosthodontic and periodontology clinical units) at San Paolo Hospital of Milan from January 2014 to October 2015 and who volunteered to participate. The questionnaire included demographic data and oral hygiene habits. Each participant received an intraoral and prosthesis examination performed by the same dental hygienist. The cleanliness of the removable dental prosthesis was classified according to a 3-point scoring system. Categorical variables were expressed as a percentage of study participants and compared by using the χ2 test, while, for the statistical correlations between continuous and categorical variables, the point-biserial correlation calculator was used (α=.05). ResultsQuestionnaires were collected from 161 study participants: 92 women (mean ±standard deviation age: 76 ±7.59 years; range: 65-93 years) and 69 men (mean ±standard deviation age: 74 ±6.31 years; range: 65-86 years). A total of 239 prostheses were considered. A significant correlation was found between older participants, older removable dental prostheses, and reduced prosthesis cleanliness, correlating age ranges of participants as well as of removable dental prostheses with the degrees of prosthesis cleanliness (P=.001 and P=.004, respectively). Half the study participants (n=81; 50.3%) reported prosthesis removal during the night, while the others reported sleeping with the prosthesis in place. Some study participants (n=32; 19.9%) reported that they had never received instructions about how to clean the prosthesis. Mechanical brushing with toothbrush and toothpaste was the most common cleaning method (n=47; 29.2%), while the recommended combined cleaning method based on both mechanical brushing and immersion in dental cleanser was applied by 34 (21.1%) study participants. A similar number (n=25; 15.5%) reported at least 1 episode of denture-related stomatitis. ConclusionsIn the analyzed cohort, patient attitude and habits toward home procedures for denture hygiene resulted in poor prosthesis cleanliness. Most individuals used a toothbrush and toothpaste to clean their device, although combining mechanical and chemical cleaning is typically reported to be the optimal method.

Denture Plaque Management of Denture-Related Stomatitis

The regular use of a removable prosthesis, in particular in fully edentulous aging subjects, constitutes, within the oral cavity, support for Denture Plaque (DP), promoting the growth of a candidosic population that often leads to Denture Stomatitis (DS).

THE EVALUATION OF THE COLONIZATION AND BIOFILM FORMATION CAPACITY OF THE CANDIDA SPECIES ISOLATED FROM DENTURE WEARER PATIENTS

Aim: C Aim: Candida species, although being a member of the oral flora, may exhibit pathological features under certain conditions. The aim of this study was to determine the distribution and biofilm production of Candida species that were isolated from denture related stomatitis (DRS) patients and to compare with healthy subjects. andida species, although being a member of the oral flora, may exhibit pathological features under certain conditions. The aim of this study was to determine the distribution and biofilm production of Candida species that were isolated from denture related stomatitis (DRS) patients and to compare with healthy subjects. Materials and Methods: The 56 non-smoker, systemically healthy, maxillary removable denture wearer subjects included in this study and diagnosed as DRS(N=27) and healthy(N=29) . Samples from the palatal mucosal surface of patients were collected by sterile swabs during 20 seconds. Cultivation and selective isolation of Candida species were performed on CHROMagar (CHROMagar ® Candida, CHROMagar, Paris, France) at 37ºC for 2 days. Isolated Candida species were identified with API ID 32 C (bioMérieux ® , France). Biofilm formation by Candida species were determined by a visual tube method. Results: The prevalence of the yeasts in the healthy group was found to be 37.94%, while in the DRS group it was 100% (p<0.001). The isolation rate of C. albicans in patients with DRS significantly higher (p<0.001). Biofilm formation was observed in a total of 37 oral yeast isolates, 9 isolates from healthy denture wearers and 28 isolates from DRS patients. The number of C. albicans and C. glabrata isolates showing biofilm formation ability in the DRS group was significantly higher than the healthy group (p<0.05). Conclusions: Within the limitations of this study, our results suggest that Candida species play a major role on the development of DRS. While C. albicans was the most isolated species in DRS, C. glabrata was as important as C. albicans on the pathogenesis of DRS. keywords: Biofilms , Candida, denture stomatitis, mycology, oral pathology HAREKETLİ PROTEZ KULLANAN HASTALARDA KANDİDA TÜRLERİNİN KOLONİZASYONUNUN VE BİYOFİLM OLUŞTURMA KAPASİTELERİNİN DEĞERLENDİRİLMESİ Öz Amaç: Candida türleri, oral floranın doğal üyesi olmakla birlikte, belirli koşullar altında patolojik özellikler sergileyebilir. Bu çalışmanın amacı, protez stomatiti (PS) olan hastalardan ve protez kullanan sağlıklı bireylerden elde edilen Candida türlerinin dağılımını ve biyofilm üretime kapasitelerini karşılaştırmaktır Gereç ve Yöntem: Sigara içmeyen, sistemik olarak sağlıklı, maksiller tam damak protez kullanan 56 kişi bu çalışmaya dahil edildi. Katılımcılar PS (N = 27) ve sağlıklı (N = 29) olmak üzere gruplandırıldı. Hastaların palatal mukoza yüzeyinde 20 saniye boyunca steril swablar gezdirilerek sürüntü örnekleri elde edildi. Candida türlerinin kültivasyon ve seçici izolasyonu 2 gün boyunca 37 ° C'de CHROMagar (CHROMagar® Candida, CHROMagar, Paris, Fransa) besiyerinde gerçekleştirildi. İzole edilen Candida türlerinin identifikasyonu API ID 32 C (bioMérieux®, Fransa) ile gerçekleştirildi. Candida türlerinin biyofilm oluşturma potansiyelleri görsel tüp yöntemi ile saptandı Bulgular: Sağlıklı gruptaki mayaların prevalansı % 37.94 iken, PS grubunda % 100'dü ( p <0.001). PS'li hastalarda C. albicans 'ın izolasyon oranı anlamlı derecede daha yüksekti ( p <0.001). Sağlıklı katılımcılardaki 9 PS katılımcılardaki 28 izolatta biyofilm oluşumu gözlendi. PS grubunda biyofilm oluşumunu gösteren C. albicans ve C. glabrata izolatlarının sayısı sağlıklı gruba göre anlamlı olarak yüksekti ( p <0.05). Sonuç: Bu çalışmanın sınırları dahilinde, sonuçlarımız Candida türlerinin PS'nin gelişiminde önemli bir rol oynadığını göstermektedir. C. albicans , PS'de en sık izole edilen tür olsa da C. glabrata da PS'nin patogenezinde C. albicans kadar önemlidir. Anahtar Kelimeler: Biyofilm , Kandida, protez stomatitisi, mikoloji, oral patoloji

ROLE OF INDIVIDUAL HYGIENE IN TREATMENT OF PATIENTS WITH DENTURE-RELATED STOMATITIS

Removable orthodontic appliances can be among the causes of microbial irritation in the oral cavity. The aim of the present study was to assess the oral hygiene status of patients with denture-related stomatitis. We carried out comprehensive dental checkup of 17 patients aged 51 to 69 years with denture-related stomatitis was performed. A bacterioscopic laboratory examination was performed for all patients. The denture hygiene index by E. Ambjörnsen has been determined. Denture-related stomatitis of the patients examined was manifested by various clinical signs. The species composition of the oral microflora when wearing removable dentures deviated from normal values. The Candida fungi were revealed in 13 (76.47%) cases; actinomycetes were recorded in 7 (42.2%) cases. We found that 82.35% of the patients with manifestations of denture-related stomatitis did not follow adequate oral hygienic. The study has shown that 3 (17.64%) cases were assessed as having satisfactory hygienic status. Poor denture hygiene (HI = 2.66) was observed in 5 (29.41%) of the cases. The unsatisfactory hygienic status of the dentures was recorded in 9 (52.94%) of cases and averaged 2.2. 15 (88.23%) patients were unaware of the importance of proper denture cleaning and did not use the hygiene algorithm in full. 3 (17.76%) patients did not did not remove dentures at nights, all the patients did not have a special double-sided brush. Only 5 (29.41%) of the respondents used dental elixirs fro mouth rinsing on regular basis. The results have demonstrated the importance of regular adequate care of dentures and strict adhering to an individual hygiene algorithm in full in order to prevent the occurrence of inflammatory processes in the oral cavity. The prevention is a key approach in the prophylaxis of side effects, which might be caused by dental appliances.

Isolamento de Candida spp. de estomatite relacionada à prótese no Pará, Brasil.

O objetivo deste estudo foi isolar e identificar espécies de Candida da cavidade oral de usuários com estomatite relacionada à dentadura, atendidos na Universidade Federal do Pará (Cidade de Belém, Pará, Brasil). Foram incluídos 36 usuários de protese com estomatite relacionada à prótese, e foram observadas estomatite tipo I (50%), tipo II (33%) e tipo III (17%). Candida spp. foram isolados em 89% dos casos e incluíram cinco espécies diferentes de Candida. C. albicans, frequentemente recuperada (78% dos casos), seguida por C. famata e C. tropicalis. Observamos uma associação significativa entre o isolamento da espécie Candidas e a condição insatisfatória da prótese (p = 0,0017). Nossos resultados demonstraram a alta frequência de isolamento de espécies de Candida em usuários de próteses com estomatite relacionada à prótese e mostraram a relação entre essas espécies e má manutenção da prótese.

Candida albicans isolated from denture-related stomatitis in elderly patients: Antifungal susceptibility and production of virulence attributes

AbstractDenture-related stomatitis caused by Candida spp. affects elderly individuals using partial/total prosthesis, provoking several discomforts including burning sensation and altered taste. Herein, we have studied 52 denture-wearing individuals (&gt;60 years-old), attended at the dentistry clinic of UNIVALE, aiming to isolate Candida spp. directly from the stomatitis lesions and to evaluate their potential to produce virulence attributes. A low prevalence of denture-related stomatitis was reported in these patients (4/52; 7.7%). Candida albicans was isolated in the 4 selected patients, with the ability to form biofilm over a polystyrene surface and to produce aspartic protease, esterase and hemolysin. However, neither phospholipase nor caseinase activities were detected. Planktonic-growing yeasts were susceptible to amphotericin B and caspofungin, while the susceptibility to azoles (fluconazol, itraconazole and voriconazole) varied depending on either the isolate or antifungal. Relevantly, biofilm-forming C. albicans cells exhibited resistance to all studied antifungals. So, new effective drugs against resistant C. albicans isolates causing denture-related stomatitis are urgently required.

Hygiene protocols for the treatment of denture-related stomatitis: local and systemic parameters analysis - a randomized, double-blind trial protocol

BackgroundDenture-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/designA 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.DiscussionThis 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 registrationBrazilian Registry of Clinical Trials, RBR-4hhwjb. Registered on 9 November 2018.

Abstract P2065: Effect of Denture-Related Stomatitis on Blood Pressure and Heart Rate Variability

Denture-related stomatitis (DRS) has recently been associated with harmful cardiovascular effects, including arterial hypertension. This study evaluated salivary parameters, blood pressure (BP) and heart rate variability (HRV), before and after the DRS treatment in edentulous patients (n=14). Collection of unstimulated and stimulated saliva, as well as blood pressure BP measurements and electrocardiogram recordings, were performed before and after ten days of DRS treatment. The salivary flow (mL/min) was found similar at both times while the pH was smaller (more neutral) after the treatment (7.3±2.2 vs. 7.1±0.24). The systolic BP (mmHg) showed a trend, but not a significant reduction after the DRS treatment (158±25.68 vs. 148±16,72, p=0,062) while diastolic BP was found similar in both times (86±13.93 and 84±9.38). Overall, the HRV measured by the standard deviation of RR intervals was not affected by DRS treatment (24±4 vs. 18±2 ms); but the differences of successive RR intervals (an index of parasympathetic cardiac modulation) increased after the treatment (26±4 vs. 19±2 ms). Moreover, another index of vagal modulation of the heart, i.e., the power of RR interval spectra at high-frequency, was also markedly higher after the DRS treatment (236±63 vs. 135±32 ms 2 ). Overall, these findings strongly suggest that the DRS is associated with an autonomic imbalance, particularly with sympathetic overactivity. Therefore, the DRS may be significantly harmful, increasing cardiovascular risk and the incidence of several diseases, for instance, arterial hypertension.

Molecular community profiling of the bacterial microbiota associated with denture-related stomatitis

Denture-associated stomatitis (DS) affects over two-thirds of denture-wearers. DS presents as erythema of the palatal mucosa in areas where denture-surface associated polymicrobial biofilms containing the fungus Candida albicans exist. The contribution of the oral bacterial microbiota toward the infection is unknown. Therefore, this study characterised the bacterial microbiota of sites within the oral cavity to identify potential associations with occurrence of DS. Denture-wearing patients were recruited (denture stomatitis (DS) n = 8; non-denture stomatitis (NoDS) n = 11) and the oral bacterial microbiota of the tongue, palate and denture-fitting surface was characterised using next-generation sequencing. Operational taxonomic units (OTUs) were identified to bacterial genera and species, and presence/absence and relative abundances were examined. A significant (P = 0.007) decrease in the number of OTUs and thus, diversity of the microbiota was observed in tongue samples of DS patients (vs non-DS). The microbiota of denture-fitting surfaces and palatal mucosae were similar. Large differences in the abundance of bacterial genera and species were observed at each sample site, and unique presence/absence of bacteria was noted. Presence/absence and relative abundance of specific bacteria associated with DS warrants further in vitro and in vivo evaluation, particularly as our previous work has shown C. albicans virulence factor modulation by oral bacteria.

Prevalence of oral mucosal lesions in young seniors in the Wrocław region.

The morbidity of certain oral pathologies, for example denture-related stomatitis, burning mouth syndrome (BMS) and benign neoplasms is higher in the elderly. It is necessary to periodically assess the changes in the profile of the occurrence of these diseases and determine the dominant risk factors associated with their incidence. The aim of the study was to evaluate the prevalence of oral mucosal pathologies (in particular, potentially malignant and cancerous disorders) in a randomly selected population of 65-74-year-old residents of Wrocław and Oława, Poland. A group of 1,600 persons aged 65-74 years, living in Wrocław (a large city) and Oława (a small town) were randomly selected to participate in the study. 285 people from Wrocław and 102 from Oława were examined. In a clinical dental examination, the following parameters were assessed: the number of teeth; probing/pocket depth (PD) and clinical attachment level (CAL) for all the teeth at 4 measuring points (on this basis, periodontal diagnoses were made according to American recommendations - of the American Center for Disease Control and Prevention and the American Academy of Periodontology (CDC/AAP)); and the presence of prosthetic restorations and their quality. In the anamnestic study, variables concerning the socioeconomic status, systemic conditions (comorbidity of selected general diseases, nicotine addiction status, body mass) and selected behaviors promoting oral health were determined. The most common clinical changes in the oral mucosa were denture-related stomatitis (6.7%), hemangiomas (5.9%) and fibromas (4.1%). Potentially malignant disorders and cancerous lesions were diagnosed in 59 persons (15.2% of the respondents). One case of tongue cancer was diagnosed in an inhabitant of Oława. More than 1/3 of the examined persons were diagnosed with certain clinical, pathological oral mucosal lesions requiring treatment, of which nearly half were potentially malignant and cancerous. Poor tooth brushing efficiency was associated with a higher incidence of pre-cancerous and cancerous lesions in the oral cavity.

Isolation of Candida spp. from denture-related stomatitis in Pará, Brazil.

The aim of this study was to isolate and identify Candida species from the oral cavity of denture wearers with denture-related stomatitis who were attended at the University Federal of Pará (Belém City, Pará State, Brazil). A total of 36 denture wearers with denture-related stomatitis were included, and type I (50%), type II (33%) and type III (17%) stomatitis were observed. Candida spp. were isolated from 89% of the cases and included five different Candida species. C. albicans was the most frequently recovered species (78% of the cases), followed by C. famata and C. tropicalis. We observed a significant association between Candida species isolation and unsatisfactory denture condition (p = 0.0017). Our results demonstrated the highly frequency of Candida species isolation in denture wearers with denture-related stomatitis and showed the relationship between these species and poor denture maintenance.

Improving practice guidelines for the treatment of denture-related erythematous stomatitis: a study protocol for a randomized controlled trial

BackgroundDenture-related erythematous stomatitis (DES) is a chronic biofilm-mediated disease, affecting one in every three complete denture wearers. Antifungals are the treatment most commonly prescribed by oral health professionals, based on the belief that colonization by Candida spp. is the main cause of DES. However, high recurrence rates and adverse effects are commonly observed, prompting the need for practice guidelines regarding treatment. Results from our pilot study demonstrate that palatal brushing can reduce the palatal inflammation and potentially associated Candida carriage without any need for antifungal therapy. The objective of this study is to validate these pilot results by means of a randomized controlled trial (RCT) and provide a practice guideline for clinicians.Methods/designA pragmatic, two-parallel-arm, multicenter RCT will be conducted in Canada, Brazil, and Chile. Fifty-two adult complete denture wearers presenting with moderate to severe DES will be allocated randomly to two groups: the Intervention arm will consist of palatal brushing and standard oral and denture hygiene measures, while the Control arm will include only standard oral and denture hygiene measures. The study outcome will be the oral Candida carriage. Participants will be assessed at baseline, and at 3 and 6 months post intervention. Descriptive, bivariate, and mixed models with repeated measures will be performed following the intention-to-treat principle.DiscussionThis pragmatic RCT will serve to provide a clinical practice guideline regarding the use of preventive measures in the treatment of biofilm-mediated oral diseases. Moreover, it will have a great impact on reducing the harm of antifungal overtreatment on patients suffering from DES.Trial registrationClinicalTrials.gov, NCT02686632. Registered on 15 February 2016.

Oral mucosal lesions in a Chilean elderly population: A retrospective study with a systematic review from thirteen countries.

BackgroundThe oral examination is an essential part of the multidisciplinary medical care in elderly people. Oral mucosal lesions and normal variations of oral anatomy (OMLs) are very common in this people, but few studies have examined the frequency and prevalence of these conditions worldwide and less in Chile. The aim of this research was to evaluate the frequency of OMLs in a Chilean elderly population.Material and MethodsIt was conducted a retrospective study (Talca, Chile). Two hundred seventy-seven OMLs were classified in groups and anatomical sites. In order to contextualize our numbers, we made a systematic review using Publish or Perish software, Google Scholar and InteractiVenn.ResultsThe most prevalent OMLs groups were soft tissue tumors, epithelial pathology, facial pain and neuromuscular diseases, and dermatologic diseases. The most frequent OMLs included irritation fibroma (30 patients, 10.8%), hemangioma (20, 7.2%), burning mouth syndrome (20 cases, 7.2%), oral lichen planus (12, 4.3%) and epulis fissuratum (12, 4.3%). In the systematic review, 75 OMLs were relevant and the more studied pathologies were traumatic ulcerations (11 of 15 articles), oral lichen planus (10/15), irritation fibroma, melanotic pigmentations, and recurrent aphthous stomatitis (9/10, respectively). Considering all included articles, most frequent OMLs in elderly people included denture-related stomatitis (13.3%), irritation fibroma (8.7%) and fissured tongue (6.3%).ConclusionsThe results reflect the frequency of OMLs diagnosed in a specialized service in south of Chile and many countries around the world. These numbers will allow the establishment of preventive politics and adequacy of the clinical services. Key words:Oral mucosal lesions, elderly people, Chilean population, frequency, systematic review.

Prevalence of Chronic Erythematous Candidiasis in Lebanese Denture Wearers: a Clinico-microbiological Study.

Objective:Chronic erythematous candidiasis also known as denture-related stomatitis refers to inflammatory changes of the denture-bearing mucosa. The aim of this study was to evaluate the prevalence of chronic erythematous candidiasis in a Lebanese population using clinical and microbiological examinations.Materials and Methods:Ninety-eight patients wearing full acrylic maxillary denture (50 women and 48 men) were included in this study. A clinical oral assessment and a microbiological exam using swab samples collected from the palate of these patients were performed and the data obtained were analyzed statistically.Results:Sixty-nine point thirty-eight per cent (69.38%) of the patients examined, (68 out of 98; 25 men and 43 women), presented chronic erythematous candidiasis. The statistical analysis showed that patient’s gender was a significant predictor of the disease while no statistically significant relationship with the patient’s age was found.Conclusion:Within the limits of this study, the prevalence of chronic erythematous candidiasis is estimated to be high in Lebanon. Women were more affected than men.

Inhibitory effects of Lactobacillus rhamnosus and Lactobacillus casei on Candida biofilm of denture surface

ObjectiveCandida albicans biofilm is associated with denture-related stomatitis and oral candidiasis of elderly. Probiotics are beneficial bacteria and have antibacterial activity against pathogenic bacteria. The purpose of this study was to investigate the antifungal activity of various probiotics against C. albicans and the inhibitory effects of probiotics on Candida biofilm on the denture surface. DesignThe spent culture media of various probiotics were investigated the antifungal efficacy against C. albicans. Candida biofilm was formed on a denture base resin and was then treated with Lactobacillus rhamnosus and Lactobacillus casei. Also, the biofilms of L. rhamnosus and L. casei were formed and were sequentially treated with C. albicans. Colony-forming units of C. albicans on the denture surface were counted after spreading on agar plate. The denture base resin was treated with the spent culture media for 30days, after which the denture surface roughness was analyzed with an atomic force microscope. ResultsL. rhamnosus and L. casei exhibited stronger antifungal activity than other probiotics. The spent culture medium of L. rhamnosus and L. casei exhibited the antifungal activity against blastoconidia and biofilm of C. albicans. L. rhamnosus and L. casei showed the antifungal activity against Candida biofilm, and the biofilm of L. rhamnosus and L. casei inhibited formation of Candida biofilm on denture surface. Neither of the probiotics affected the surface roughness of the denture base resin. ConclusionsL. rhamnosus and L. casei may be the ideal probiotics for the prevention and treatment of denture-related stomatitis.