Chemical cleaning methods for prostheses colonized by Candida spp.: A systematic review.

ABSTRACT

STATEMENT OF PROBLEM: Different chemical agents have been used to clean and decontaminate dentures. However, consensus on their effectiveness and protocol for use is lacking. PURPOSE: The purpose of this systematic review was to evaluate chemical cleaning methods used to promote a reduction in or elimination of Candida spp. from dental prostheses. MATERIAL AND METHODS: Searches were performed in the electronic databases MEDLINE, Cochrane Library, Elsevier, Embase, SciELO, Scopus, Web of Science, Bvsalud, and Google Scholar. Manual searches were also performed. There were no restrictions on date of publication or language. Randomized clinical trials on the reduction of prosthesis surface colonization by Candida spp. by using chemical agents compared with distilled water were included. RESULTS: After the first screening, 52 studies were included, of which 5 were included for quality assessment. The studies evaluated the efficacy of alkaline peroxides, chlorhexidine, and chlorine dioxide. Among the studied solutions, alkaline peroxides demonstrated no effect on the decrease of Candida spp. on prostheses. Chlorhexidine and chlorine dioxide significantly reduced colony-forming unit (CFU) rates of these microorganisms. CONCLUSIONS: The evaluated studies presented a high risk of bias and weak evidence of the effects of chemical agents to reduce CFU counts of Candida spp. Only chlorhexidine and chlorine dioxide demonstrated some evidence of a reduction in Candida spp. colonization. Clinical trials with better methodological designs should be performed to clarify the effectiveness of these solutions in prosthesis decontamination.