Development Of Denture Stomatitis Research Articles

Local Factors for Development of Denture Stomatitis and Strategies for Their Management

One of the most frequent diseases of oral cavity in elderly people that use removable dentures is denture stomatitis. Large set of local factors predispose towards the occurrence of denture stomatitis – quantity and Ph of saliva, violations of oral mucosa integrity, surface characteristics of the denture base materials, the maintenance of dentures and oral cavity hygiene, the period of using one and the same dentures, etc. Development of denture stomatitis can deteriorate not only the oral health but general health status of patients, hence their quality of life. This predefines problem’s great social significance. The purpose of this review was to analyse the local factors that make impact on development of denture stomatitis in complete dentures wearers, the contemporary prevention strategies and the role of the patients in their realization. Successful prevention of the disease could be achieved with the application of complex approach that includes evaluation of all the general and local factors and implementation of multi-component strategy for the management of their influence. The active collaboration with patient is essential for successful prevention of the denture stomatitis. Keywords: denture stomatitis; local factors; strategies for prevention

A novel rat model of denture stomatitis and the role of antibiotics in the development of the disease.

This study compared different conditions to establish a rat model of denture stomatitis. Immunocompetent Wistar rats were divided into two groups (n=35): Tetracycline=administration of 0.83mg/ml of tetracycline hydrochloride 7 days before induction of denture stomatitis and amoxicillin=administration of 0.156mg/ml of amoxicillin with clavulanic acid 4 days before induction of denture stomatitis. A suspension of Candida albicans was inoculated on the palate followed by the use of a palatal device contaminated with C. albicans inoculum for 4 days to induce denture stomatitis. As controls, some rats were not submitted to any procedure or used a sterile palatal device for 4 days. The development of denture stomatitis was confirmed by visual analysis, colony-forming units per milliliter (CFU/ml) count, histopathological and immunohistochemical analyses, and through myeloperoxidase (MPO) and N-acetylglucosaminidase (NAG) assays. Rats were euthanized right after device removal (T0), 4 (T4), or 6 (T6) days after device removal. Tetracycline improved the development of the disease, with more severe clinical signs at T0. Similar results were observed in the CFU/ml count and in the histometric and immunohistochemical analyses. Higher MPO expression was detected in the palates of the tetracycline group (P=.006). Despite the subtle differences between antibiotics, tetracycline showed better results in inducing and maintaining denture stomatitis for at least 4 days after device removal.

A novel acrylic resin palatal device contaminated with Candida albicans biofilm for denture stomatitis induction in Wistar rats.

Denture stomatitis is the most frequent oral lesion in removable prosthesis wearers, with high recurrence rates and a complex treatment. ObjectiveThis study describes a protocol to obtain and to contaminate a palatal device with Candida albicans biofilm that could be used for an animal model of denture stomatitis.Methodology Acrylic resin devices (N=41) were obtained from impressions of the palates of Wistar rats with individual trays and polyether. The efficacy of microwave irradiation (MW), ultraviolet light (UV), or ultrasonic bath (US) was assessed by colony viability and spectrophotometric analyses (n=5) in order to select the most appropriate method for sterilizing the devices. Then, different devices (n=5) were contaminated with C. albicans and evaluated by CFU/mL determination, scanning electron microscopy, and laser confocal microscopy. Device stabilization was assessed with either autopolymerizing acrylic resins or a self-adhesive resin cement (n=2). The spectrophotometric data were analyzed by one-way ANOVA followed by the Tukey’s HSD post-hoc test (α=0.05).Results MW was the only method capable of sterilizing the devices, and the contamination protocol developed a mature and viable C. albicans biofilm (~1.2 x 106 CFU/mL). The self-adhesive resin cement was the best stabilization material.Conclusions This acrylic resin palatal device was designed to be similar to the clinical situation of contaminated prostheses, with easy manufacturing and handling, effective stabilization, and satisfactory contamination. Thus, the acrylic device can be a valuable tool in the development of denture stomatitis in rats.

The essential oil of Allium sativum as an alternative agent against Candida isolated from dental prostheses

BackgroundThe colonization of the surfaces of dental prostheses by Candida albicans is associated with the development of denture stomatitis. In this context, the use of fluconazole has been proposed, but its disadvantage is microbial resistance. Meanwhile, the oil of Allium sativum has shown an effect in controlling biofilm formation by C. albicans. AimsThe objective of this study was to determine the antifungal activities of the essential oil of A. sativum and fluconazole against clinical isolates of Candida species obtained from rigid, acrylic-based partial or total dentures and to compare these agents’ effects on both biofilm and planktonic cells. MethodsA total of 48 clinical isolates obtained from the acrylic surface of partial or complete dentures were examined, and the following species were identified: C. albicans, Candida glabrata, Candida tropicalis, and Candida krusei. For each isolate, the antifungal activities of the essential oil of A. sativum and fluconazole against both biofilm and planktonic cells were evaluated using the Clinical & Laboratory Standards Institute (CLSI) M27-A3 method. The isolates were also evaluated by semiquantitative XTT reduction. ResultsAll planktonic Candida isolates were susceptible to the essential oil of A. sativum, whereas 4.2% were resistant to fluconazole. Regarding susceptibilities in biofilms, 43.8% of biofilms were resistant to A. sativum oil, and 91.7% were resistant to fluconazole. ConclusionsAll planktonic cells of the different Candida species tested are susceptible to <1mg/ml A. sativum oil, and the majority are susceptible to fluconazole. Susceptibility decreases in biofilm cells, with increased resistance to fluconazole compared with A. sativum oil. The essential oil of A. sativum is thus active against clinical isolates of Candida species obtained from dentures, with effects on both biofilm and planktonic cells in vitro.

Invitro Antifungal Evaluation of Denture Soft Liner Incorporated with Tea Tree Oil: A New Therapeutic Approach Towards Denture Stomatitis.

Adherence and colonization of candida on denture soft liners is the most important contributing factor in development of denture stomatitis. This invitro study is undertaken to investigate whether the incorporation of tea tree oil into denture soft liners would inhibit the growth of candida albicans. Each 10 specimen disks incorporated with tea tree oil into soft liners (St) and without tea tree oil (S) were prepared. Both the tea tree oil daily. These disks were inoculated with candida albicans suspension for assessment of fungal growth and were rinsed with sterile water to remove loosely attached surface organisms. The attached yeasts were measured by inoculating them on saboraud's agar. Treated and control disks were stored in distilled water for 1, 30, 60 days and washed daily with wet cotton. Data between treated and control disks were compared by applying t-test. The mean colony forming units (CFU) per mm(2) for specimens without tea tree oil after water storage and wash with wet cotton for 1, 30 and 60 days was 7.1 × 10(6), 6.5 × 10(6), 6.8 × 10(6), respectively and for specimens with tea tree oil CFU decreased significantly to 2.1 × 10(6), 2.8 × 10(6), 3.1 × 10(6) after 1, 30 and 60 days. Treated disks were effective in controlling the growth of C.albicans for two months following water storage. Addition of tea tree oil to denture soft liner significantly reduced growth of C.albicans suggesting a new form of intra oral effective antifungal management for denture stomatitis.

Relationship among local and functional factors in the development of denture stomatitis in denture wearers in northern Brazil

OBJECTIVE: The aim of this study was to evaluate the relationship among functional and qualitative factors in the development of denture stomatitis (DS) (according to Newton's classification) in acrylic-based denture wearers residents from northern Brazil.MATERIAL AND METHOD: A total of 99 patients who wore partial or total acrylic resin-based upper dentures were included in this study. The subjects completed an epidemiological data form that includes the patient's gender, age, local factors (hygiene habits, remove denture to sleep, use of mouthwash, present condition of the denture, age of the denture) and functional factors (vertical dimension at rest, vertical dimension of occlusion, occlusion, retention, and static and dynamic stability). To detect yeasts, samples were collected from the inner surface of the dentures and from the palatal mucosa in contact with it. Subsequently, the samples were cultured on Sabouraud dextrose agar, observing macro and microscopic characteristics.RESULT: In the present study, we did not find any significant relationship between the gender and disease onset. Based on the Newton classification, 36.3% of the patients presented with DS and 89.0% were colonized by yeasts; of these subjects, 50% had type I lesions, 33.3% had type II lesions, and 16.6% had type III lesions. All of the qualitative and local factors, except the use of mouthwash, were clinically relevant to the development of disease.CONCLUSION: Denture stomatitis in denture users in northern Brazil was multifactorial, involving local, functional and microbiological factors.

Whole Saliva has a Dual Role on the Adherence of Candida albicans to Polymethylmetacrylate

Adhesion of Candida albicans to acrylic of dental prostheses or to salivary macromolecules adsorbed on their surface is believed to be a critical event in the development of denture stomatitis. In previous studies our group has shown that adhesion of C. albicans germ tubes to polystyrene is decreased by saliva whereas C. albicans yeast cells adhesion to the same material is enhanced. The results presented in this study confirm this dual role played by whole saliva, since it decreased the adhesion of germ tubes but increased the adhesion of yeast cells to polymethylmetacrylate (PMMA). These effects mediated by whole saliva do not seem to be related to an inhibition of the germination of C. albicans, since similar levels of filamentation were observed in presence and absence of saliva. These results may give new insights into the conflicting role of saliva in the adhesion of C. albicans to acrylic resins of dental prostheses.

Immunohistochemical localization of type IV collagen and laminin (alpha1) in denture stomatitis.

Chronic clinical irritation of the palatal mucosa by dentures involves a series of histological changes in epithelial and connective tissues, inflammatory cells and the vasculature. No single change is pathognomic of this inflammatory process. The rupture of basement membrane associated with the development of denture stomatitis often marks an important stage. This study investigated modifications in basement membrane organisation, especially the distribution of type IV collagen and a specific laminin chain (alpha1), during denture stomatitis. Biopsies of palatal mucosa were obtained from 12 patients (8 with denture stomatitis and 4 with clinically healthy mucosa) who had worn removable dentures for more than 3 years. Immunohistochemical studies performed with specific antibodies to type IV collagen and a laminin (alpha1) revealed strong expression in the basement membrane of healthy palatal mucosa. In denture stomatitis, some discontinuities or disruptions in basement membrane were observed at the interface between connective tissue and epithelial cells. These findings suggest a relationship between the expression of laminin (alpha1) and type IV collagen and the development of denture stomatitis, a disorder involving modification of soft tissues in which initial inflammation of the palatal mucosa results from stress under the denture. These changes in basement membrane can be detected by histological studies.

Effect of salivary secretory IgA on the adhesion of Candida albicans to polystyrene.

Attachment of Candida albicans to plastic materials of dental prostheses or to salivary macromolecules adsorbed on their surface is believed to be a critical event in the development of denture stomatitis. In an earlier study, it was shown that adhesion of C. albicans to polystyrene, a model system to study the adhesion of C. albicans to plastic materials, can be partially inhibited with an mAb directed against cell wall polysaccharides of C. albicans. In the present study, the role of whole saliva in the adhesion of C. albicans to polystyrene has been investigated, and three mAbs directed against epitopes of cell wall mannoproteins have been used to mimic the inhibitory effect observed with salivary secretory IgA (sIgA) on the adhesion of C. albicans to polystyrene. In the absence of whole saliva, adherence of C. albicans 3153 increased with germination. However, the presence of whole saliva enhanced the adhesion to polystyrene of C. albicans 3153 yeast cells but decreased the adhesion of germinated cells. The enhancement of adhesion of yeast cells to polystyrene mediated by saliva was confirmed with an agerminative mutant of C. albicans 3153. The inhibition of the adhesion of C. albicans 3153 germ tubes to polystyrene was due to the salivary sIgA since sIgA-depleted saliva enhanced the adhesion of C. albicans 3153 to polystyrene. The inhibitory effect mediated by sIgA was not related to the inhibition of germination but to the blockage of adhesins expressed on the cell wall surface of the germ tubes. The three mAbs studied reduced the adhesion of C. albicans 3153 to polystyrene at levels equivalent to those for purified sIgA. The highest reduction in the adhesion was obtained with the IgA mAb N3B. The best results were obtained when the three mAbs were combined. The results suggest that whole saliva plays a different role in the adhesion of C. albicans to polystyrene depending on the morphological phase of C. albicans. These results may give new insights into the conflicting role of saliva in the adhesion of C. albicans to plastic materials of dental prostheses.

The association of yeasts and denture stomatitis with behavioral and biologic factors

Objectives. This study describes the association of yeasts and denture stomatitis with behavioral and biologic factors. Study design. Seven hundred eighty 55-year-old citizens of Oulu, Finland, were examined clinically; 452 of them had complete dentures. Salivary yeasts and lactobacillus counts were detected through the use of Oricult-N and Dentocult-LB dip-slide techniques. Lifestyle factors were measured by means of questions concerning physical activity, tobacco smoking, alcohol consumption, and dietary habits. Other background variables used in cross-tabulations and logistic regression analysis were unstimulated salivary secretion rate, retention of denture, oral hygiene, gender, and socioeconomic status. Results. The prevalence of denture stomatitis was greater among subjects with an unhealthy lifestyle, subjects with higher lactobacillus counts, and subjects with poor oral hygiene. Salivary secretion rate and smoking were associated with the presence of yeasts, but general lifestyle measures were not. Conclusion. The presence of yeasts tended to be associated with biologic factors, but behavioral factors reflecting lifestyle may be more important in the development of denture stomatitis.

Inhibition of adherence of Candida albicans to acrylic by a chitin derivative.

The purpose of this study was to assess the effect of a chitin derivative (CSE) on the adherence of Candida albicans to acrylic. Fungal adherence to acrylic dentures is considered an essential step in the development of denture stomatitis. Adherence of C. albicans to acrylic pieces (5 x 5mm) was assessed microscopically using a calibrated ocular objective and expressed as number of adherent yeasts/mm2 of acrylic. CSE was prepared from commercial chitin (crab shell) and from chitin isolated from C. albicans blastospores. The effect of both CSE types on the adherence of C. albicans to acrylic was examined in two experimental systems: CSE present during the adherence assay and acrylic pieces pretreated with CSE prior to the assay. Both CSE types exerted a significant inhibitory effect when tested in the two experimental systems. These findings are significant for possible prevention of denture stomatitis.