Management of Chronic Atrophic Candidiasis (Denture Stomatitis)-A Narrative Review.

One of the most common oral diseases affecting people wearing dentures is chronic atrophic candidiasis or denture stomatitis (DS). The aim of the paper is to provide an update on the pathogenesis, presentation, and management of DS in general dental practice settings. A comprehensive review of the literature published in the last ten years was undertaken using multiple databases, including PubMed via MEDLINE, EMBASE, and Scopus. The eligible articles were analyzed to identify evidence-based strategies for the management of DS. Despite its multifactorial nature, the leading cause of DS is the development of oral Candida albicans biofilm, which is facilitated by poor oral and denture hygiene, long-term denture wear, ill-fitting dentures, and the porosity of the acrylic resin in the dentures. DS affects between 17 and 75% of the population wearing dentures, with a slight predominance in elderly females. The mucosal denture surfaces and posterior tongue are the common sites of DS, and the affected areas exhibit erythema, the swelling of the palatal mucosa and edema. Oral and denture hygiene protocols, adjusting or re-fabricating poorly adapting dentures, smoking cessation, avoiding nocturnal denture wear, and the administration of topical or systemic antifungals are the mainstay of management. Alternate treatments such as microwave disinfection, phytomedicine, photodynamic therapy, and incorporation of antifungals and nanoparticles into denture resins are being evaluated for the treatment of DS but require further evidence before routine use in clinical practice. In summary, DS is the most common oral inflammatory lesion experienced by denture wearers. Most patients with DS can be managed in general dental practice settings. Effective management by general dental practitioners may be supported by a thorough understanding of the pathogenesis, the recognition of the clinical presentation, and an awareness of contemporary treatment strategies.

Efficacy of Rose Bengal and Curcumin mediated photodynamic therapy for the treatment of denture stomatitis in patients with habitual cigarette smoking: A randomized controlled clinical trial.

BACKGROUND: Cigarette smoking in conjugation with bad oral hygiene is considered a typical predisposing factor for many oral diseases including denture stomatitis. This study investigated the effect of Rose Bengal (RB)-and Curcumin (CUR)-mediated photodynamic therapy (PDT) in comparison with nystatin therapy in the intervention of denture stomatitis in cigarette smokers. METHODS: Overall, 45 habitual cigarette smokers aged ~58 years having denture stomatitis were categorized into three groups: Group-I - RB-mediated PDT, Group-II - CUR-mediated PDT, and Group-III - Nystatin therapy. The primary outcome of the interest was: counts of Candida colony from denture surface and palatal mucosa, calculated as CFU/mL, whereas the prevalence of Candida species determined in 3 research groups comprised the secondary outcome. Oral swab specimens were gathered from the denture surfaces and palatal mucosa. All clinical assessments were performed at baseline, 6 weeks, and 12 weeks. RESULTS: C. albicans was the most prevalent yeast identified on both denture surfaces and palatal mucosa, followed by C. tropicalis and C. glabrata. A considerable decrease in the CFU/mL scores were observed in Group-I and Group-II at the end of the interventions and on the 12-week follow-up (p<0.05). Group-I, II, and III demonstrated clinical efficacy rates of 53%, 51%, and 49%, respectively. CONCLUSION: CUR-and RB-mediated PDT was found to be as effective as topical Nystatin therapy for the intervention of denture stomatitis among cigarette smokers.

Oral candidiasis and denture stomatitis in diabetic patients: Systematic review and meta-analysis

Abstract Here, the prevalence of oral candidiasis and denture stomatitis among diabetic patients compared to healthy ones was summarized through a systematic review with meta-analysis. Medline, Scopus, Web of Science, Lilacs, Cochrane Library, Embase, and the grey literature were searched without restriction, until May 2020. Eligibility criteria were established, data were extracted, and quality assessment was conducted by two trained examiners. Qualitative synthesis was based on the recommendations of Fowkes and Fulton. Two meta-analyses were performed on studies investigating patients with: a) oral candidiasis and b) denture stomatitis. Out of 6034 screened studies, seven were eligible for qualitative and quantitative synthesis; of these, three evaluated oral candidiasis and four evaluated denture stomatitis. Qualitative synthesis showed that the main methodological problems of the studies included sample size, source of controls, matching, and randomization. Diabetic patients had a similar chance of developing oral candidiasis to non-diabetic patients (OR1.40 [0.96; 2.04], p = 0.08, I2 = 94%). However, diabetic patients had a higher chance to present denture stomatitis compared to non-diabetic patients (OR 1.92 [1.42, 2.59] p < 0.0001, I2 = 0%). Therefore, diabetic patients have a higher chance of developing denture stomatitis compared to non-diabetic patients. However, for all analyses, the certainty of the evidence was considered to be very low.

Prevalence of risk factors for denture stomatitis in complete denture wearers

Aim: The prevalence of denture stomatitis and the relationship with its risk factors was evaluated via secondary data from 62 complete denture (CD) wearers, between 2015 and 2017. Methods: The data was stored in an Excel database and was analyzed using the statistics software STATA/SE 12.0. A descriptive analysis was performed taking into account a categorization of the clinical variables according to risk factor in 4 domains: CD usage, systemic health, hygiene habits, and usage habits. The association amongst the denture stomatitis and risk factors variables was tested by the Chi-square test and the results were statistically significant at p-values <0.05. Results: The CD wearers participants were composed by a majority of elderly (80.64%) and women (72.78%); with 45.16% having been using the current denture for more than 10 years and another 74.19% related a continuous usage. Diabetes and hypertension were related by 83.87% and 67.74%, respectively, with 87.10% using medication. Although 75.80% reported cleaning their dentures 3 times per day or more, and 59.68% considered their oral hygiene very good, 50% of the complete dentures showed dirtiness and clinical signs of Denture Stomatitis were present in 30.64% of the patients. Despite of the evaluated sample shows many risk factors for the development of the disease, an association between the variables was not observed. Conclusion: Considering the high prevalence of the disease in the studied sample, preventive and educational measures on denture usage and hygiene must be reinforced in order to maintain the oral health of the edentulous patients

Inflammatory papillary hyperplasia: A systematic review.

INTRODUCTION: Inflammatory papillary hyperplasia (IPH) is a benign lesion of the palatal mucosa. It is usually found in denture-wearers but also has been reported in patients without a history of use of a maxillary prosthesis use. OBJECTIVES: The aim of this study is to review the literature to assess the prevalence of denture stomatitis and inflammatory papillary hyperplasia and the etiological factors associated. MATERIAL AND METHODS: A search was carried out in PubMed (January 2005 to October 2015) with the key words "inflammatory papillary hyperplasia", "denture stomatitis", "granular stomatitis" and "Newton's type III" The inclusion criteria were studies including at least a sample of 50 apparently healthy patients, articles published from 2005 to 2015 written in English. The exclusion criteria were reviews and non-human studies. RESULTS: Out of the 190 studies obtained initially from the search 16 articles were selected to be included in our systematic review. The prevalence of denture stomatitis was 29.56% and 4.44% for IPH. We found 5 cases of denture stomatitis among non-denture-wearer individuals. All IPH cases were associated with the use of prosthesis. Smoking and continued use of ill-fitting dentures turned out to be the most frequent risk factors for developing IPH. CONCLUSIONS: IPH is a rare oral lesion and its pathogenesis still remains unclear. Its presentation among non-denture-wearers is extremely unusual.

10-year survival rate and the incidence of peri-implant disease of 374 titanium dental implants with a SLA surface: a prospective cohort study in 177 fully and partially edentulous patients.

PURPOSE: This prospective cohort study evaluates the 10-year survival and incidence of peri-implant disease at implant and patient level of sandblasted, large grid, and acid-etched titanium dental implants (Straumann, soft tissue level, SLA surface) in fully and partially edentulous patients. MATERIAL AND METHODS: Patients who had dental implant surgery in the period between November 1997 and June 2001, with a follow-up of at least 10 years, were investigated for clinical and radiological examination. Among the 506 inserted dental implants in 250 patients, 10-year data regarding the outcome of implants were available for 374 dental implants in 177 patients. In the current study, peri-implantitis was defined as advanced bone loss (≧1.5 mm. postloading) in combination with bleeding on probing. RESULTS: At 10-year follow-up, only one implant was lost (0.3%) 2 months after implant surgery due to insufficient osseointegration. The average bone loss at 10 year postloading was 0.52 mm. Advanced bone loss at 10-year follow-up was present in 35 dental implants (9.8%). Seven percent of the observed dental implants showed bleeding on probing in combination with advanced bone loss and 4.2% when setting the threshold for advanced bone loss at 2.0 mm. Advanced bone loss without bleeding on probing was present in 2.8% of all implants. CONCLUSION: In this prospective study, the 10-year survival rate at implant and patient level was 99.7% and 99.4%, respectively. Peri-implantitis was present in 7% of the observed dental implants according to the above-mentioned definition of peri-implantitis. This study shows that SLA implants offer predictable long-term results as support in the treatment of fully and partially edentulous patients.

A study to evaluate the frequency and association of various mucosal conditions among geriatric patients.

UNLABELLED: Geriatric dentistry or gerodontics is the delivery of dental care to older adults involving the diagnosis, prevention and treatment of problems associated with normal aging and age-related diseases as part of an interdisciplinary team with other health care professionals. AIM: To evaluate the oral mucosal status in the elderly population of different age group and fnd out the association of age, gender and denture with oral mucosal disorders. MATERIALS AND METHODS: The study sample consisted of 570 geriatric persons concentrating mainly on the oral mucosal changes or lesions occurring in the geriatric population. Individuals those are aged above 60 years were selected, and all the examined geriatric persons were categorized into 3 age groups to fnd out the association of oral mucosal lesions in each group. Group I-60 to 65 years, Group II-66 to 70 years, Group III-71 and above years. RESULTS: The sample of 570 elderly patients included 279 (48.95%) men and 291 (51.05%) women in three age groups: 61 to 65 years (40.35%), 66 to 70 years (31.05%), and 71 years and older (28.60%). The sample included 254 (44.56%) dentate patients, 205 (35.96%) denture wearers (partial and complete denture wearers) and 111 (19.47%) edentulous persons who lacked dentures in both the jaws. Almost half of the patients examined (48%) had one or more oral mucosal lesions. The 48% of the patients who presented with oral mucosal lesions, twenty fve different oral mucosal conditions were identifed and the three most common fndings were lingual varices (13.68%), denture induced infammatory fbrous hyperplasia (4.21%), squamous cell carcinoma (4.21%). There was some differences in the distribution of oral mucosal condition among the sexes. Leukoplakia and dysplasia were signifcantly associated with men (p < 0.001) whereas the association of fbroma and lichen planus with women were signifcant (p < 0.001). CONCLUSION: In our study it was found that patients in groups II and III had more prevalence of oral mucosal disorders. Lingual varices, oral squamous cell carcinoma, fbroma and denture induced infammatory fbrous hyperplasia were more commonly associated with the geriatric patients. The oral lesions (fbroma and lichen planus) were strongly associated with women while leukoplakia was strongly associated with men. Ageing is an important factor that can infuence the occurrence of mucosal lesions and with age the oral mucosa becomes more permeable to noxious substances and more vulnerable to external carcinogens.

Does the presence of anterior mandibular teeth increase the incidence of denture stomatitis?

PURPOSE: To compare the frequency of denture stomatitis (DS) under maxillary complete dentures (CDs) in patients with opposing mandibular distal extension removable partial dentures (RPDs) and CDs. MATERIALS AND METHODS: Participants included 365 maxillary CD wearers (241 women, mean age 70.5 ± 13.2 years; 124 men, mean age 71.5 ± 10.4 years) from 7 rest homes in Istanbul. A total of 268 had mandibular CDs; 97 had mandibular distal extension RPDs. Two independent, calibrated examiners performed oral examinations. Presence of maxillary denture-related stomatitis and the effect of risk factors on DS were evaluated and recorded. RESULTS: The frequency of palatal DS (Newton I-III) was 45.1% (n = 121) in the mandibular CD group and 49.5% (n = 48) in the mandibular distal extension RPD group, a statistically insignificant difference (p= 0.4). Factors significantly associated with palatal DS were maxillary denture age (p= 0.02), reduced occlusal vertical dimension (p= 0.04), and nocturnal denture wear (p= 0.03). CONCLUSION: In this study, DS beneath maxillary CDs did not differ between mandibular distal extension RPD and CD wearers. The presence of mandibular anterior teeth did not influence the occurrence of palatal DS.

Prevalence of oral mucosal lesions in an elderly population in the city of Valparaiso, Chile.

OBJECTIVE: Chilean population is ageing, which means an increase in the prevalence of multiple pathologies, including those located in the oral cavity. AIM: To measure the prevalence and distribution of oral mucosal lesions and to identify associated risk factors in elderly patients in the city of Valparaiso. MATERIAL AND METHODS: This study includes 126 patients over 60 years. The sample was calculated with a sampling error of 3.7% from a population size of 6000 file cards. Frequency and contingency tables were made together with odds ratios, with a confidence interval of 95%. Finally, we built a predictive model based on a binary logistic regression. RESULTS: From the whole sample, 85 patients (67.5%) had some oral mucosal lesion. The most frequent lesions were denture-induced stomatitis (37.1%). It was noted that there is a statistically significant association between the use of denture and the presence of oral candidiasis. The consumption of drugs and the use of denture increase the likelihood of having oral mucosal lesions. CONCLUSION: There is a high prevalence of oral lesions in the elderly patients of Valparaiso. The use of drugs and /or denture increases significantly the likelihood that a person over 60 years presents lesions in the oral mucosa.

Prevalence of oral mucosal lesions in institutionalized elderly people in Mashhad, Northeast Iran.

OBJECTIVE: The aim of this study was to determine the prevalence of oral mucosal lesions in institutionalized elderly people in Mashhad, northeast of Iran. BACKGROUND: This study was conducted to assess the prevalence of oral lesions in the institutionalized elderly. METHODS: In this survey, we studied all of the nursing homes in Mashhad; a total of five encompassing 237 residents. The subjects were examined and lesions recorded in a designed checklist. T-test, chi-square and Fisher's exact tests were used for the analysis. RESULTS: The mean age of the patients was 79.59 ± 8.88. Ninety-eight per cent of cases had at least one oral mucosal lesion. The most common lesions were fissured tongue (66.5%), atrophic glossitis (48.8%), sublingual varicosity (42%) and xerostomia (38%). There was no significant difference in the prevalence of denture-related lesions (DRLs) between men and women (p > 0.05). Xerostomia was more prevalent in 70-79-year-old than in 60-69-year-old subjects. No case of oral malignant lesion was detected. DISCUSSION: These findings revealed a higher prevalence of oral mucosal lesions in Mashhad city compared with other studies conducted in other major cities in Iran and abroad. The results emphasise the necessity of national programmes towards oral health promotion.

The prevalence of denture stomatitis and its predisposing conditions in an older Greek population.

BACKGROUND: Pathology related to complete denture-wearing will remain an important issue because of an increase in the ageing population. OBJECTIVE: To investigate the prevalence and the risk factors for denture-related stomatitis in the edentulous maxilla of older patients with a maxillary complete denture. MATERIAL AND METHODS: One hundred and six patients treated in the Department of Prosthodontics of the Athens Dental School were interviewed and clinically examined. The results were analysed using chi-square tests and multiple logistic regression. RESULTS: Denture stomatitis was recorded in 39.6% of the sample (pinpoint hyperaemia: 17%, diffuse erythema: 16%, papillary hyperplasia: 6.6%). Chi-square tests recorded significant associations between denture stomatitis and the continuous use of dentures (particularly the diffuse erythema type), the increased duration of denture experience and the poor retention of the maxillary denture. Other significant associations were recorded between the increased age of the current denture and pinpoint hyperaemia, and the reduced frequency of denture cleaning and papillary hyperplasia. Multiple logistic analysis revealed that the most important risk factor for denture stomatitis was the continuous use of the denture. CONCLUSION: The prevalence of denture stomatitis was high in denture users. Although many predisposing conditions were recorded, the most important risk factor was the continuous use of the denture. Therefore, appropriate advice on denture maintenance should be provided.

Oral mucosal alterations among the institutionalized elderly in Brazil

This study determined the prevalence of oral mucosal alterations and associated factors among the institutionalized elderly in Brazil. Data were collected through a structured questionnaire, a review of their medical records and an intra-oral examination. A sample of 335 individuals over 60 years of age was randomly selected. In total, 646 alterations were diagnosed; 59.1 percent were variations of the normal oral mucosa. The most frequent variation consisted of sublingual varicosities (51.6 percent). Denture stomatitis (15.2 percent) and denture hyperplasia (12.8 percent) were the most frequent lesions. Elderly patients who wore dentures had a significantly higher prevalence of oral mucosal lesions (p = 0.00) than those that didn't wear dentures. There was a high prevalence of variations of the normal oral mucosa and of mucosal lesions, especially denture-induced lesions, among the institutionalized elderly.

Oral mucosal lesions in denture wearers.

OBJECTIVE: To determine the prevalence of oral mucosal lesions (OMLs) and denture-related mucosal lesions (DMLs) in denture wearers and to co-relate the prevalence with age, gender, type of denture and any systemic conditions. MATERIALS AND METHODS: Dental records of 380 denture wearers were retrospectively reviewed for OMLs and DMLs. RESULTS: We found 45% of the denture wearers had DMLs and 60.8% had OMLs not related to denture wearing. Although the prevalence of DMLs was higher in complete denture wearers than in partial denture wearers (49% vs. 42.2%), this difference was not significant. The most common DMLs were traumatic ulcer (19.5%) and denture-induced stomatitis (18.1%). When analysed by type, traumatic ulcer, denture hyperplasia, frictional keratosis and candidiasis were more common in complete denture wearers, whereas denture-induced stomatitis was more common in partial denture wearers. Frictional keratosis was more common in men than in women. The prevalence of OMLs not related to denture wearing was higher in complete denture wearers than in partial denture wearers, and the most common OML was fissured tongue (27.6%). No association between DMLs and systemic conditions or xerostomic drugs was noted. CONCLUSION: No differences in the prevalence of DMLs in association with denture type were found. The prevalence of OMLs not related to denture wearing was higher in complete denture wearers than in partial denture wearers. This difference was affected by age, and the data were similar to the findings observed in the elderly.

Denture stomatitis and its risk indicators in south Brazilian older adults.

OBJECTIVE: The purpose of this study was to evaluate if socio-demographic, behaviour and health variables are risk indicators for denture-related stomatitis in community-dwelling older adults from Carlos Barbosa, Brazil. MATERIALS AND METHODS: In this cross-sectional study, 872 subjects aged 60 years or more were evaluated. Data collection included dental examinations and questionnaires to assess socio-demographic, behaviour, general and oral health data. All questionnaires and examinations were carried out during 2004. Associations between the independent variables and the outcomes 'prevalence of denture stomatitis' or 'prevalence of granular stomatitis' were adjusted by means of multivariate logistic regressions. RESULTS: Participants with denture stomatitis were significantly more likely to be females, to display increased amounts of plaque, and significantly less likely to visit the dentist for treatment. Participants with granular stomatitis were significantly more likely to be females and participants with granular stomatitis were significantly more likely to be females, aged 70 years or more and current smokers. In addition, participants with granular stomatitis displayed increased amounts of plaque. CONCLUSION: The data presented here confirms the central role of denture biofilm accumulation in denture stomatitis. It also indicates that smoking may increase susceptibility to infection in its most severe form.

Denture-related hyperplasia: a clinical study of a turkish population group

Inflammatory fibrous hyperplasia (epulis fissuratum) (IFH) and inflammatory papillary hyperplasia (IPH) are oral mucosal diseases caused by ill-fitting denture wearing. A study was carried out on a group of Turkish people consisted of 131 female and 39 male complete denture wearers (n= 170) distributed in two age groups (30-60 and 60-80 years old). The analysis of data collected from patients showed that while the incidence of IFH was higher in women than in men, the incidence of IPH was similar. Most lesions were found in the 30-60 year-old group. The incidence of lesions increased as the denture wearing period increased. Soft tissue growth was the main complaint of the patients with IFH and IPH. In the maxilla, the incidence of IFH was higher than IPH. There was also a significant difference between the distribution of the lesion types in the jaws. There were a larger number of lesions in the maxilla compared to the mandible and most IFH lesions were located in the anterior region of the jaws.

A hiperplasia fibrosa inflamatória (epulis fissuratum) (HFI) e a hiperplasia papilar inflamatória (HPI) são doenças da mucosa causadas por próteses mal-ajustadas. Foi feito um estudo num grupo de pessoas, na Turquia, composto por 131 mulheres e 39 homens (n=170) usuários de próteses totais. O grupo foi subdividido em duas faixas etárias (30 a 60 e 60 a 80 anos). A análise dos dados coletados dos pacientes mostrou que a incidência de HFI foi mais alta entre as mulheres, ao passo que a incidência de HPI foi similar em ambos os sexos. A maioria das lesões foi encontrada no grupo indivíduos de 30 a 60 anos. A incidência das lesões aumentou com o tempo de uso da prótese. A queixa principal dos pacientes com HFI e HPI foi o aparecimento de tecidos moles. A incidência de HFI foi maior do que HPI, na maxila. Houve também diferença significativa de distribuição dos tipos de lesão nos maxilares. Houve maior número de lesões na maxila, em comparação com a mandíbula e a maioria das lesões HFI estava localizada na parte anterior dos maxilares.

Prevalence and risk factors associated with denture-related stomatitis in healthy subjects attending a dental teaching hospital in North Jordan.

UNLABELLED: There is scant information regarding the prevalence of denture-related stomatitis (DRS) in Jordan. AIMS: The aims of this study were to investigate the prevalence of DRS in a group of healthy Jordanian subjects wearing removable complete dentures, and to investigate for the factors that may be associated with this infection. MATERIALS AND METHODS: A total of 300 complete denture patients attending a dental teaching centre in North Jordan for replacement dentures were examined thoroughly for the presence of DRS. Demographic data, including denture-wearing habits, duration of denture usage and smoking, were also obtained. Oral mucosal tissues were examined for signs of denture trauma. Dentures were assessed for plaque accumulation. RESULTS: Of the 300 subjects examined, 175 were male and 125 were female. The overall prevalence of DRS in males and females was 52% (157/300). Increased plaque deposits (plaque indices 2 and 3) were significantly more prevalent in subjects with severe forms of DRS (p<0.01). Dentures that were more than 20 years old were located in the group of subjects with grade 2 and 3 infections. A total of 86% of patients with DRS complained of denture trauma compared to 10% of subjects with healthy mucosa, and 87% of the DRS group wore dentures continuously day and night. A total of 70% of subjects with grade 3 DRS were heavy smokers (more than 15 cigarettes/day). CONCLUSION: Local factors studied contributed significantly to the development of DRS in healthy subjects and are important factors to be considered in the pathogenesis of this infection.

Lesões da mucosa oral em pacientes portadores de próteses dentárias: ilustrações clínicas e abordagem preventiva / Oral mucosal lesions in patients using dental prosthesis: clinical illustrations and preventive approach

A mucosa oral está sujeita ao desenvolvimento de diversas patologias, muitas das quais relacionadas com o uso de próteses removíveis, que, paralelamente à sua função reabilitadora, podem agir como um agente irritante aos tecidos moles da cavidade bucal. Estudos epidemiológicos têm evidenciado que lesões provocadas por próteses ocorrem com uma freqüência considerável, havendo publicações que indicam prevalência de lesões da mucosa oral em até 62% dos pacientes usuários de aparelhos protéticos. Diante disto, pretende-se, com este artigo, revisar a literatura a respeito daquelas lesões nas quais as próteses podem agir como fator etiológico, enfatizando as medidas preventivas que podem ser adotadas para que seja reduzida a incidência das mesmas. São ilustrados casos clínicos das seguintes lesões: estomatite por dentadura, hiperplasia fibrosa inflamatória, úlcera traumática e quelite angular. A prevalência de lesões em tecidos moles relacionados ao uso de próteses removíveis pode ser diminuída através de medidas relativamente simples, como: a orientação adequada dos pacientes quanto aos cuidados que devem ter com suas próteses; a preservação da saúde bucal dos usuários de prótese removível; e cuidados nas diversas etapas de confecção das próteses, resultando em oclusão estável, boa adaptação da base à fibromucosa e selamento periférico adequado, dentro dos limites da área chapeável.

On the oral mucosa, diverse pathologies may develop, many of them related to the use of removable prosthesis, which, parallel to their role in rehabilitation, can act as an irritant agent to the soft tissues of the mouth. Epidemiological studies have evidenced that lesions induced by prosthesis occur with a considerable frequency, and there are publications that indicate a prevalence of oral mucosal lesions in up to 62% of the patients using prosthetic devices. Therefore, this article aims to review the literature related to those lesions of which the prosthesis can act as an etiological factor, emphasizing the preventive measures that can be adopted to reduce their incidence. Clinical cases of the following lesions are illustrated: denture stomatitis, fibrous inflammatory hyperplasia, traumatic ulcer and angular cheilitis. The prevalence of soft tissue lesions related to the use of removable prosthesis can be decreased through relatively simple measures, as: adequate directions to the patients regarding the care they should take of their prosthesis; follow-up of removable prosthesis wearers' oral health; and diligence in the diverse phases of the prosthesis' construction, resulting in stable occlusion, fine adaptation of the base to the underlying mucosa, within the limits of the bearing area.

Oral mucosal conditions and risk factors among elderly in a Turkish school of dentistry.

BACKGROUND: Prevalence studies are important to determine the oral health status and treatment needs of elderly people. Our aim was to obtain data for the prevalence of oral mucosal conditions (OMC) in a Turkish elderly sample and to compare our results with different geographic regions. OBJECTIVE: The purpose of this clinical-based study was to determine the prevalence of OMC and associated risk factors in a clinical-based Turkish elderly sample. METHODS: The study sample consisted of 700 patients >60 years old. The clinical examination of patients was performed by both authors. All participants were questioned about their general health status, medication use, oral hygiene habits, tobacco or alcohol use, use of dentures, and the length of denture use. Chi2 Pearson's test with Fisher's exact probability test was used to analyze the data. Logistic regression models were used to assess the influence of independent variables; odds ratios were calculated with 95% confidence intervals. Statistical significance was defined as p <0.05. RESULTS: OMC were recorded in 40.7% of the study sample. The logistic regression model revealed that male gender, length of denture use, smoking habit, and being a former smoker increased the probability of having an OMC. Smoking habit also increased the risk of having leukoplakia. The denture-related lesions accounted for 36.4% with the length of denture use and diabetes mellitus being significant risk factors for denture stomatitis and denture hyperplasia. The model for traumatic ulcer included medication use as a significant risk factor. CONCLUSIONS: Our results regarding an elderly Turkish sample support the studies of other populations where the prevalence of OMC was related to length of denture use, smoking, and gender. We also observed some important associations between denture-related lesions, systemic diseases, and medication use which require further investigation.

Occurrence rate of oral Candida albicans in denture wearer patients.

PURPOSE: The aim was to determine the fungi occurrence rate in the oral cavity of denture wearer patients in comparison to those without dentures. MATERIAL AND METHODS: The examinations were conducted in patients treated in two clinical departments of the University Hospital. Demographic data and those connected with basic diseases were collected and the evaluation concerning dentition and oral hygiene was performed. Samples for mycological examinations from the tongue dorsa, palatal mucosa, and mucosal surfaces of dentures were collected from patients with dentures while tongue and palate swabs were taken from those without dentures. For culture and identify of fungi standard methods were used. RESULTS: Dental and mycological examinations were performed in 95 patients, out of which 57 (60.0%) used complete or partial dentures and 38 (40.0%) had their own dentition (without dentures). Oral cavity revealed only growth of Candida albicans species, more frequently in patients with dentures (38/57; 66.7%) than in those without dentures (11/ 38; 28.9%) (p = 0.0003). C. albicans statistically significantly more frequently was isolated in denture wearer patients with diabetes mellitus (p = 0.0207) and without diabetes (p = 0.0376) comparing to such groups of patients but without dentures. Among 32 patients with diabetes mellitus, 14 (43.8%) revealed C. albicans; this rate was comparable with 9/23 (39.1%) patients without diabetes (p > 0.05). A similar analysis, conducted in 25 surgical patients with abdominal cancer and 15--without--cancers, did not show statistically significant differences in the incidence rate of C. albicans; it also concerned denture wearers (14/16; 87.5%) and non-wearing dentures (5/9; 55.6%) (p > 0.05) with cancer. In 37 (64.9%) wearer patients denture stomatitis was observed, associated mainly with C. albicans infections (29/37; 78.4%). CONCLUSIONS: 1) Mycological findings from the present study do not indicate that diabetes mellitus or advanced cancer has a significant effect on oral colonisation by Candida albicans or other species of Candida genus. 2) The occurrence rate of oral Candida albicans in patients with dentures (diabetic and non-diabetic, cancer and non-cancer patients) was higher than in patients without dentures (p < 0.05).

Study of denture-induced fibrous hyperplasia cases diagnosed from 1979 to 2001.

OBJECTIVE: The purpose of this research was to study the cases of inflammatory fibrous hyperplasia (IFH) at the Clinic of Semiology, Department of Bioscience and Oral Diagnosis, São Jose dos Campos Dental School, State University of São Paulo, Brazil. METHODS AND MATERIALS: A total of 141 clinical file cards indicating a final diagnosis of IFH, from the archives of the Department of Bioscience and Oral Diagnosis and dated from 1979 to 2001, were included in the study. Of these files, 50 indicated a diagnosis of denture-induced fibrous hyperplasia. Sex, age, race, duration, and clinical features that confirm their classification in the non-neoplastic proliferating process were analyzed statistically. RESULTS: Of the 50 analyzed cases of denture-induced lesion, 22% occurred in men and 78% in women. Patients in the age group of 41 to 50 years presented the highest frequency of the lesion. CONCLUSIONS: Inflammatory fibrous hyperplasia occurs more frequently in women (71.63%), and denture-induced lesions appear mainly in patients over 40 years of age (70% of cases). Patients with denture-induced hyperplasia reported pain associated with the lesion (70%).