Palatal brushing for the treatment of denture stomatitis: A multicentre randomized controlled trial.

PURPOSE: To determine the effectiveness of palatal brushing in the treatment of denture-related erythematous stomatitis (DES) in complete denture wearers. METHODS: This two-parallel-arm RCT was conducted in three university clinics in Brazil, Canada, and Chile. Participants (n=77) were randomly allocated to receive (i) instructions for palatal brushing and standard oral/denture hygiene ("intervention"); or (ii) standard oral/denture hygiene instructions only ("control"). Data collection was carried out at the baseline and at 3 and 6 months after intervention. Outcomes included the magnitude of oral Candida carriage and the degree of inflammation of denture-bearing tissues. Groups were compared using generalized estimating equations and chi-square test (α=0.05). RESULTS: Palatal inflammation levels were reduced significantly in the "intervention" compared to "control" group at 6 months (intervention: 70%, control: 40%; chi-square, p=0.04). There was no between-group significant difference in the Candida count from denture and palatal biofilms; however, a subgroup analysis restricted to baseline Candida carriers showed further reduction with the intervention at 6 months. No adversity was observed by trialist or reported by participants. CONCLUSIONS: Including palatal brushing in oral instructions for denture wearers has positive impact on DES-related mucosal inflammation. Thus, our findings endorse the inclusion of palatal brushing in standard oral hygiene instructions to treat DES.

Effect of Denture Hygiene Protocols on Patient Satisfaction, Oral Health-Related Quality of Life, and Salivary Parameters: A Randomized Clinical Trial.

PURPOSE: This randomized controlled trial compared four denture hygiene protocols in terms of patient satisfaction, oral health-related quality of life (OHRQoL), and salivary parameters in complete denture wearers with denture stomatitis. MATERIAL AND METHODS: For this randomized, double-blind, controlled clinical trial, 108 participants were assigned to soak their dentures in one of the following solutions: (1) 0.25% sodium hypochlorite (positive control), (2) 0.15% Triclosan, (3) denture disinfecting tablets, or (4) denture disinfecting tablets plus palatine mucosa brushing solution. The outcomes of patient satisfaction, OHRQoL, and salivary parameters (salivary flow rate and pH) were measured at baseline and after 10 days. The Kruskal-Wallis and Dunn tests (between groups), and Wilcoxon test (between times) were used to compare the results. (α = 0.05). RESULTS: After the hygiene protocols, and when compared with baseline, the overall patient satisfaction, maxillary denture satisfaction, maxillary denture comfort, and maxillary denture retention were ameliorated. A significant improvement was noted in OHRQoL in 3 of 4 domains evaluated (orofacial pain and discomfort, masticatory discomfort and disability, and psychological disability and discomfort). The salivary flow rate (unstimulated and stimulated) and salivary pH were not significantly affected at the times evaluated. CONCLUSIONS: Complete denture wearers may feel more satisfied with their complete dentures when treated for denture stomatitis. The tested treatments lead to similar improvement in terms of patient satisfaction and OHRQoL.

Experimental animal models for denture stomatitis: A methodological review.

Denture stomatitis is the most prevalent form of oral candidiasis and the most frequent oral lesion in removable prosthesis wearers. It is characterized by an inflammatory response of the denture-bearing mucosa, especially the palatal mucosa, and its clinical signs include chronic edema and erythema, and papillary hyperplasia. Despite having a multifactorial etiology, its main etiological agent is the infection by Candida albicans. Given its high treatment failure rates, an in vivo model of denture stomatitis should be established to test alternative treatments. The aim of this study is to review the existing denture stomatitis models and to provide an overview of the main methodological differences between them. Over the last 40 years, different animal models were developed in order to study denture stomatitis etiopathogenesis and to assess novel therapies. Many approaches, including the use of antibiotics and immunosuppressors, have to be further investigated in order to establish which protocol is more appropriate and effective for the development of an animal model of denture stomatitis.

Effectiveness of denture microwave disinfection for treatment of denture stomatitis: A systematic review and meta-analysis.

OBJECTIVE: The aim of this systematic review was to evaluate the effectiveness of removable complete denture disinfection using microwaves for the treatment of denture stomatitis. METHODS: This review identified studies comparing the efficacy of microwave prosthesis disinfection (I) to topical antifungal therapy (C) in the treatment of denture stomatitis (O), which included only individuals who used complete dentures and presented with denture stomatitis (P). The search was performed in six databases and identified 1524 records; after the removal of duplicates, 816 articles remained. Three articles were selected for qualitative synthesis and two for meta-analysis. Random-effects meta-analysis estimated the polled effects of microwave disinfection and antifungal therapy on the Candida counts and clinical manifestation of denture stomatitis. The GRADE approach was used to estimate the certainty of evidence. RESULTS: All included studies reported significant reductions in Candida counts and the frequency of denture stomatitis of groups subjected to microwave disinfection of dentures and topical antifungal therapy with nystatin. Significative differences between treatments were only detected for Candida quantification in the palate, within 90 days follow-up period (SMD = 0.47, 95% CI = 0.02-0.91). Meta-analyses did not show any further differences between treatments (p > .05), considering the Candida quantification in dentures and the frequency of clinical signs of denture stomatitis. The certainty of the evidence was considered as low, according to GRADE approach. CONCLUSION: Microwave disinfection of complete dentures can be considered as efficient as antifungal therapy for the treatment of denture stomatitis. However, further well-designed studies are necessary to confirm such evidence.

Estomatite protética associada a candidíase pseudomembranosa em paciente geriátrico: relato de caso / Prosthetic stomatitis associated with pseudomembranus candidiasis in geriatric patient: case report

As próteses removíveis são consideradas facilitadoras em potencial da estomatite protética, caracterizada por aspectos hiperplásicos e eritematosos na mucosa de suporte. Este trabalho tem como objetivo relatar as principais manifestações orais da estomatite protética em um paciente geriátrico associada a candidíase oral pseudomembranosa. Paciente do gênero masculino, setenta e quatro anos, apresentava uma lesão exofítica, na região de palato com dois centímetros de extensão, além da presença de candidíase pseudomembranosa, fazia o uso de uma prótese parcial superior removível há aproximadamente dez anos. Foi levantada a hipótese diagnóstica de estomatite protética associada a candidíase pseudomembranosa. A terapêutica instituída consistiu no uso de antifúngico por um período de quinze dias e biópsia incisional. O exame histopatológico confirmou o diagnóstico de hiperplasia fibrosa inflamatória. Foi recomendado a confecção de uma nova prótese para que fosse evitado a recorrência da lesão, e o paciente também foi instruído quanto a sua higiene oral evitando-se desta forma a recorrência da candidíase. O cirurgião-dentista deve ser capaz de reconhecer e diagnosticar a estomatite protética em sua prática diária e tratar o paciente de acordo com a sua etiologia, oferecendo desta forma para o paciente um maior conforto e melhores condições de vida(AU)

Removable total dentures are considered potential facilitators of prosthetic stomatitis, characterized by hyperplastic and erythematous aspects in the supporting mucosa. This paper aims to report the main oral manifestations of prosthetic stomatitis in an elderly patient associated with pseudomembranous oral candidiasis. A seventyseven-year-old male patient presented with an exophytic lesion in the palate region of two centimeters in length, in addition to the presence of pseudomembranous candidiasis, and had been using a removable upper partial denture for approximately ten years. The diagnostic hypothesis of prosthetic stomatitis associated with pseudomembranous candidiasis was raised. The therapy instituted consisted of the use of antifungal for a period of fifteen days and incisional biopsy. Histopathological examination confirmed the diagnosis of inflammatory fibrous hyperplasia. It was recommended to make a new prosthesis to avoid recurrence of the lesion, and the patient was also instructed as to its oral hygiene, thus avoiding the recurrence of candidiasis. The dentist should be able to recognize and diagnose prosthetic stomatitis in his daily practice and treat the patient according to its etiology, thus offering the patient greater comfort and better living conditions(AU)

The effects of three disinfection protocols on Candida spp., denture stomatitis, and biofilm: A parallel group randomized controlled trial.

STATEMENT OF PROBLEM: Antifungals are used to treat Candida infections. However, because of increased antifungal resistance and the length of antifungal therapy, Candida spp. infections can be prevented using the prosthesis hygiene method. Therefore, establishing efficient, safe, and low-cost hygiene protocols for complete denture wearers is necessary. PURPOSE: The purpose of this clinical trial was to compare 10% Ricinus communis (RC10%) and 0.5% chloramine-T (CT0.5%) with negative (water) and positive (0.25% sodium hypochlorite [SH0.25%]) controls to establish a protocol to treat denture stomatitis (DS), remove denture biofilm, reduce overall microbiota, and decrease Candida spp. on the palate and denture bases. MATERIAL AND METHODS: This randomized, double blind, controlled clinical trial allocated 60 DS-positive participants in parallel groups: RC10%, CT0.5%, negative control, and SH0.25%. All participants brushed their palate and dentures and applied 1 of the solutions only to the denture. The following outcomes were assessed at baseline and after 7 and 37 days: Candida spp. counts, frequency of species by presumptive identification, DS severity, and photographic quantification of biofilm. The Kruskal-Wallis and Friedman tests with stepwise step-down post hoc test compared the anticandidal effect and the DS score (between groups and time). ANOVA and the Tukey post hoc test were used for biofilm removal comparison (α=.05). RESULTS: Microbial counts were solution- and time-dependent for dentures, with C. albicans, C. tropicalis, and C. glabrata being the most prevalent species. RC10% presented similar results to baseline and control after 7 and 37 days. CT0.5% reduced the CFU/mL compared with the baseline. SH0.25% was the most effective. DS reduced in all groups, independent of the solution. SH0.25% reduced biofilm the most, followed by RC10%. CT0.5% was similar to the control. CONCLUSIONS: SH0.25% demonstrated potential for Candida spp. control in denture wearers with DS. The other protocols showed intermediate activity and might be more suitable for longer immersion periods.

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

BACKGROUND: Denture-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/DESIGN: A 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. DISCUSSION: This 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 REGISTRATION: Brazilian Registry of Clinical Trials, RBR-4hhwjb. Registered on 9 November 2018.

Influencia de género en la efectividad de la ozonoterapia en la estomatitis subprótesis / Influência do gênero na eficácia da ozonioterapia na subprótese estomatite / Influence of gender on the effectiveness of ozone therapy in stomatitis subprosthesis

Introducción: el análisis de género es imprescindible para determinar inequidades relacionadas con la salud de hombres y mujeres, es un campo por explorar en la Estomatología y más cuando se trata de la efectividad de la ozonoterapia en el tratamiento de la estomatitis subprótesis. Objetivo: evaluar cómo influye el género en la efectividad de la ozonoterapia en el tratamiento de la estomatitis subprótesis en pacientes que acudieron al servicio de Prótesis de la Clínica Estomatológica Docente "Julio Antonio Mella" en el período enero-junio de 2018. Método: se realizó un estudio descriptivo-transversal. El universo lo constituyeron los pacientes portadores de prótesis que acudieron al servicio en dicho período y se seleccionó la muestra de forma no probabilística. La información se obtuvo mediante una guía de observación y un cuestionario, esta se procesó con el paquete estadístico SPSS, versión 15. Resultados: fue más efectivo el tratamiento en los hombres y los días para curar inferiores en estos. Las mujeres que demoraron más de diez días en curar la lesión o que no curaron constituyen el porciento mayor con respecto a los hombres, fundamentalmente debido a sus responsabilidades domésticas. Conclusiones: el género influye en la efectividad de la ozonoterapia marcado por las diferencias en las responsabilidades domésticas que interfieren en la adherencia al tratamiento por hombres y mujeres(AU)

Introduction: gender analysis is essential to determine inequities related to the health of men and women, is a field to be explored in Stomatology and more when it comes to the effectiveness of ozone therapy in the treatment of stomatitis subprosthesis. Objective: to evaluate how gender influences the effectiveness of ozone therapy in the treatment of subprosthesis stomatitis in patients who attended the Prosthetics service of the Clinic "Julio Antonio Mella" in the period January-June 2018. Method: a descriptive-transversal study was carried out. The universe was constituted by the patients with prosthesis who came to the service in that period and the sample was selected in a non-probabilistic way. The information was obtained through an observation guide and a questionnaire, which was processed with the statistical package SPSS, version 15. Results: treatment was more effective in men and days to cure inferior in these. Women who took more than ten days to heal the injury or who did not heal constitute the highest percentage with respect to men, mainly due to their domestic responsibilities. Conclusions: gender influences the effectiveness of ozone therapy marked by differences in domestic responsibilities that interfere in adherence to treatment by men and women(AU)

Introdução: a análise de gênero é essencial para determinar as iniqüidades relacionadas à saúde de homens e mulheres, é um campo a ser explorado em estomatologia e mais quando se trata da eficácia da terapia de ozônio no tratamento de subpróteses de estomatite. Objetivo: avaliar como o gênero influencia a eficácia da ozonioterapia no tratamento da estomatite subprotética em pacientes atendidos no serviço de Prótese da Clínica "Julio Antonio Mella" no período de janeiro a junho de 2018. Método: estudo descritivo-transversal foi realizado. O universo foi constituído pelos pacientes com prótese que compareceram ao serviço naquele período e a amostra foi selecionada de forma não probabilística. As informações foram obtidas por meio de um roteiro de observação e questionário, que foi processado com o pacote estatístico SPSS, versão 15. Resultados: o tratamento foi mais efetivo em homens e dias para curar inferiores nestes. As mulheres que levaram mais de dez dias para curar a lesão ou que não se curaram constituem a maior porcentagem em relação aos homens, principalmente devido às suas responsabilidades domésticas. Conclusões: o gênero influencia a eficácia da ozonioterapia, marcada por diferenças nas responsabilidades domésticas que interferem na adesão ao tratamento por homens e mulheres(AU)

Efectividad de la tintura de propóleos al 10 % en pacientes con estomatitis subprótesis / Effectiveness of 10 % propolis tinction in patients with subprosthesis stomatitis

Se efectuó un estudio de intervención terapéutica en 50 pacientes con estomatitis subprótesis, quienes acudieron a la consulta de prótesis de la Clínica Estomatológica Ramón Guevara Montano de Baracoa, provincia de Guantánamo, desde abril del 2015 hasta junio del 2016, con vistas a determinar la efectividad del tratamiento con tintura de propóleos al 10 por ciento en los afectados. Se conformaron 2 grupos: uno de estudio (A) y otro de control (B), con 25 integrantes cada uno; el primero fue tratado con propóleos y el segundo con medicina alopática (nistatina en suspensión). La evaluación se realizó a los 4, 8 y 12 días. Al finalizar la terapia se observó que en 100,0 por ciento de los pacientes del grupo A se eliminó la lesión; por tanto, esta alternativa terapéutica resultó efectiva. Se recomendó extender dicha aplicación a otras afecciones bucales.

A study of therapeutic intervention was carried out in 50 patients with subprosthesis stomatitis who went to the Prosthesis department of "Ramón Guevara Montano" Stomatological Clinic in Baracoa, Guantánamo province, from April, 2015 to June, 2016, aimed at determining the effectiveness of the treatment with 10 percent propolis tinction in the affected patients. Two groups were formed: a study group (A) and a control group (B), with 25 members each; the first one was treated with propolis tinction and the second with allopathic medicine (nystatin in suspension). The evaluation was carried out at 4.8 and 12 days. When concluding the therapy it was observed that in 100.0 percent of the patients of the group A the lesion was eliminated; therefore, this therapeutic alternative was effective. It was recommended to extend this procedure to other oral disorders.

Management of denture stomatitis: a narrative review.

Candida albicans is a typical commensal microorganism of the oral cavity that can become virulent in certain conditions and cause denture stomatitis (DS). Many conditions can predispose for DS, including local and systemic alterations. The therapeutical approach to DS is various and both topical and systemic alternatives can be considered. Azoles molecules are the most common used, both topically and systemically, but in recent years various alternatives have been proposed. This review aims to examine the scientific literature to evaluate the effectiveness of conventional therapies and the potential of the new ones.

Efectividad del Oleozón® tópico en la estomatitis subprótesis / Effectiveness of topical Oleozón® in the stomatitis sub-prosthetic

Se realizó un estudio de evaluación de una intervención terapéutica para determinar la efectividad del Oleozón® tópico en el tratamiento de la estomatitis subprótesis en pacientes del Policlínico Universitario "Hermanos Martínez Tamayo" del municipio Baracoa, Guantánamo, en el período comprendido desde junio 2015-2016. El universo de estudio estuvo constituido por 80 pacientes con diagnóstico clínico de estomatitis subprótesis. La muestra se obtuvo de forma intencionada, quedando constituida por 40 pacientes. Se utilizó un diseño caso control: al grupo estudio A se le aplicó oleozón tópico y al grupo control B se aplicó medicina alopática consistente en nistatina en suspensión. El tratamiento con Oleozón® tópico fue efectivo al lograr erradicar o disminuir en grado la estomatitis subprótesis por tanto es factible su aplicación(AU)

Came true a study of evaluation of a therapeutic intervention to determine the effectiveness of the commonplace Oleozón® in the treatment of Stomatitis sub-prosthesises in patients of the Policlínico Hermanos Martinez Tamayo of the municipality Baracoa, Guantánamo in the period understood from Junio 2015-2016. The universe of study was constituted for 80 patients with clinical diagnosis of Estomatitis subprosthesises. You got the sign from intentional form, getting constituted by 40 patients. Case utilized a design itself control: I study to the group to the commonplace his Oleozón® applied itself and to the group control the B applied allopathic medicine consisting of hanging nistatina itself. The treatment with commonplace Oleozón® the cash was going to manage to eradicate or to decrease in grade the Stomatitis, therefore his application in the stomatitis sub-prosthetic is feasible(AU)

Eficácia do diacetato de clorexidina incorporado a um reembasador macio no tratamento da estomatite protética: um ensaio clínico randomizado / Efficacy of chlorhexidine diacetate incorporated into a soft liner rebase in the treatment of denture stomatitis: a randomized clinical trial

O objetivo deste estudo piloto foi comparar a eficácia de um reembasador acrílico macio com ou sem diacetato de clorexidina a 1% no tratamento de pacientes com estomatite protética. As hipóteses testadas foram: (I) o eritema seria melhorado (IIa): a contagem de unidades formadoras de colônias seria reduzida, (IIb): a predominância de um tipo morfológico de Candida seria correlacionada com características clínicas e, (IIc) se uma concentração inibitória mínima do antimicrobiano, poderia ser capaz de atuar sobre o crescimento do fungo. Dezesseis pacientes desdentados totais, portadores de prótese e com estomatite protética foram distribuídos aleatoriamente para os grupos controle (reembasamento com Trusoft) e grupo teste (reembasamento com Trusoft contendo 1% de clorexidina) sendo acompanhados por exames clínicos e laboratoriais por 14 dias. Os parâmetros analisados nas duas consultas de acompanhamento foram: avaliação clínica (exame e fotos) e avaliações microbiológicas (esfregaços e culturas de palato e prótese total). Este estudo foi um ensaio clínico randomizado, duplo-cego,controlado.Os resultados obtidos demonstraram que a superfície do eritema foi significativamente reduzida, mas não diferiu significativamente entre os dois grupos (P> 0,05), assim como a redução da contagem de Candida durante o tratamento entre os grupos (P> 0,05). O tipo de Candida não pôde ser correlacionado ao estágio clínico alcançado. Os resultados dos testes de concentração inibitória mínima, revelaram que uma concentração de 0,05 µg/ml de clorexidina já é capaz de inibir o crescimento de 85% das cepas de testadas.A hipótese principal foi confirmada, o que pode ser interpretado como uma remissão clínica acelerada em ambas as terapias propostas. Embora as hipóteses secundárias não tenham sido confirmadas, a persistência de Candida pode ser apenas a colonização, e a plasticidade morfológica de Candida parece ser fortemente influenciada pela virulência fúngica. Sendo assim, os resultados da análise de concentração inibitória mínima sugerem que uma concentração subinibitória de clorexidina possa estar atuando na virulência da Candida spp. No entanto, não foram encontrados resultados para confirmar a eficácia clínica do diacetato de clorexidina a 1% incorporado ao reembasador macio testado no tratamento da estomatite protética.

The aim of this pilot study was to compare the efficacy of rebase using soft acrylic liner with or without 1% chlorhexidine diacetate in denture stomatitis patients. It was hypothesised that: (I) erythema would be improved (IIa): colony forming unit count would be reduced, (IIb): the predominance of a morphological type of Candida would be correlated with clinical features and, (IIc) a minimum inhibitory concentration of the antimicrobial, could be able to act on the growth of the fungus.Sixteen patients who wearing removable dentures and diagnosed with denture stomatitis were randomly assigned to the control groups (rebase with resilient liner) and test group (rebase with resilient liner containing 1% of chlorhexidine), followed by clinical and laboratory tests for 14 days. The analyzed parameters at two follow-up were: clinical evaluation (examination and photos) and microbiological evaluations (smears and cultures of palates and dentures). This study was a randomized, double-blind, controlled clinical trial. The results obtained showed that the erythema surface was significantly reduced, but did not differ significantly between the two groups (P> 0.05), as did the reduction of colony forming unit during treatment between the groups (P> 0.05) . The Candida type could not be correlated to the achieved clinical stage. The minimum inhibitory concentration test results showed that a concentration of 0,05 µg/ml chlorhexidine is already able to inhibit the growth of 85% of the tested strains. The primary hypothesis was confirmed, which can be interpreted as an accelerated clinical remission in both proposed therapies. Although secondary hypotheses have not been confirmed, Candida's persistence may be just colonization, and the morphological plasticity of Candida seems to be strongly influenced by fungal virulence. Thus, the results of the minimum inhibitory concentration analysis suggest that a subinhibitory concentration of chlorhexidine may be acting on the virulence of Candida spp. However, no results were found to confirm the clinical efficacy of 1% chlorhexidine diacetate incorporated into the soft liner in denture stomatitis.

Efectividad del Oleozón® tópico en la estomatitis subprótesis / Eficácia do Oleozón® tópico na subprótese estomatite / Effectiveness of topical Oleozón® in the stomatitis sub-prosthetic

Introducción: la prótesis estomatológica tiene como objetivo la sustitución adecuada de las porciones coronarias de los dientes o de sus partes asociadas, cuando se encuentran perdidos o ausentes, por medios artificiales capaces de restablecer la función masticatoria, estética y fonética. Objetivos: determinar la efectividad del Oleozón® tópico en el tratamiento de la estomatitis subprótesis en pacientes del Policlínico Universitario "Hermanos Martínez Tamayo" del municipio Baracoa, Guantánamo. Método: se realizó un estudio de evaluación de una intervención terapéutica, en el período comprendido desde junio 2015-2016. El universo de estudio estuvo constituido por 80 pacientes con diagnóstico clínico de estomatitis subprótesis. La muestra se obtuvo de forma intencionada, quedando constituida por 40 pacientes. Se utilizó un diseño caso control: al grupo estudio A se le aplicó oleozón tópico y al grupo control B se aplicó medicina alopática consistente en nistatina en suspensión. Resultados: en la caracterización de los pacientes con estomatitis subprótesis según grupos de edades predominando el grado I en el grupo de edades de 60 y más años para ambos grupos. Como hábito nocivo resultó el uso continuo de la prótesis. La aplicación diaria del Oleozón® fue efectiva para el tratamiento de esta enfermedad entre cuatro y siete visitas a consulta, por lo que el tiempo necesario para desaparecer los signos clínicos de la enfermedad fue menor que cuando se aplicó la nistatina crema en el grupo control. Conclusiones: el Oleozón® resultó efectivo para el tratamiento de la estomatitis subprótesis en la población objeto de estudio, lográndose la curación de las lesiones en menor tiempo comparado con la nistatina como tratamiento convencional(AU)

Introduction: the stomatological prosthesis aims at the adequate replacement of the coronary portions of the teeth or their associated parts, when they are lost or absent, by artificial means able to restore the masticatory, aesthetic and phonetic function. Objective: to determine the effectiveness of topical Oleozón® in the treatment of sub-prosthesis stomatitis in patients of the "Hermanos Martínez Tamayo" University Polyclinic in the municipality of Baracoa, Guantánamo. Method: an evaluation study of a therapeutic intervention was carried out, in the period from June 2015-2016. The study universe consisted of 80 patients with clinical diagnosis of stomatitis subprosthesis. The sample was obtained intentionally, consisting of 40 patients. A control case design was used: group A study was applied topical oleozon and control group B was applied allopathic medicine consisting of nystatin in suspension. Results: in the characterization of the patients with subprosthesis stomatitis according to age groups, grade I predominated in the group of ages 60 and over for both groups. The continuous use of the prosthesis resulted as a harmful habit. The daily application of Oleozón® was effective for the treatment of this disease between four and seven visits to consultation, so that the time needed to disappear clinical signs of the disease was lower than when nystatin cream was applied in the control group. Conclusions: Oleozón® was effective for the treatment of stomatitis sub-prosthesis in the population under study, achieving healing of the lesions in less time compared with nystatin as conventional treatment(AU)

Introdução: a prótese estomatológica visa a substituição adequada das porções coronarianas dos dentes ou de suas partes associadas, quando perdidas ou ausentes, por meios artificiais capazes de restaurar a função mastigatória, estética e fonética. Objetivo: Para determinar a eficácia de OLEOZON® tópica no tratamento de estomatite protética em pacientes Universidade Policlinico "Irmãos Martinez Tamayo" município Baracoa, Guantánamo. Método: estudo de avaliação de uma intervenção terapêutica, no período de junho de 2015 a 2016. O universo do estudo consistiu de 80 pacientes com diagnóstico clínico de subprótese estomatite. A amostra foi obtida intencionalmente, composta por 40 pacientes. Utilizou-se o delineamento de caso controle: no grupo A foi aplicado o oleozon tópico e no grupo controle B foi aplicado medicamento alopático composto por nistatina em suspensão. Resultados: na caracterização dos pacientes com estomatite subprotésica de acordo com as faixas etárias, o grau I predominou no grupo de 60 anos e mais para os dois grupos. O uso contínuo da prótese resultou como um hábito nocivo. A aplicação diária de Oleozón® foi eficaz para o tratamento desta doença entre quatro e sete visitas à consulta, de modo que o tempo necessário para desaparecer os sinais clínicos da doença foi menor do que quando o creme de nistatina foi aplicado no grupo controle. Conclusões: Oleozón® foi efetivo no tratamento de subpróteses de estomatite na população estudada, conseguindo cicatrizar as lesões em menor tempo em relação à nistatina como tratamento convencional(AU)

Denture Stomatitis: Causes, Cures and Prevention.

Removable dentures are worn by 20% of the UK population and two thirds of these individuals have denture stomatitis. Poor oral hygiene is commonplace among this group, as is smoking and xerostomia, which also contribute to the development of denture stomatitis. A complex polymicrobial biofilm is able to proliferate on the surface of denture materials and matures to form visible denture plaque. This denture plaque biofilm stimulates a local inflammatory process that is detectable clinically as erythema, and hyperplasia. Systemically, denture plaque represents a potential risk factor for systemic disease, in particular aspiration pneumonia. Respiratory pathogens have been detected in the denture plaque and overnight denture wear has been linked to an increased risk of aspiration pneumonia. There is a general lack of evidence on the adequate management of denture stomatitis and we present a protocol for use in the primary care setting.

Interventions for the Management of Denture Stomatitis: A Systematic Review and Meta-Analysis.

OBJECTIVES: To assess the effectiveness of different interventions for treating or preventing denture stomatitis (DS). DESIGN: Systematic review. SETTING: Randomized controlled trials (RCTs) comparing any agent or procedure prescribed to treat or prevent DS in adults. PARTICIPANTS: Older adults with denture stomatitis. MEASUREMENTS: There were two main outcomes reported in the trials included in this review: clinical signs of DS and remaining presence of yeast. There were no restrictions regarding language or date of publication. The search period was up to February 2016. RESULTS: Thirty-five studies were included in the systematic review, with 32 judged as having high risk of bias. Three RCTs compared nystatin with placebo and found a significant effect on the reduction of clinical signs of stomatitis (risk ratio (RR) = 0.51, 95% confidence interval (CI) = 0.36-0.72), four RCTs compared nystatin with placebo and found a significant effect on mycological assessment (RR = 0.61, 95% CI = 0.46-0.80). Five studies of disinfectant agents also showed a significant effect in comparison with an inactive agent (RR = 0.52, 95% CI = 0.30-0.92) in clinical assessment. No evidence was found of an effect of miconazole, amphotericin, or imidazolic drugs. No RCT evaluated the effectiveness of preventive approaches. CONCLUSION: The results are supportive of the use of nystatin and disinfecting agents in the treatment of DS, but clinicians need to be aware that individual studies had high risk of bias and that the overall quality of the individual reports was judged to be low.

Methylene Blue-Mediated Photodynamic Inactivation Followed by Low-Laser Therapy versus Miconazole Gel in the Treatment of Denture Stomatitis.

PURPOSE: Photodynamic therapy (PDT) appears to be an effective method for the in vitro and in vivo inactivation of Candida spp., but no clinical trials in this context have yet been conducted. The aim of this study was to compare the effect of oral miconazole gel to PDT combined with low-power laser (LPL) therapy in the treatment of denture stomatitis. MATERIALS AND METHODS: Forty participants with clinical and microbiological diagnoses of type II denture stomatitis were randomly allocated to two treatment groups (PDT and miconazole gel), each with 20 individuals. The PDT group was submitted to one session of methylene blue-mediated PDT plus two sessions of low-laser therapy twice a week for 15 days. The miconazole group was submitted to the drug four times a day for 15 days. RESULTS: Forty percent of the patients achieved clinical and microbiological resolution of denture stomatitis after methylene blue-mediated photodynamic inactivation followed by low-laser therapy. The cure rate associated with miconazole was 80% (p < 0.05). Fifteen days after the end of treatment, the recurrence rate was 25% in patients treated with PDT combined with LPL therapy and 12.5% in patients treated with miconazole. CONCLUSION: Miconazole gel provides better results than a protocol combining methylene blue-mediated PDT and LPL therapy in the treatment of type II denture stomatitis.

Denture Stomatitis ­ A Clinical Update.

Denture stomatitis is a benign condition, usually asymptomatic, that can affect edentulous patients. Studies have reported a prevalence of denture stomatitis affecting over 75% of denture wearers and, whilst the aetiology may be multifactorial, Candida albicans has a strong association with the condition, along with denture trauma and poor denture hygiene being associated local risk factors. This paper describes the aetiology, diagnosis and treatment of denture stomatitis, with the aim of helping clinicians to provide appropriate management of this condition. Clinical relevance: Denture stomatitis can be a recurrent problem amongst denture wearers and is often asymptomatic to the patient. Dental practitioners should be able to identify and manage this condition. Clinical relevance: Denture stomatitis can be a recurrent problem amongst denture wearers and is often asymptomatic to the patient. Dental practitioners should be able to identify and manage this condition.

Effectiveness of a Chlorhexidine Digluconate 0.12% and Cetylpyridinium Chloride 0.05% Solution in eliminating Candida albicans Colonizing Dentures: A Randomized Clinical in vivo Study.

BACKGROUND: Effective denture hygiene is important for patients suffering from denture stomatitis (DS). This study aimed to evaluate the efficacy of a solution containing 0.12% chlorhexidine (CHX) digluconate and 0.05% cetylpyridinium chloride (CPC) in eliminating Candida albicans colonizing dentures. MATERIALS AND METHODS: Forty denture wearers (11 men, 29 women; age range 40 to 80 years) with clinical evidence of DS were randomly divided into two groups, one test and one control. The dentures of the test group were treated by immersion in a solution of 0.12% CHX and 0.05% CPC while those of the control group were immersed in distilled water. Swabs were collected from the fitting surfaces of the upper dentures prior and post cleaner use and examined mycologically. RESULTS: Reduction in the number of colony-forming units (CFU) of Candida albicans after immersion of the dentures in a solution of 0.12% CHX and 0.05% CPC was significantly greater than that of the control group. CONCLUSION: A solution of 0.12% CHX and 0.05% CPC tested as a product of disinfection of the acrylic dentures showed significant results after immersion of 8 night hours for 4 days.

Linking evidence to treatment for denture stomatitis: a meta-analysis of randomized controlled trials.

OBJECTIVES: The aim of this meta-analysis was to compare the efficacy of antifungal therapy with any other alternative methods used for the treatment of denture stomatitis. DATA SOURCES: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews were searched, complemented by hand searching, until the first week of January 2013. STUDY SELECTION: Included studies consisted of randomized clinical trials published in English or French, which compared antifungals with any other alternative or placebo, used for the treatment of denture stomatitis. The remission of clinical signs of denture stomatitis, and the reduction in Candida colony counts were considered as the clinical and microbiological outcomes, respectively. Random effects models were used to conduct the statistical analyses. RESULTS: From 233 identified articles, a total of 15 manuscripts on 14 randomized controlled trials were included in systematic review and 8 in the meta-analysis. No statistically significant difference between antifungal treatment and disinfection methods was found for both clinical (OR=0.7; 95% CI: 0.32-1.36; Z=-1.14; p=0.256) and microbiological (OR=0.8; 95% CI: 0.26-2.5; Z=-0.35; p=0.724) outcomes. The meta-analysis showed a statistically significant difference between an antifungal and a placebo for the microbiological outcome (OR=0.32; 95% CI: 0.12-0.89; Z=-2.2; p=0.028), favouring the antifungals. However, there was no statistically significant difference between antifungal and placebo for the clinical outcome (OR=0.2; 95% CI: 0.04-1.04; Z=-1.9; p=0.056). CONCLUSIONS: Disinfection agents, antiseptic mouthwashes, natural substances with antimicrobial properties, microwave disinfection and photodynamic therapy could be suggested as an adjunct or alternative to antifungal medications in the treatment of denture stomatitis.

A nonsurgical approach to treating aggressive inflammatory papillary hyperplasia: a clinical report.

Preprosthetic interventions in patients with aggressive forms of inflammatory papillary hyperplasia have historically involved surgery. These procedures often involve significant postoperative discomfort and morbidity. Additionally, some patients who present with dental phobias, aversions to surgery, or underlying systemic disease may not be amenable to this type of surgical intervention. In this report, a patient with severe inflammatory papillary hyperplasia and phobias regarding the dentist and dental surgery was treated nonsurgically, following strict adherence to a clinical protocol. The methodology involved greater patient comfort during treatment, encouraged positive reinforcement to visiting the dentist for recall appointments, and effectively eliminated the underlying inflammatory papillary hyperplasia, allowing for the successful fabrication of the definitive removable prostheses.