Denture Stomatitis Research Articles

Oral Candidiasis in a Diabetic Patient Wearing Bar-Retained Provisional Overdenture: Clinical Case Report

Background: Denture stomatitis is a clinical manifestation of oral candidiasis, often seen in individuals wearing removable dentures that lead to the formation of sub-prosthetic stomatitis. This is particularly common in maladjusted appliances that have been in use for many years. Studies have shown that patients with systemic diseases such as diabetes, or other medical complexities, have a higher likelihood of developing denture stomatitis. To address this problem, the use of implant-retained dentures with different types of attachments has been introduced, providing increased comfort and hygiene for edentulous patients. However, this solution is not without its own set of challenges, being that the prolonged contact with mucosal surfaces can lead to challenges in cleaning and managing plaque depending on the attachment. Case Presentation: In this clinical case report, we present a female patient who developed bar-retained prosthetic stomatitis induced by oral candidiasis a few months after receiving her provisional prosthesis. Conclusions: In conclusion, this case report emphasizes the need to consider both systemic and local factors when preventing and treating denture stomatitis. By understanding the risk factors involved, healthcare professionals can provide their patients with the best possible care, helping to reduce the prevalence of oral candidiasis in individuals who use implant-retained dentures.

Natural products for denture base disinfection: A scoping review.

This study aims to map the existing literature on natural products used as disinfection substances for conventional polymethyl methacrylate (PMMA) and computer-aided design and manufacturing (CAD-CAM) dentures. Denture wearers are at high risk for denture stomatitis. Natural products have attracted the interest of the scientific community as an alternative to synthetic ones. The guiding question "Which natural products have been applied to disinfect complete dentures in conventional PMMA or CAD-CAM PMMA resin?" Searches were conducted in the PubMed/MEDLINE, Embase, Web of Science, and Cochrane databases, and manual searches were performed in reference journals in the area with studies published until December 2023, without language or date restrictions. A total of 4272 articles were identified, and 46 studies were included after applying the eligibility criteria. Thirty-nine natural products were evaluated. Of the included studies, 43 presented positive findings and three obtained negative findings on the effectiveness of natural products in inhibiting or killing Candida albicans. Natural products, predominantly sourced from the Plantae kingdom, have demonstrated efficacy in reducing Candida albicans on the surface of conventional PMMA. However, the evidence primarily stems from invitro studies, underscoring the necessity for additional clinical research to validate their applicability under real microbiological conditions in prosthesis users.

Lemongrass (Cymbopogon citratus) oil nanoparticle synthesis, characteristic, and evaluation of antibacterial and antifungal effects and the influence on hardness of acrylic resin

Context: Acrylic resin is used in dentistry as a removable denture base. It can cause various pathologies when not properly cleaned. One of the pathologies is denture stomatitis caused by Candida albicans and Streptococcus mutans accumulation on the acrylic resin surface. Therefore, microbial agents such as denture cleansers are needed. Aims: To evaluate the characteristics of lemongrass (Cymbopogon citratus) nanoparticles as a better antibacterial and antifungal herbal ingredient and their relationship with acrylic hardness. Methods: C. citratus oil nanoparticles (LON) were synthesized and analyzed by transmission electron microscopy (TEM). Electrospray ionization tandem mass spectrometry (ESI-MS) analysis was used to analyze the characteristics of LON bioactive components. Minimum inhibitory concentration (MIC) and minimum bacterial concentration (MBC) against C. albicans and S. mutans and mechanical hardness test of acrylic were performed. Results: The LON concentration of MIC and MBC against C. albicans and S. mutans was 25 and 100%, respectively. One-way ANOVA showed no significant difference between groups of LON with different concentrations (p=0.687). A paired t-test showed significant differences in acrylic resin hardness before and after treatment of LON with 100% (p=0.022) and 50% (p=0.021) concentration. There was no significant difference in hardness before and after treatment of other concentrations of LON and chlorhexidine as positive control. Conclusions: LON treatment on acrylic resin decreased the growth of C. albicans and S. mutans without altering the mechanical properties (hardness).

Prosthetic stomatitis: treatment and prevention

Relevance. Traumatic prosthodontic stomatitis is the most frequent in clinical prosthetic dentistry, increasing the effectiveness of prevention and treatment of which is considered an urgent problem of practical dentistry. Objective. To study the effectiveness of using various domestic means for oral care in patients suffering from traumatic prosthetic stomatitis. Materials and methods. The study involved 42 elderly patients suffering from denture stomatitis due to the use of removable acrylic dentures. The patients were divided into 2 groups. In the control group after dentures correction they were recommended to use rinses and irrigations of the oral cavity with antiseptic solutions for a week, and later with infusions of medicinal herbs. Patients of the main group during their follow-up used local anti-inflammatory and wound-healing agents produced by thedomestic industry, as well as those improving the fixation of removable dentures. The effectiveness of denture stomatitis treatment and prevention of recurrence was evaluated on the basis of the patient’s complaints and clinical condition of the oral mucosa. Results. . It was established that for effective therapy of denture stomatitis it is necessary to use specially produced anti-inflammatory agents for the oral cavity during the period of acute inflammatory changes in the mucous membrane of the denture bed, and when using removable acrylic dentures it is necessary to recommend ASEPTA denture fixation cream, which has proved itself not only in the aspect of optimization of microbiota and mucosal immunity of the mouth, but also for optimization of psychophysiological state of patients. Their use makes it possible to achieve 81.47% efficacy of prosthetic stomatitis treatment on the 5th day and 100% efficacy of therapy on the 7th day from the beginning of their use by the patient, as well as in the nearest period to provide prevention of this disease recurrence. Conclusion. For secondary prophylaxis of traumatic prosthetic stomatitis, which occurs most often among the complications when patients use removable acrylic dentures, it is advisable to use specially produced by the domestic industry means possessing anti-inflammatory and wound-healing properties, as well as favorably acting on the mucous membrane of the prosthetic bed.

Benzyldimethyldodecyl Ammonium Chloride-Doped Denture-Based Resin: Impact on Strength, Surface Properties, Antifungal Activities, and In Silico Molecular Docking Analysis.

Candida albicans (C. albicans) adhering to denture-based resins (DBRs) is a known cause of denture stomatitis. A new approach to prevent denture stomatitis is to include antimicrobial substances within DBRs. Here, we examined the mechanical performance and antifungal properties of DBRs containing benzyldimethyldodecyl ammonium chloride (C12BDMA-Cl) as an antimicrobial compound. C12BDMA-Cl is a quaternary ammonium compound, and its antifungal properties have never been investigated when combined with dental acrylic resin. Therefore, we modified a commercially available heat-polymerized acrylic DBR to contain 3 and 5 wt.% of C12BDMA-Cl. Unmodified DBR was used as a control group. Specimens were prepared using the conventional heat processing method. The specimen's flexural strength, elastic modulus, microhardness, and surface roughness were evaluated. C. albicans biofilm was grown on the specimens and assessed via colony-forming units (CFUs) and scanning electron microscopy (SEM). In silico molecular docking was applied to predict the potential C12BDMA-Cl inhibition activity as an antifungal drug. The 3% C12BDMA-Cl DBR demonstrated antifungal activities without a deterioration effect on the mechanical performance. SEM images indicated fewer colonies in DBR containing C12BDMA-Cl, which can be a potential approach to managing denture stomatitis. In conclusion, C12BDMA-Cl is a promising antifungal agent for preventing and treating denture stomatitis.

Influence of nanohydroxyapatite mouthwash on the growth of Candida albicans biofilm on milled denture surfaces: An in vitro study.

There is a need for effective solutions for the persistent prevalence of denture stomatitis (DS) in denture-wearing populations. This study assessed the impact of nanohydroxyapatite (nanoHAP) nanoparticles on Candida albicans biofilm formation on milled polymethylmethacrylate (PMMA) denture bases. Acquired salivary pellicle was formed on disks milled from a prepolymerized PMMA puck. The disks were assigned to two groups, A (n=18) and B (n=18), and each group was further subdivided into three subgroups (6/subgroup), each treated with either Polident solution (antibacterial denture cleanser), nanoHAP mouthwash, or distilled water. Disks in group A subgroups were soaked in their respective treatment solutions for 8h, followed by biofilm formation on thedisk for 24h. Disks in group B subgroups had C. albicans biofilm formed on them for 24h, followed by soaking in their respective treatment solutions for 8h. Biofilm thickness, biomass, and live/dead cell ratio were determined using aconfocal laser scanning microscope. Biofilm morphology was examined with ascanning electron microscope (SEM). Data were analyzed by ANOVA and Tukey-Kramer multiple comparisons (α=0.05). In group A, nanoHAP mouthwash displayed significant anti-adhesive properties. In group B, biofilm biomass and thickness significantly decreased (p<0.05), with the nanoHAP showing the most substantial reduction in existing biofilm compared to other solutions, but it did not significantly affect cell viability. This study demonstrated the efficacy of nanoHAP mouthwash in inhibiting C. albicans biofilm formation when used as a storage medium for acrylic dentures. It suggests its potential clinical application for preventing denture stomatitis in patients.

Denture microbiome shift and changes of salivary inflammatory markers following insertion of 3D printed removable partial PMMA denture: a pilot study

BackgroundThe aim of this study was to investigate the microbiome shift of denture biofilm formation, the incidence of Candida and changes of salivary inflammatory markers following insertion of 3-dimensional printed PMMA denture.MethodsThis was a pilot study of 6 patients provided with 3D printed (test group) or conventionally heat-cured (control group) removable partial acrylic dentures followed up for 6 weeks. 3 denture swabs were collected at week 1, 3 and 6; and saliva samples were collected at baseline, week 1, 3 and 6 following denture insertion. Microbial DNA was isolated, and the 16S rRNA gene was amplified and sequenced to assess the denture microbiota. The presence of Candida was determined using PCR assay. The levels of salivary biomarkers lactoferrin (LTF) and histatin (HTN) were determined using ELISA.ResultsDenture microbiome of both groups exhibited similar microbial compositions at weeks 1, 3 and 6. However, the percentage of Streptococcus in the test group was significantly lower at week 1 (p < 0.05). Greater bacterial diversity was detected in the test group (p < 0.05; pairwise Wilcoxon) after 6 weeks. The presence of Candida was only detected in one sample of the 3D printed denture (test group) after 6 weeks. The level of LTF biomarkers increased in both groups after 6 weeks, however, the level of HTN increased only in the control group.ConclusionsDenture microbiome of both groups demonstrated similar microbial compositions. After 6 weeks, 3D printed denture demonstrated higher diversity with delayed microbiome shift compared to conventional heat cure dentures. 3D printed denture may be a viable alternative to conventional denture and it has a potential to delay microbial dysbiosis.Clinical RelevanceAmong wearers, 3D printed denture can potentially reduce the risk of denture stomatitis. A greater diversity may delay or slow the transition of denture microbiome to dysbiosis.

Tissue response in a rat model of denture stomatitis treated with tissue conditioner containing antifungal complexed with β-cyclodextrin.

Introduction. Tissue conditioners modified with antifungals are a potential alternative to denture stomatitis (DS) treatment.Gap Statement. Information on tissue response to this treatment before its clinical application is lacking.Aim. This study aimed to evaluate the tissue response of a tissue conditioner modified with antifungals in a rat model of DS.Methodology. After DS induction for 4 days under antibiotic therapy, Wistar rats had their intraoral devices (IODs) relined with the tissue conditioner Softone without (Soft) or with the MICs against Candida albicans of nystatin (Nys) or chlorhexidine (Chx) complexed or not with β-cyclodextrin (Nys:βCD and Chx:βCD). Three controls were included: healthy rats [negative control (Nc)], rats using a sterile IOD [sterile device (Sd)] and rats with DS that did not receive treatment (DS). After 4 days of treatment, the palatal mucosa under the IODs underwent histological processing for morphohistopathological and histometric analyses, morphology of collagen fibres (birefringence), immunohistochemistry for the expression of cell proliferation (proliferating cell nuclear antigen) and cytokine (IL-1β).Results. The Nc and Sd groups were similar (P>0.05), displaying epithelial and connective tissues without any discernible changes in the parameters assessed. The DS and Soft groups exhibited pronounced epithelial alterations, cell proliferation and expression of the cytokine IL-1β. In groups treated with drug incorporation (Nys, Chx, Nys:βCD and Chx:βCD), all samples demonstrated a reduction in tissue inflammation or complete tissue recovery, with an epithelium compatible with health. For the immunohistochemical parameters, the Chx, Nys:βCD and Chx:βCD groups were comparable with Nc (P>0.05).Conclusion. The proposed treatment could be promising for DS, as it led to the tissue recovery of the palatal mucosa. Nevertheless, much lower concentrations of complexed antifungals were required to achieve a similar or higher degree of tissue response compared with uncomplexed drugs in a modified tissue conditioner formulation.

Enhancing antifungal and antibacterial properties of denture resins with nystatin-coated silver nanoparticles

Long-term oral health issues caused by fungi and bacteria are a primary concern for individuals who wear dentures. Denture stomatitis, primarily caused by Candida albicans (C. albicans), is a prevalent condition among denture users. Metal nanoparticles exhibit improved antimicrobial effectiveness and fewer adverse effects. This study aimed to evaluate the antifungal and antibacterial effects of nystatin-coated silver nanoparticles (Nys-coated AgNPs) embedded in acrylic resin as a more biocompatible material for denture resins. AgNPs and Nys-coated AgNPs were synthesized and characterized using UV-Vis, SEM, EDX, and DLS. Specimens of polymethyl methacrylate (PMMA) with three different concentrations of Nys, AgNPs, and Nys-coated AgNPs (0.1%, 1%, 10% w/w) were prepared. The water absorption properties of the disks and drug release were investigated for 14 days and 120 h, respectively. The hydrophilic and hydrophobic properties of the samples and their contact angles were evaluated using the sessile drop technique. The antifungal and antimicrobial activity of the prepared discs was studied against C. albicans and Streptococcus mutans, respectively. Adding Nys-coated AgNPs decreased the contact angle of discs from 67° to 49°. Furthermore, the water absorption rates of the different discs were not significantly different from those of the control groups. Results showed that Nys-coated AgNPs (10% w/w) in PMMA effectively inhibited C. albicans growth better than Nys composites (10% w/w). Additionally, Nys-coated AgNPs composites, as well as AgNPs-containing composites, showed considerable antibacterial activity against S. mutans. Nys-coated AgNPs (10% w/w) had no toxic effect on NIH3T3 cells. In conclusion, Nys-coated AgNPs could be considered a good candidate for incorporation into denture resins to address chronic oral diseases.

Evaluation of symbiotic relationships of oral microorganisms and their effect on the development of inflammatory changes of the oral mucosa in the complete absence of teeth

Introduction. By fixing on the exposed surfaces of complete removable dentures and oral soft tissues, bacteria form a biofilm, thereby increasing their overall virulence and resistance. The microorganisms that make up the biofilm are often in a symbiotic relationship, which allows them to increase their pathogenic potential and cause the development of denture stomatitis. Accordingly, when a particular strain is present in the oral cavity, the risks of symbiosis are significantly increased. The aim of the study was to evaluate the effect of symbiotic relationships of oral bacteria on the development of inflammatory changes in the oral cavity in the absence of teeth. Materials and methods. Two groups of patients belonging to the elderly age according to WHO systematization (60–74 years) with complete absence of teeth (K08.1) were formed, differing in the presence of clinical manifestations of inflammation (82 men and 49 women). Biological material sampled from the oral cavity of patients was studied using the culture method and RT-PCR. To quantify the interaction between members of the microbiocenosis, we used the Jaccard similarity coefficient. Results. Coagulase-negative and coagulase-positive staphylococci, Neisseria, Candida spp., Enterobacterales and F. nucleatum were more frequently found in patients with complete absence of teeth. Expressed symbiotic relations between microorganisms of the Enterobacterales order, Lactobacillus, Neisseria and Corynebacterium genera, as well as S. salivarius, C. albicans, F. nucleatum were established. The nature of these relations depended on the presence of inflammatory changes in the oral mucosa and, in turn, influenced the development of the latter. Thus, in the absence of inflammation, Corynebacterium, Lactobacillus and S. salivarius showed stable synergism. In case of inflammation, the association between these bacteria was accompanied by the introduction of F. nucleatum and displacement of S. salivarius. Conclusion. Thus, conditionally pathogenic microorganisms, forming microbial associations with multidirectional symbiotic relations increase their virulence, which allows them to occupy free niches in the oral cavity and subsequently trigger the development of pathological process of inflammatory character of prosthetic bed tissues.

Comparison of the Antimicrobial Efficacy of Conventional Versus Chitosan Re-inforced Heat-Polymerized Polymethylmethacrylate Dental Material: An In Vitro Study.

Polymethylmethacrylate (PMMA) is widely used in the fabrication of dentures due to its aesthetic appeal and mechanical strength. However, PMMA's susceptibility to microbial colonization often leads to oral infections such as denture stomatitis. Enhancing the antimicrobial properties of denture materials is crucial for improving patient outcomes.Chitosan, a natural biopolymer, possesses inherent antimicrobial properties and could potentially enhance the microbial resistance of PMMA. This study has investigated thepotential of chitosan-reinforced heat-polymerized PMMA denture material to reduce microbial colonization. The aim of the study was to evaluate and assess the anti-bacterial and antifungal properties of chitosan-reinforced heat-polymerized PMMA with conventional heat-polymerized PMMA Materials and methods:Chitosan-reinforced PMMA samples were fabricated with varying chitosan concentrations (0% control, 5%, 10%, and 15% by weight). The fabrication involved mixing chitosan powder with PMMA powder, adding monomer liquid, followed by mixing, packing, and curing using the conventional heat polymerization technique. The antimicrobial efficacy was assessed in vitro using two common oral pathogens: Streptococcus mutans and Candida albicans. Blood agar plates were used for S. mutans and Sabouraud agar plates were used for C. albicans. Each sample was placed on the respective agar plates inoculated with a standardized microbial suspension and incubated at 37°C for 24 hours. The number of colony-forming units (CFUs) was counted to quantify microbial growth. Statistical analyses, including linear regression analysis, one-way ANOVA test, and Pearson correlation were performed to evaluate the relationship between chitosan concentration and antimicrobial efficacy. The p-value was calculated to determine the statistical significance of the results. The chitosan-reinforced PMMA samples showed significantly greater antimicrobial efficacy compared to the conventional PMMA samples. The CFU counts for both S. mutans and C. albicans decreased with increasing chitosan concentration. Linear regression analysis indicated a strong negative correlation between chitosan concentration and CFU counts, with Pearson correlation coefficients of -0.97 for S. mutans and -0.98 for C. albicans. ANOVA analysis revealed a statistically significant difference in antimicrobial efficacy across different chitosan concentrations (p < 0.001). Incorporating chitosan into heat-polymerized PMMA significantly enhances its antimicrobial properties against S. mutans and C. albicans. The antimicrobial efficacy improves with higher concentrations of chitosan, with the 15% chitosan-reinforced samples showing the most substantial reduction in microbial growth. These results suggest that chitosan-reinforced PMMA dentures could be a superior alternative to conventional PMMA dentures, potentially reducing denture-related infections and improving oral health outcomes for denture wearers.

Enhanced Antimicrobial Properties of Polymeric Denture Materials Modified with Zein-Coated Inorganic Nanoparticles.

Polymeric denture materials can be susceptible to colonization by oral microorganisms. Zein-coated magnesium oxide nanoparticles (zMgO NPs) demonstrate antimicrobial activity. The aim of this study was to investigate the antimicrobial effect and adherence of different oral microorganisms on hybrid polymeric denture materials incorporated with zMgO NPs. Five types of polymeric denture materials were used. A total of 480 disc-shaped specimens were divided by material type (n=96/grp), then subdivided by zMgO NPs concentration: control with no nanoparticles and other groups with zMgO NPs concentrations of 0.3%, 0.5% and 1% by weight. Characterization of the polymeric denture materials incorporating zMgO NPs was done, and the antimicrobial activity of all groups was tested against four types of microorganisms: 1) Streptococcus mutans, 2) Staphylococcus aureus, 3) Enterococcus faecalis and 4) Candida albicans. The samples underwent an adherence test and an agar diffusion test. Experiments were done in triplicates. The characterization of the hybrid samples revealed variation in the molecular composition, as well as a uniform distribution of the zMgO NPs in the polymeric denture materials. All hybrid polymeric denture materials groups induced a statistically significant antimicrobial activity, while the control groups showed the least antimicrobial activity. The agar diffusion test revealed no release of the zMgO NPs from the hybrid samples, indicating the NPs did not seep out of the matrix. The zMgO NPs were effective in reducing the adherence of the tested microorganisms and enhancing the antimicrobial activity of the polymeric denture materials. This antimicrobial effect with the polymeric dentures could aid in resisting microbial issues such as denture stomatitis.

CLINICAL IMPACT OF DIODE LASER ON TRUENESS, PRECISION, AND QUALITY OF LIFE OF COMPLETE DENTURE WEARERS (CLINICAL STUDY)

Background: Candida Albicans (C. albicans) is a major fungal infection affecting the majority of complete denture wearers and causes denture stomatitis (DS) which has many local treatment modalities, such as Chlorohexidine mouthwash and the Diode Laser. Their clinical impact on denture Accuracy, Retention, and the Patients ability to utilize dentures normally has not yet been discussed. Hence, a complete dentures Accuracy titled Trueness and Precision is a vital hidden key for achieving its success post-disinfection. Objectives: This studys objective was to evaluate and compare Diode Laser and Chlorhexidine mouthwashs impact on Trueness, Precision, Retention, and the Patients oral health-related quality of life (OHRQoL) in complete denture wearers. Materials and Methods:An overall of 16 complete edentulous patients were elected, dentures constructed from Heat-cure acrylic resin, and grouped equally owing to the antifungal disinfectant employed into Group I (Diode Laser) and Group II (Chlorhexidine). Assessments were carried out pre- and post-disinfectant application in both groups. The Pre-Disinfectant assessments of Trueness and Precision took place before delivery whereas, those of Retention andOHRQoLwere carried out immediately post-delivery. All the Post-Disinfectant assessments were carried out 60 days following delivery. Results: There was an insignificant difference between Diode Laser and Chlorhexidine mouthwash regarding Trueness, Precision, Retention, and OHRQoLin maxillary complete dentures. Conclusion:It has been concluded that the Diode Laser beam and the 2% Chlorhexidine mouthwash are safe antifungal Heat-cure CD disinfectants regarding Trueness, Precision, Retention, and the OHRQoL.

La eficacia de los aceites ozonizados en el tratamiento de pacientes con micosis superficiales.

Abstract. Superficial mycoses are one of the main reasons for consulta-tion in the dermatological area. In recent years, the therapeutic effectiveness of ozonated oils in fungal infections has been verified in different countries due to its broad germicidal and antifungal spectrum. The objective is to evaluate the efficacy of the use of ozonated sunflower oil in the treatment of superficial mycoses in patients of the Mycology consultation at the Dermatology Service of the Hospital Vargas de Caracas, Instituto Autonómo de Biomedicina “Dr. Ja-cinto Convit”. A cross-sectional descriptive, experimental study was conducted, where 36 patients diagnosed with superficial mycosis and ten healthy subjects were evaluated. Of the group of 36 patients, 26 were treated with ozonated sun-flower oil (AGO) and ten patients with non-ozonized sunflower oil (AGNO). Ten healthy individuals represented the AGO sensitivity control. The most frequent superficial mycosis evaluated in the AGO group was tinea corporis (31%), fol-lowed by denture stomatitis (23%) and for the AGNO group, tinea pedis (50%). Regarding the etiological agent, an improvement with the AGO treatment of 86% for Candida albicans and 60% for the Trichophyton rubrum complex was evidenced at week eight of treatment. It is concluded that the antifungal effect of AGO is more significant for the genus Candida spp than for dermatophytes, evidencing a total improvement of the lesions with six weeks of treatment.

Antifungal recombinant psoriasin of human origin effectively inhibits fungal growth on denture base.

To evaluate the efficacy of recombinant psoriasin as a novel treatment for oral candidiasis by eliminating Candida albicans growth on polymethyl methacrylate denture base. Recombinant psoriasin protein was expressed and purified from E. coli, and Candida growth was monitored invitro with varying concentrations of psoriasin. Subsequently, denture-base polymethyl methacrylate was immersed in psoriasin's solution or voriconazole, and fungal growth on the acrylic base and in the medium was examined by scanning electron microscopy and optical density, respectively. Cellular viability of HeLa and human gingival fibroblast cells treated with psoriasin was measured by methylene blue assay. The findings reveal an effective antifungal activity of psoriasin, completely inhibiting Candida albicans growth in RPMI at a protein concentration above 400 nM. Immersing the polymethyl methacrylate with 50 μM psoriasin completely eradicates fungal growth. Psoriasin has low cytotoxicity in HeLa cells at a concentration higher than 12 μM and no toxic effect on human gingival fibroblasts. This study marks psoriasin as an effective alternative to conventional antifungal treatments for denture stomatitis and a safe alternative to chemical antifungals in dental medicine and beyond.

Candidiasis and Oral Health

Candidiasis, primarily caused by Candida albicans, poses significant oral health concerns. This review highlights its clinical manifestations, diagnostics, and management strategies. Predisposing factors include poor oral hygiene and systemic conditions like HIV/AIDS and diabetes. Clinical presentation varies from asymptomatic colonization to symptomatic mucosal infections, with complications such as denture stomatitis. Diagnostics encompass clinical examination and various laboratory methods, guiding tailored treatment with topical or systemic antifungals. Prevention strategies targeting modifiable risk factors are crucial. Despite challenges like antifungal resistance, interdisciplinary collaboration among healthcare providers is essential for the effective management of oral candidiasis and its impact on overall health. Keywords: Candidiasis; Candida albicans; Oral health; Diagnostics; Antifungals; Prevention strategies

Oral Colonization by Different Candida Species: First Comparative Study between Denture and Nondenture Wearers in Tunisia.

This study aimed to compare different Candida species present in patients with and without removable dentures to identify alterations in biofilm composition following denture wear within a Tunisian population. A cross-sectional study was conducted, comprising a group of patients wearing removable dentures (test group) and a control group without dentures. In the test group, two mycological samples were obtained: one from the prosthetic intaglio and another from the osteomucosal area bearing the denture. For the control group, mycological samples were collected from the oral mucosa. The collected swabs were cultured on CHROMagar Candida medium, and yeast counts were quantified as colony forming units (CFUs). Candida species were identified through chromogenic analysis. The normality of quantitative variables was evaluated using the Kolmogorov-Smirnov's test. To compare means and ranks between the test and control groups, the independent samples t-test and the Mann-Whitney's U test were employed, respectively. Qualitative variables were compared using Fisher's exact test. Statistical significance was determined at a critical uncertainty value of p < 0.05. A total of 150 participants were involved in this study, with 75 patients in each group. Wearing an acrylic removable denture was found to increase the number of detected Candida species (p < 0.001) and significantly increases the overall growth of Candida spp. (p = 0.001). Specifically, the numbers of CFUs of Candida tropicalis and Candida glabrata were elevated in denture wearers (p < 0.001). Findings stemming from this study indicate that removable dentures promote the growth of Candida species. This can be a predisposing factor for Candida-associated denture stomatitis in cases of poor oral hygiene or compromised immunity. Therefore, it is imperative to emphasize the fabrication of high-quality dentures and the implementation of rigorous postdenture maintenance protocols to prevent or limit Candida infection.

EPIDEMIOLOGY OF PROSTHETIC DENTISTRY IN THE ORTHOPEDIC DENTISTRY CLINIC

Introduction. The urgent task of orthopedic dentistry is the timely and optimal restoration of masticatory efficiency. Removable prosthetics remains one of the most popular methods of dental prosthetics. At the same time, removable prosthetics is associated with a number of clinical complications. An analysis of modern available domestic and foreign sources of literature on the epidemiology of prosthetic stomatitis, as well as the potential role of removable prostheses in the development of this disease, was carried out. Aim. To present the collected updated information from the current available systematic literature on the epidemiology of denture stomatitis, as well as the potential role of removable dentures in the development of the disease and make it accessible to orthopedic dentists. Materials and methods. A literature search was conducted using the electronic database PubMed to find studies related to the epidemiology and etiology of prosthetic stomatitis. The search period covered the period from January 2012 to December 2022, and 53 sources of literature were analysed. Results. A selection of 19 scientific articles was formed as a result of the conducted search and selection of scientific works that most closely corresponded to the set goal of the research. It was established that the prevalence of prosthetic stomatitis varies depending on a certain number of factors. According to the results of research by various authors, this disease affects from 20% to 80% of patients who use removable dentures. Variability of the prevalence of prosthetic stomatitis depends significantly on the age of the patient, gender, type of prosthesis, general health and oral hygiene of people using these structures. Analysis of data from an epidemiological study shows that the prevalence of prosthetic stomatitis among users of removable dentures varies from 20% to 80%. It is possible that the spread of stomatitis prevalence rates was influenced by conducting the study among various samples of the population. In general, the incidence of prosthetic stomatitis was higher among women and the elderly in the studies reviewed. Conclusions. The analysis of available sources of literature on the issue of epidemiology of prosthetic stomatitis allows to systematize the available modern developments, conduct their detailed analysis and make the obtained data available to practicing orthopedic dentists. The perspective of research consists in the detailed study of etiological factors contributing to the development of prosthetic stomatitis in patients with removable prostheses.

Preparation of iron nanoparticles mediated by Punica granatum and its application for the treatment of denture stomatitis

Denture stomatitis affects around 50% of denture wearers in certain populations as a prevalent oral mucosal lesion. There has been a high interest in utilizing natural antibacterial composites, such as medicinal plants extracts. Punica granatum, a popular medicinal plant, has various pharmacological applications. In this particular research, iron NPs were formulated by the Punica granatum aqueous extract, following the principles of green chemistry. The study objective was to assess the effectiveness of FeNPs on denture stomatitis. The usual analytical examinations were applied for FeNPs. The FE-SEM results confirmed that the nanoparticles exhibited a spherical morphology, with sizes ranging from 21.6 to 65.8 nm. This clinical trial involved 30 patients who received FeNPs. Over a period of two weeks, the patients were instructed to consume the mouthwash four times per day, with 15–20 drops each time, for a duration of 2–3 minutes. Following the mouthwash, they were advised to refrain from eating or drinking for 0.5 hour. The patients in both classes were instructed to consume the medication at particular times. The erythema and inflammation levels were recorded and assessed at each session using a 6-point scale and a graded blade. Additionally, palatal mucosa mycological samples were collected for culture during each visit. The data revealed a notable reduction in the palatal erythema surface compared to the initial condition in the follow-up visits. This study suggests that FeNPs can effectively reduce the Candida colonies number and the area affected by erythema in the denture stomatitis management.

Evaluation of flexural strength and microhardness in Vaccinium macrocarpon (cranberry)-added self-cure polymethyl methacrylate dental resin: An in vitro study.

Occurrence of denture stomatitis and prosthesis breakage are common problems faced by elderly people wearing removable dentures. To overcome this, several attempts are made to improve the denture material by addition of antimicrobials without compromising original properties. The aim of the study was to evaluate flexural strength and microhardness of self-cured polymethyl methacrylate (PMMA) denture base resin after addition of Vaccinium macrocarpon (commonly called as cranberry), extract as antimicrobial, at varying proportions. Experimental in vitro study. Frozen cranberry fruits were subjected to extraction process in the presence of aqueous solvents. Lyophilized extract was added in proportions of 0, 0.5, 1.0, 1.5, and 2.0 dry wt/wt % into polymer of self-cure PMMA denture base resin. Based on cranberry inclusion, the study comprised one control (0%) and four test groups (0.5%-2%) with total of 100 samples. A three-point bending test for flexural strength was done for fifty study samples (n = 10). Surface of fractured samples was analyzed using a scanning electron microscope (SEM). Microhardness was determined using Vickers hardness test. One-way statistical ANOVA test was done to find the difference between groups, followed by Tukey's post hoc test for multiple pairwise comparison. Flexural strength ranged from 66.80 to 69.28 MPa, and a statistically insignificant difference was observed between groups (P > 0.05). SEM evaluation showed uniformly dispersed strands of cranberry extract in PMMA matrix. With higher concentration, less voids were seen. Vickers microhardness value significantly decreased from 15.96 in the control group to 14.57 with 2% cranberry addition (P < 0.05). Incorporation of cranberry extract into self-cure PMMA denture base resin, up to 2 dry wt %, did not decline the flexural strength. However, there was a significant decrease in Vickers microhardness values when compared against the control group (0% cranberry inclusion).