Atividade antifúngica de nanofibras de policaprolactona/nistatina: estudo in vitro e in vivo / Antifungal activity of polycaprolactone/nystatin nanofibers: in vitro and in vivo study

Este estudo avaliou a eficácia in vitro e in vivo de mantas de nanofibras (NF) de policaprolactona (PCL) incorporadas com nistatina (NIS) no tratamento da estomatite protética (EP) em modelos animais. NF foram sintetizadas com diferentes concentrações de NIS, totalizando quatro soluções: PCL puro, PCL/NIS 0,045 g, PCL/NIS 0,090 g e PCL/NIS 0,225 g. A liberação da NIS foi analisada por espectroscopia Ultravioleta-Visível. A capacidade das mantas de inibirem o biofilme de Candida albicans, principal fator etiológico da EP, dividindo-se cinco grupos (N=5) compostos por um grupo com controle de células de C. albicans e com PCL puro, além das três concentrações de NIS. A seguir, foi analisada a viabilidade celular em queratinócitos humanos (HaCat) por meio do teste colorimétrico de resazurina. Cinco grupos foram divididos (N=10): controle celular, PCL puro e as três concentrações de NIS. Em modelos animais de ratos Wistar albinos (N=18), dispositivos palatinos (DP) de resina acrílica foram confeccionados simulando próteses totais e utilizados para a indução da EP. Para isso, DP contaminados com C. albicans foram cimentados na região molar da cavidade bucal dos animais e permaneceram em boca por 48 h. Após esse período, os DP foram removidos e os animais foram divididos em três grupos: (C) controle; (B1) com tratamento por mantas de PCL/NIS 0,045 g e (B2) PCL/NIS 0,225 g, com N=6. Então novos DP, livres de contaminação, foram cimentados na cavidade oral dos animais e permaneceu por mais 48 h. Após esse período, os animais foram eutanasiados, a contagem de UFC/ mL foi realizada e os palatos foram coletados para a análise histológica. A curva padrão de NIS obtida apresentou R2 de 0,99. As três concentrações de NF apresentaram liberação de NIS, com pico no tempo de 6 h e valores de 66,26 µg/ mL para PCL/NIS 0,045 g, de 333,87 µg/ mL para PCL/NIS 0,090 g e 436,51 µg/ mL para PCL/NIS 0,225 g, constantes até o fim do experimento. Os grupos com NIS reduziram em 2,5 log10 de crescimento do biofilme fúngico em relação aos grupos sem tratamento, Controle e PCL, sem diferença estatística significativa. Não foi observada citotoxicidade nas células HaCat, com viabilidade celular de 93,7% para PCL/NIS 0,045 g, 72,6% para PCL/NIS 0,090 g e 72,4% para PCL/NIS 0,225 g. A indução da EP nos três grupos foi possível e, porém, sem redução significativa na contagem de UFC/ mL de C. albicans nos grupos B1 e B2. Na análise histológica do grupo C pôde-se observar infiltração de hifas de Candida na camada queratinizada, presença de células inflamatórias formando micro abscessos e um discreto infiltrado inflamatório no tecido conjuntivo subjacente ao epitélio infectado. Nos grupos B1 e B2 não foram encontradas alterações epiteliais, concluindo-se que as NF demonstraram atividade antifúngica in vitro e foram efetivas na prevenção da penetração de hifas no tecido palatino de animais com DP (AU)

This study evaluated the in vitro and in vivo efficacy of nanofiber (NF) mats of polycaprolactone (PCL) incorporated with nystatin (NIS) in the treatment of denture stomatitis (DS) in animal models. NFs were synthesized with different concentrations of NIS, totaling four solutions: pure PCL, PCL/NIS 0.045 g, PCL/NIS 0.090 g, and PCL/NIS 0.225 g. The release of NIS was analyzed by Ultraviolet-Visible spectroscopy. The ability of the mats to inhibit Candida albicans biofilm, the main etiological factor of DS, was assessed by dividing five groups (N=5) composed of a group with C. albicans cell control and with pure PCL, in addition to the three concentrations of NIS. Next, cell viability in human keratinocytes (HaCat) was analyzed using the resazurin colorimetric test. Five groups were divided (N=10): cell control, pure PCL, and the three concentrations of NIS. In albino Wistar rat animal models (N=18), palatal devices (PD) made of acrylic resin were fabricated to simulate total prostheses and used to induce DS. For this, PD contaminated with C. albicans were cemented in the molar region of the animals' oral cavity and remained in the mouth for 48 hours. After this period, the PDs were removed, and the animals were divided into three groups: (C) control; (B1) treated with PCL/NIS 0.045 g mats, and (B2) PCL/NIS 0.225 g, with N=6. Then new, uncontaminated PDs were cemented in the animals' oral cavity and remained for another 48 hours. After this period, the animals were euthanized, UFC/ mL counts were performed, and the palates were collected for histological analysis. The standard NIS curve obtained showed an R2 of 0.99. The three concentrations of NF showed NIS release, with a peak at 6 h and values of 66.26 µg/ mL for PCL/NIS 0.045 g, 333.87 µg/ mL for PCL/NIS 0.090 g, and 436.51 µg/ mL for PCL/NIS 0.225 g, remaining constant until the end of the experiment. The groups with NIS reduced fungal biofilm growth by 2.5 log10 compared to the untreated groups, Control and PCL, with no significant statistical difference. No cytotoxicity was observed in HaCat cells, with cell viability of 93.7% for PCL/NIS 0.045 g, 72.6% for PCL/NIS 0.090 g, and 72.4% for PCL/NIS 0.225 g. Induction of DS in the three groups was possible; however, there was no significant reduction in UFC/ mL counts of C. albicans in groups B1 and B2. Histological analysis of group C revealed infiltration of Candida hyphae in the keratinized layer, presence of inflammatory cells forming micro abscesses, and a discreet inflammatory infiltrate in the connective tissue underlying the infected epithelium. No epithelial alterations were found in groups B1 and B2, concluding that NFs demonstrated in vitro antifungal activity and were effective in preventing hyphal penetration into palatal tissue in animals with PD.(AU)

Avaliação in vitro de formulações do óleo essencial de citronela (Cymbopogon nardus) sobre propriedades biológicas, físicas e mecânicas de resina acrílica para prótese dentária / In vitro evaluation of citronella (Cymbopogon nardus) essential oil formulations on biological, physical and mechanical properties of acrylic resin for dental prosthesis

O controle de formação de biofilme deve ser promovido por meio de técnicas diárias de higienização, sendo uma delas o uso de soluções de desinfecção. Dentre as soluções químicas comercialmente disponíveis, algumas podem ocasionar efeitos adversos quando utilizadas em longo prazo. Dessa forma, a busca por métodos alternativos de desinfecção, com soluções que não alterem as propriedades do material e que sejam inertes para o seu usuário torna-se essencial. Este estudo teve como objetivos: avaliar in vitro, a ação antifúngica de formulações de 5 mg/mL à base do óleo de citronela em biofilmes mistos de espécie de Candida em resina acrílica ativada termicamente (RAAT) para base protética por meio de contagem do número de unidades formadoras de colônias (UFC/mL), em dois tempos de exposição (15 e 30 minutos) e avaliar a citotoxicidade das formulações em células da linhagem epitelial HaCat, e verificar a ação destas formulações de citronela a 5 mg/mL na alteração de propriedades físicas e mecânicas de amostras de RAAT. Inicialmente, foram feitas as formulações à base de citronela em forma de emulsão e nanoemulsão. Em seguida, por meio de ensaios de microdiluição em caldo, foi obtida a concentração inibitória mínima (CIM) e concentração fungicida mínima (CFM) das cepas de Candida testadas. Foram confeccionadas amostras de RAAT para a realização dos ensaios, sendo 96 amostras para o ensaio de biofilme, divididas de acordo com os grupos: GI - controle negativo (Biofilme misto C. albicans ATCC + C. glabrata ATCC + C. albicans oral 6892 + C. albicans oral 7037); GII- Nanoemulsão de Citronela 5mg/mL; GIIIControle da Nanoemulsão (Tween 20); GIV- Emulsão de Citronela 5mg/mL; GV- Controle da Emulsão (Goma Xantana); GVI- Clorexidina 0,12% (Periogard), e 20 para o ensaio de viabilidade celular, divididas nos grupos: GI- Nanoemulsão de Citronela 5mg/mL; GII- Controle da Nanoemulsão (Tween 20); GIII- Emulsão de Citronela 5mg/mL; GIV- Controle da Emulsão (Goma Xantana); GV- Clorexidina 0,12% (Periogard). Biofilmes mistos de Candida foram formados sobre as superfícies das amostras, e foram quantificados por meio de contagem de unidades formadoras de colônias (UFCs). Para o teste de viabilidade celular utilizou-se células epiteliais da linhagem HaCaT, avaliadas através da coloração com resazurina. Para avaliação das propriedades físicas e mecânicas foram confeccionadas 50 amostras retangulares e 50 circulares de RAAT, separadas aleatoriamente em 5 grupos, de acordo com a formulação utilizada: GI ­ controle (água destilada); GII ­ saliva artificial; GIII ­ nanoemulsão de citronela a 5mg/mL; GIV - emulsão de citronela a 5mg/mL e GV - Clorexidina 0,12% (Periogard). As amostras foram imersas nas respectivas formulações, simulando a desinfecção de próteses dentarias pelo período de 30 minutos diários, durante 6 meses. Após este período, foi feita a análise da alteração de rugosidade de superfície (Ra - µm), estabilidade de cor (CIEDE 2000), avaliação da microdureza Knoop e resistência a flexão (MPa) das amostras. Os dados obtidos foram submetidos às análises estatísticas (p< 0,05). As formulações fitoterápicas à base de citronela apresentaram valores de CIM e CFM que variaram entre 0,156-1 mg/mL sobre as espécies de Candida e inibiram o crescimento do biofilme misto, apresentando uma redução estatisticamente significativa na contagem de UFC/mL, de até 2,7 Log destes fungos, principalmente quando submetidas ao tempo de exposição de 30 minutos. As formulações fitoterápicas testadas não apresentaram diferenças estatísticas entre si, apresentando viabilidade da célula HaCaT maior que 70%, diferentemente da clorexidina a 0,12%. Não houve diferença nos valores médios de rugosidade de superfície em nenhum dos grupos após serem submetidos à imersão nas formulações testes, com exceção do grupo controle, que apresentou diferença estatística significativa na rugosidade de superfície após o período de imersão. Nos valores de alteração de cor (ΔE00) foi possível observar que não houve diferença estatística significativa entre os grupos experimentais antes e após serem submetidos a imersão nas formulações testes. Nos valores de microdureza Knoop houve diferença estatística significativa apenas entre o grupo controle e o grupo emulsão de citronela. Para os dados de resistência flexural, módulo de elasticidade, força máxima e alongamento não houve diferença estatística significativa entre os grupos após imersão. Em suma, concluiu-se que as formulações fitoterápicas à base de citronela apresentaram efeito antifúngico sobre as diferentes espécies de Candida em superfície de resina acrílica para próteses dentárias, não apresentaram efeito citotóxico sobre células da linhagem epitelial, e se mostraram seguras como formulações antissépticas no que se refere às propriedades físicas e mecânicas estudadas, sendo potencialmente promissoras para serem indicadas como soluções desinfetantes para próteses dentárias(AU)

The control of biofilm formation should be promoted through daily hygiene techniques such as the use of disinfection solutions. Among the commercially available chemical solutions, some can lead to adverse effects in long-term use. Thus, the search for alternative methods of disinfection with solutions that do not interfere with properties of the material and those inert to the user becomes essential. This study aimed to: evaluate, in vitro, the antifungal effect of 5 mg/mL formulations based on citronella oil on mixed biofilms of Candida species in thermally activated acrylic resin (TAAR) for prosthetic base by counting the number of colony forming units (CFU/mL), in two exposure times (15 and 30 minutes) and to evaluate the cytotoxicity of the formulations in cells of the HaCat epithelial lineage, and to verify the action of these formulations of citronella at 5 mg/mL in the alteration of physical and mechanical properties of TAAR samples. Initially, citronella-based formulations were prepared as emulsion and nanoemulsion. Then, by means of broth microdilution assays, the minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of the tested Candida strains were obtained. For the biofilm test, 96 TAAR samples were prepared and assigned to the groups, as follows: GI - negative control (Mixed biofilm C. albicans ATCC + C. glabrata ATCC + C. albicans oral 6892 + C. albicans oral 7037); GII- Citronella Nanoemulsion 5mg/mL; GIII- Nanoemulsion Control (Tween 20); GIV- Citronella Emulsion 5mg/mL; GVEmulsion Control (Xanthan Gum); GVI- Chlorhexidine 0,12% (Periogard). For the cell viability assay, 20 samples were prepared and assigned to the following groups: GI- Citronella Nanoemulsion 5mg/mL; GII- Nanoemulsion Control (Tween 20); GIII- Citronella Emulsion 5mg/mL; GIV- Emulsion Control (Xanthan Gum); GV- Chlorhexidine 0,12% (Periogard). Mixed Candida biofilms were formed on the surfaces of the samples, and were quantified by counting colony forming units (CFUs). For the cell viability test, epithelial cells of the HaCaT lineage were used, evaluated by staining with resazurin. To evaluate the physical and mechanical properties, 50 rectangular and 50 circular samples of TAAR were prepared and randomly assigned into 5 groups, according to the formulation used: GI ­ control (distilled water); GII ­ artificial saliva; GIII ­ citronella nanoemulsion at 5mg/mL; GIV ­ citronella emulsion at 5mg/mL and GV ­ chlorhexidine 0,12% (Periogard). The samples were immersed in the respective formulations, simulating the disinfection of dental prostheses for a period of 30 minutes daily, for 6 months. After this period, the analysis of surface roughness change (Ra - µm), color stability (CIEDE 2000), evaluation of Knoop microhardness and flexural strength (MPa) of the samples was performed. The data obtained were submitted to statistical analysis (p< 0,05). The phytotherapic formulations based on citronella presented MIC and MFC values that varied between 0,156-1 mg/mL on Candida species and inhibited the growth of mixed biofilm, showing a statistically significant reduction in the CFU/mL counts, up to 2,7 Log of these fungi, mainly when subjected to an exposure time of 30 minutes. The phytotherapic formulations tested did not show statistical differences between them, showing HaCaT cell viability greater than 70%, unlike 0,12% chlorhexidine. There was no difference in the mean values of surface roughness in any of the groups after being subjected to immersion in the test formulations, except for the control group, that presented a statistically significant difference in surface roughness after the immersion period. Regarding color change (ΔE00) it was possible to observe that there was no statistically significant difference between the experimental groups before and after being subjected to immersion in the test formulations. In the Knoop microhardness values, there was a statistically significant difference only between the control group and the citronella emulsion group. For data on flexural strength, modulus of elasticity, maximum force and stretching, there was no statistically significant difference between the groups after immersion. In summary, it can be concluded that phytotherapic formulations based on citronella had an antifungal effect on different Candida species on acrylic resin surfaces for dental prostheses, besides not presenting a cytotoxic effect on cells of the epithelial lineage, and proved to be safe as antiseptic formulations in the which refers to the physical and mechanical properties studied, being potentially promising to be indicated as disinfectant solutions for dental prostheses(AU)

Desenvolvimento de formulações probióticas de isolados clínicos de Lactobacillus spp. para controle de Candida albicans / Development of probiotic formulations of clinical isolates of Lactobacillus spp. for the control of Candida albicans

O uso de probióticos tem sido considerado uma alternativa para o controle das candidoses bucais, como a estomatite protética. Recentemente, nosso grupo de pesquisa isolou cepas clínicas bucais de Lactobacillus rhamnosus (5.2) e Lactobacillus fermentum (20.4) com atividade antifúngica contra Candida albicans. Entretanto, é necessário o desenvolvimento de formulações para uso clínico dessas cepas probióticas na cavidade bucal. Assim, o objetivo desse projeto foi desenvolver formulações probióticas em hidrogel gellan gum com atividade antifúngica que possam ser usadas no controle da estomatite protética. Para o preparo das formulações probióticas, as cepas L. rhamnosus 5.2 ou L. fermentum 20.4 foram incorporadas em formulações com diferentes concentrações de gellan gum (0,6 a 1%). A viabilidade das células de Lactobacillus nas formulações e o sistema de liberação foram testados em diferentes condições de armazenamento, incluindo tempo e temperaturas de estocagem. A seguir, os efeitos das formulações probióticas foram avaliados sobre C. albicans pelo método de difusão em ágar e sobre biofilmes microcosmos por contagem de células viáveis e análise de microscopia eletrônica de varredura. Os resultados demonstraram que todas as concentrações do gellan foram capazes de manter a viabilidade das células de L. rhamnosus e L. fermentum em torno de 5 a 7 log, durante 14 semanas, independentemente da temperatura de armazenamento (4°C ou temperatura ambiente). No teste de difusão em ágar, verificou-se que as formulações probióticas levaram à inibição de cepas padrão e clínicas de C. albicans, demonstrando que as cepas de Lactobacillus incorporadas no gellan mantiveram sua atividade antifúngica. As formulações probióticas também conseguiram inibir os biofilmes microcosmos provenientes de pacientes com estomatite protética, reduzindo o número de células viáveis de Candida e desestruturando a arquitetura dos biofilmes. Concluiu-se que o gellan gum mostrou ser um biomaterial promissor como carreador das cepas probióticas de L. rhamnosus 5.2 e L. fermentum 20.4. Além disso, as formulações probióticas desenvolvidas apresentaram ação antifúngica sobre células de C. albicans e biofilmes de estomatite protética, podendo desta forma atuar na prevenção da candidose bucal. (AU)

The use of probiotics has been considered an alternative for the control of oral candidiasis such as denture stomatitis. Recently, our research group isolated oral clinical strains of Lactobacillus rhamnosus (5.2) and Lactobacillus fermentum (20.4) with antifungal activity against Candida albicans. However, it is necessary to develop formulations for clinical use of these probiotic strains in the oral cavity. Thus, the purpose of this project was to develop probiotic formulations in gellan gum hydrogel with antifungal activity that could be used in the control of denture stomatitis. For the preparation of probiotic formulations, the strains L. rhamnosus 5.2 or L. fermentum 20.4 were incorporated into formulations with different concentrations of gellan gum (0.6 to 1%). The viability of Lactobacillus cells in the formulations and the delivery system were tested under different storage conditions, including storage time and temperatures. Next, the effects of the probiotic formulations were evaluated on C. albicans by the agar diffusion method and on microcosm biofilms by viable cell count and scanning electron microscopy analysis. The results showed that all concentrations of gellan were able to maintain the viability of L. rhamnosus and L. fermentum cells around 5 to 7 log for 14 weeks, regardless of storage temperature (4°C or room temperature). In the agar diffusion test, it was found that the probiotic formulations led to the inhibition of standard and clinical strains of C. albicans, demonstrating that the Lactobacillus strains incorporated into gellan maintained their antifungal activity. Probiotic formulations were also able to inhibit microcosm biofilms from patients with denture stomatitis, reducing the number of viable Candida cells and disrupting the architecture of biofilms. As a conclusion, the gellan gum proved to be a promising biomaterial as a carrier of the probiotic strains of L. rhamnosus 5.2 and L. fermentum 20.4. In addition, the probiotic formulations developed showed antifungal action on C. albicans cells and denture stomatitis biofilms, thus being able to act in the prevention of oral candidiasis. (AU)

Lesiones paraprotésicas en pacientes geriátricos portadores de prótesis removibles / Paraprosthetic lesions in geriatric patients with removable prostheses / Lesões paraprotéticas em pacientes geriátricos com próteses removíveis

RESUMEN Introducción: Los pacientes geriátricos portadores de prótesis removible con frecuencia presentan lesiones paraprotésicas que repercuten en su calidad de vida. Objetivo: Identificar los tipos de lesiones paraprotésicas en pacientes geriátricos portadores de prótesis removibles. Método: Se realizó un estudio observacional y descriptivo en 97 pacientes de cualquier sexo, mayores de 60 años, portadores de prótesis removible, que acudieron a la Clínica Estomatológica Docente Provincial "Dr. Justo Ortelio Pestana Lorenzo" de Sancti Spíritus, por presentar algún tipo de lesión en la mucosa bucal, desde enero de 2019 hasta febrero de 2020. Se utilizaron métodos del nivel teórico, empírico y estadístico-matemático para el estudio de las variables: edad, sexo, tipo de lesión. Resultados: El 49,5 % del universo correspondió a pacientes de 60 a 69 años y el 66 % del sexo femenino. Las lesiones paraprotésicas más frecuentes fueron la estomatitis subprótesis (55,6 %) y las úlceras traumáticas (31,9 %). Conclusiones: Las lesiones de la mucosa bucal asociadas al uso de prótesis removible fueron más frecuentes en las mujeres. La estomatitis subprótesis fue la lesión paraprotésica que predominó, seguida de la úlcera traumática y épulis fisurado.

ABSTRACT Introduction: Geriatric patients with removable prostheses often present paraprosthetic lesions that have an unfavorable impact on their quality of life. Objective: To identify the type of paraprosthetic lesions in geriatric patients with removable prostheses. Method: An observational and descriptive study in a total of 97 patients with removable prostheses, no specific sex, and over 60 years of age, was carried out. All patients studied were presented to the Clínica Estomatológica Docente Provincial "Dr. Justo Ortelio Pestana Lorenzo" in Sancti Spíritus, from January 2019 throughout February 2020, with any type of oral lesions. Theoretical, empirical and statistical-mathematical methods were used to study the following variables: age, sex, type of lesions. Results: The 49.5% of the total of patients studied were 60 to 69 years old and 66% were female. Most common paraprosthetic lesions found were the subprosthetic stomatitis (55.6%) and traumatic ulcers (31.9%). Conclusions: The oral lesions related to removable prostheses were most common in females. The subprosthetic stomatitis was the most predominant followed by the traumatic ulcer and fissured epulis.

RESUMO Introdução: Pacientes geriátricos com próteses removíveis freqüentemente apresentam lesões paraprotéticas que afetam sua qualidade de vida. Objetivo: Identificar os tipos de lesões paraprotéticas em pacientes geriátricos com próteses removíveis. Método: Foi realizado um estudo observacional e descritivo em 97 pacientes de ambos os sexos, maiores de 60 anos, com próteses removíveis, atendidos na Clínica Provincial de Ensino de Estomatologia "Dr. Justo Ortelio Pestana Lorenzo "de Sancti Spíritus, por apresentar algum tipo de lesão na mucosa oral, de janeiro de 2019 a fevereiro de 2020. Foram utilizados métodos de nível teórico, empírico e estatístico-matemático para estudar as variáveis: idade, sexo, tipo de lesão. Resultados: 49,5% do universo corresponderam a pacientes de 60 a 69 anos e 66% ao sexo feminino. As lesões paraprotéticas mais frequentes foram estomatite subprotética (55,6%) e úlceras traumáticas (31,9%). Conclusões: As lesões da mucosa oral associadas ao uso de próteses removíveis foram mais frequentes nas mulheres. A estomatite subprotética foi a lesão paraprotética predominante, seguida por úlcera traumática e epúlide fissurada.

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

Abstract Denture stomatitis is the most frequent oral lesion in removable prosthesis wearers, with high recurrence rates and a complex treatment. Objective This 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.

Beneficial effects of three natural products for the treatment of denture stomatitis: a randomized clinical trial / Efeitos benéficos de três produtos naturais para o tratamento da estomatite protética: um ensaio clínico randomizado

Aim: To evaluate the effect of three natural antifungal agents combined with routine denture care on the treatment of DS, using a quantitative mycological culture analysis. Methods: Thirty denture wearers with denture stomatitis DS were treated using five substances: sterile distilled water (G1), nystatin oral suspension (G2), 20% alcoholic extract propolis (G3), Punica granatumLinné gel (G4), and Uncaria tomentosa gel (G5). The substances were used 3 times a day for 14 days. Quantitative mycological culture analysis of samples collected from the palatal mucosa was performed at three stages: before treatment (T0), after 14 days of treatment (T1), and 30 days after treatment completion (T2). Data were evaluated using Kruskal-Wallis and Friedman tests (p < 0.05). Results: Palatal mucosa intragroup analysis showed a significant reduction of Candida CFU/mL values for all groups at T1 compared to T0 (p < 0.05). However, they did not present statistical differences when comparing T1 and T2 (p > 0.05). The intergroup analysis demonstrated that there are no statistical differences, regardless of the evaluation time (p > 0.05). Conclusion:The natural products tested showed a satisfactory result on DS treatment, which proved to be equivalent to conventional topical therapy with nystatin and to treatment using only regular oral hygiene procedures.

Objetivo: Avaliar o efeito de três antifúngicos naturais combinados com o cuidado rotineiro com próteses dentárias no tratamento da EP, por meio de uma análise quantitativa de cultura micológica. Métodos: Trinta usuários de próteses dentárias com EP foram tratados com cinco substâncias: água destilada estéril (G1), suspensão oral de nistatina (G2), extrato alcoólico de própolis 20% (G3), gel Punica granatum L. (G4) e gel Uncaria tomentosa (G5). As substâncias foram utilizadas 3 vezes ao dia durante 14 dias. A análise micológica quantitativa das amostras coletadas da mucosa palatina foi realizada em três etapas: antes do tratamento (T0), após 14 dias do tratamento (T1) e 30 dias após o término do tratamento (T2). Os dados foram avaliados pelos testes de Kruskal-Wallis e Friedman (p < 0,05). Resultados: A análise intragrupo da mucosa palatina mostrou uma redução significativa dos valores de Candida UFC/mL para todos os grupos em T1 em comparação com T0 (p < 0,05). No entanto, não apresentaram diferenças estatísticas na comparação de T1 e T2 (p > 0,05). A análise intergrupos demonstrou que não há diferenças estatísticas, independentemente do tempo de avaliação (p > 0,05). Conclusão: Os produtos naturais testados apresentaram resultado satisfatório no tratamento da EP, sendo equivalente à terapia tópica convencional com nistatina e ao tratamento apenas com procedimentos rotineiros de higiene bucal.

Caracterización de la estomatitis subprotésica en portadores de prótesis removible en clínicas de la Universidad San Gregorio de Portoviejo, Ecuador / Characterization of subprosthetic stomatitis in patients with removable prosthesis. San Gregorio de Portoviejo University

RESUMEN Introducción: La estomatitis subprotésica es un proceso inflamatorio de la mucosa bucal que se encuentra cubierta por una prótesis removible, de causa multifactorial y alta prevalencia. Objetivo: Caracterizar la estomatitis subprotésica en pacientes portadores de prótesis removible atendidos en las clínicas odontológicas de la Universidad San Gregorio de Portoviejo en el período marzo-noviembre de 2019. Método: Se realizó un estudio descriptivo transversal, con los criterios de inclusión siguientes: mayores de 18 años, ambos sexos, buen estado de salud general, no practicar hábitos tóxicos, usar prótesis removible, total o parcial, confeccionada de acrílico o metales. Todos los sujetos de la investigación firmaron el consentimiento informado antes de realizarles la historia clínica de odontología del Ministerio de Salud Pública del Ecuador de donde se extrajeron los datos sociodemográficos, signos clínicos y características de la prótesis. Resultados: Fueron evaluados 100 pacientes. El 45 %, presentaba signos clínicos de estomatitis subprotésica; predominó el sexo femenino con el 33 % y el grupo de edad de 40 a 59 años con un 26 %. La mayoría de las prótesis no se ajustan ni adaptan de manera correcta, y tienen un mal estado físico, en el 80, 82,2 y el 91 %, respectivamente. El 84,4 % de los pacientes utilizaba prótesis parcial removible, confeccionadas con acrílico, por un periodo de 1 a 6 años en el 60 % de los casos. Conclusiones: El diagnóstico de estomatitis subprotésica se asocia con el mal estado físico, desajuste e inadecuada adaptación de las prótesis removibles, lo que indica la necesidad de la institución para el establecimiento de estrategias docentes hacia la comunidad para su prevención y diagnóstico temprano.

ABSTRACT Introduction: Subprosthetic stomatitis is an inflammatory process of the mucosa in the oral cavity covered by a removable prosthesis, with a multifactorial cause and high prevalence. Objective: To characterize subprosthetic stomatitis in patients with removable prosthesis treated at the dental clinics of San Gregorio University in Portoviejo in the period March-November 2019. Method: A cross-sectional descriptive study was conducted, with the following inclusion criteria: patients over 18 years old, both sexes, good general health, no toxic habits, use of removable prosthesis, total or partial, made of acrylic or metals. All the patients involved in the research signed their consent, information given to them before taking their dental records taken by the Ministry of Public Health of Ecuador, from which socio-demographic data, clinical signs and characteristics of the prosthesis were extracted. Results: 100 patients were evaluated. Forty-five per cent showed clinical signs of subprosthetic stomatitis; the female sex (33%) predominated and the age group 40-59 years with (26%). Most of the prosthesis did not fit or adapt correctly and were in poor physical condition in 80%, 82.2% and 91% respectively. 84.4% of the patients used removable partial prosthesis, made of acrylic, for a period of 1 to 6 years, (60%) of the cases. Conclusions: The diagnosis of subprosthetic stomatitis is associated with poor physical condition, maladjustment and inadequate adaptation of removable prostheses, which indicates the need for the institution to establish educational strategies towards the community for prevention and early diagnosis.

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)

Efficacy of copper sulphate on candida albicans on heat-polymerized acrylic resin / Eficacia del sulfato de cobre sobre candida albicans en resinas acrílicas de termocurado

The ageing of population is increasing, and a great percentage of these patients wear removable prostheses, and can suffer denture stomatitis, a condition that has been associated with candidiasis. Aims: To evaluate in vitro the effectiveness of Copper Sulfate against Candida albicans in samples of heat-polymerized acrylic resin, compared to nystatin, sodium hypochlorite and chlorhexidine. Materials and Methods: Initially, the minimum inhibitory concentration (MIC) of copper sulfate for Candida albicans was determined by microdilution. Then, 54 resin samples were divided into 6 treatment groups corresponding to Nystatin 100.000 UI, Sodium Hypochlorite 0.5%, chlorhexidine 0.12%, Copper Sulfate 4.7µg/ml, Copper Sulfate 9.4µg/ml and physiological saline solution, in which samples were submerged for 6 hours. Resin samples were then washed and cultured on solid media at 37°C for 72 hours. The number of colony-forming units was determined using a Quebec colony counter. The statistical analysis was performed using the Kruskal-Wallis test and the Mann-Whitney U test. Results: Copper sulfate at a concentration of 9.4µg/ml presented a similar effectiveness as the other control products regarding the reduction in the number of colonies of Candida albicans post-treatment. Conclusion: The effectiveness of copper sulfate against Candida albicans on acrylic resin was similar to that of nystatin, sodium hypochlorite and chlorhexidine.

En las últimas décadas se ha observado un aumento de la población de adultos mayores, de los cuales un gran porcentaje es portador de prótesis removible, y dos tercios pueden sufrir estomatitis subprotésica, enfermedad que es asociada a infecciones como candidiasis. Objetivo: Evaluar la efectividad antimicótica in vitro del sulfato de cobre en placas de resinas acrílicas de termocurado inoculadas con Candida albicans, frente a Nistatina, Hipoclorito de Sodio y Clorhexidina. Material y Métodos: Inicialmente, y mediante microdilución del sulfato de cobre, se determinó la concentración mínima inhibitoria (CMI) para Candida albicans. En la fase experimental, 54 muestras de resina se dividieron en 6 grupos correspondientes a Nistatina 100.000 UI, Hipoclorito 0.5%, Clorhexidina 0.12%, Sulfato de Cu 4.7µg/ml, Sufato de Cu 9.4 µg/ml y suero fisiológico. Las muestras fueron sumergidas en estos agentes por 6 horas, para posteriormente ser lavadas y cultivada en medios solidos a 37°C por 72 horas. Luego se realizó el conteo de unidades formadoras de colonias mediante contador tipo Quebec. El análisis estadístico se realizó mediante la prueba de Kruskal-Wallis y la prueba U de Mann-Whitney. Resultado: El sulfato de cobre a una concentración de 9.4µg/ ml presentó una efectividad similar a los otros productos, en la reducción de colonias de Candida albicans. Conclusión: La efectividad del sulfato de cobre contra Candida albicans fue semejante a la de Nistatina, Hipoclorito y Clorhexidina.

Surface morphology and in vitro leachability of soft liners modified by the incorporation of antifungals for denture stomatitis treatment

Abstract Objective: To evaluate the surface morphology and in vitro leachability of temporary soft linings modified by the incorporation of antifungals in minimum inhibitory concentrations (MIC) for Candida albicans biofilm. Methodology:Specimens of soft lining materials Softone and Trusoft were made without (control) or with the addition of nystatin (Ny), miconazole (Mc), ketoconazole (Ke), chlorhexidine diacetate (Chx), or itraconazole (It) at their MIC for C. albicans biofilm. The surface analyses were performed using Confocal laser scanning microscopy after 24 h, 7 days, or 14 days of immersion in distilled water at 37ºC. In vitro leachability of Chx or Ny from the modified materials was also measured using Ultraviolet visible spectroscopy for up to 14 days of immersion in distilled water at 37ºC. Data (µg/mL) were submitted to ANOVA 1-factor/Bonferroni (α=0.05). Results: Softone had a more irregular surface than Trusoft. Morphological changes were noted in both materials with increasing immersion time, particularly, in those containing drugs. Groups containing Chx and It presented extremely porous and irregular surfaces. Both materials had biexponential release kinetics. Softone leached a higher concentration of the antifungals than Trusoft (p=0.004), and chlorhexidine was released at a higher concentration than nystatin (p<0.001). Conclusions: The surface of the soft lining materials changed more significantly with the addition of Chx or It. Softone released a higher concentration of drugs than Trusoft did, guiding the future treatment of denture stomatitis.

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.

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)

The effect of nanodiamonds on candida albicans adhesion and surface characteristics of PMMA denture base material - an in vitro study

Abstract Candida albicans is the main causative pathogen of denture stomatitis, which affects many complete denture patients. Objective: To evaluate the effect of different concentrations of nanodiamonds (NDs) added to polymethyl methacrylate (PMMA) denture base material on Candida albicans adhesion as well as on surface roughness and contact angle. Methodology: Acrylic resin specimens sized 10×10×3 mm3 were prepared and divided into four groups (n=30) according to ND concentration (0%, 0.5%, 1%, 1.5% by wt). Surface roughness was measured with a profilometer, and the contact angle with a goniometer. The effect of NDs on Candida albicans adhesion was evaluated using two methods: 1) slide count and 2) direct culture test. Analysis of variance (ANOVA) and Tukey's post hoc test were used in the statistical analyses. Results: Addition of NDs decreased the Candida albicans count significantly more than in the control group (p<0.05), with a lowest of 1% NDs. Addition of NDs also significantly decreased the surface roughness (p<0.05), but the contact angle remained the same. Incorporation of NDs into the PMMA denture base material effectively reduced Candida albicans adhesion and decreased surface roughness. Conclusion: PMMA/NDs composites could be valuable in the prevention of denture stomatitis, which is considered one of the most common clinical problems among removable denture wearers.

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

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.

Efecto de miconazol sobre el recuento de levaduras en candidiasis asociada a estomatitis protésica / Effect of miconazole on the yeast count in candidiasis associated with denture stomatitis

RESUMEN: Introducción: Estomatitis Subprotésica, proceso inflamatorio crónico de la mucosa adyacente a prótesis removible. 71,4% de los sujetos con esta condición es portador de Candida y la severidad se relaciona con la presencia de esta levadura. Para su tratamiento se indica antimicóticos tópicos de la familia de polienos o de azoles. El propósito del estudio fue determinar el recuento de levaduras del género Candida en adultos mayores con candidiasis oral, antes y después de ser tratados con miconazol. Materiales y métodos: Se consignaron antecedentes sistémicos y locales en 32 adultos mayores con estomatitis subprotésica. Se determinó recuento de levaduras del género Candida en saliva, antes y después del tratamiento tópico con Miconazol 2%. Se aceptaron diferencias estadísticamente significativas con un error alfa igual o menor a 0.05%. Resultados: Los recuentos de levaduras del inicio del estudio disminuyeron significativamente a los días 8 y 15 después del tratamiento (mediana 6.800, 163, 60, respectivamente). 56,2% de los individuos presentó persistencia de levaduras después del tratamiento; 21,8% de ellos con recuentos superiores a 400 UFC/ml de saliva. Conclusiones: En el 56,2% de los individuos del estudio se observó persistencia de levaduras del género Candida luego de 2 semanas de tratamiento con miconazol al 2%.

ABSTRACT: Introduction: Denture stomatitis is a chronic inflammatory process of the mucosa adjacent to removable prosthesis. 71.4% of the subjects with this condition are carriers of Candida and the severity is related to the presence of this yeast. Topical antimycotics belonging to the polyene or azole family are indicated for its treatment. Efficacy of miconazole is reported to be from 80% to 100%, although resistance is described in isolates of Candida. The purpose of the study was to determine the count of Candida in older adults with oral candidiasis, before and after being treated with miconazole. Methodology: Systemic and local antecedents were recorded in 32 elderly adults with denture stomatitis. Differences in number of the colony forming units of Candida yeast, were determined before and after topical treatment with Miconazole 2%. Statistical significances were set at a value of p < 0.05. Results: Yeast counts at the start of the study significantly decreased 8 and 15 days after treatment (median 6,800, 163, 60, respectively). 56.2% of the subjects presented persistence of yeasts after treatment; 21.8% of them with counts higher than 400 CFU / ml saliva. Conclusion: In 56.2% of the study subjects, persistence of Candida yeasts was observed after 2 weeks of treatment with 2% miconazole.

Isolation of Candida spp. from denture-related stomatitis in Pará, Brazil

ABSTRACT The aim of this study was to isolate and identify Candida species from the oral cavity of denture wearers with denture-related stomatitis who were attended at the University Federal of Pará (Belém City, Pará State, Brazil). A total of 36 denture wearers with denture-related stomatitis were included, and type I (50%), type II (33%) and type III (17%) stomatitis were observed. Candida spp. were isolated from 89% of the cases and included five different Candida species. C. albicans was the most frequently recovered species (78% of the cases), followed by C. famata and C. tropicalis. We observed a significant association between Candida species isolation and unsatisfactory denture condition (p = 0.0017). Our results demonstrated the highly frequency of Candida species isolation in denture wearers with denture-related stomatitis and showed the relationship between these species and poor denture maintenance.

Denture wearers' recognition for their oral health status, denture cleansing methods, and insurance health system / 대한치과보철학회지

PURPOSE: The aim of the present investigation was to understand the incidence, prevalence of denture stomatitis in denture wearers, who were over 60 years old, and use the results for a fundamental data to promote public awareness about denture stomatitis and its education tools. MATERIALS AND METHODS: From August 21 to September 8 2017, 500 denture wearers, who were more than 60 years old in Seoul and 4 other metropolitan cities (Busan, Daegu, Gwangju, and Daejeon), received questionnaires. The questionnaires included denture wearers' demographic distributions, specific dental treatment experiences, discomforts with current dentures, their oral health conditions, and the method of denture cleansing. RESULTS: Thirty-two percent of 500 denture wearers responded that they have healthy oral conditions. Two hundred and eight respondents (41.6%) were aware of denture stomatitis. Only 131 (26.2%) were informed about the removable denture covered by national health insurance and 327 (65.4%) of denture wearers were using the improper denture cleansing methods. CONCLUSION: A large number of denture wearers still do not recognize the importance of proper treatment for denture stomatitis, insurance covered denture treatments, and adequate denture cleansing methods.

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)