Photoactivated disinfection procedure for denture stomatitis in diabetic rats.

Objective: To study the efficacy of PADTM Plus-based photoactivated disinfection (PAD) for treating denture stomatitis (DS) in diabetic rats by establishing a diabetic rat DS model. Methods: The diabetic rat DS model was developed by randomly selecting 2-month-old male Sprague-Dawley rats and dividing them into four groups. The palate and denture surfaces of rats in the PAD groups were incubated with 1 mg/mL toluidine blue O for 1 min each, followed by a 1-min exposure to 750-mW light-emitting diode light. The PAD-1 group received one radiation treatment, and the PAD-2 group received three radiation treatments over 5 days with a 1-day interval. The nystatin (NYS) group received treatment for 5 days with a suspension of NYS of 100,000 IU. The infection group did not receive any treatment. In each group, assessments included an inflammation score of the palate, tests for fungal load, histological evaluation, and immunohistochemical detection of interleukin-17 (IL-17) and tumor necrosis factor (TNF-α) conducted 1 and 7 days following the conclusion of treatment. Results: One day after treatment, the fungal load on the palate and dentures, as well as the mean optical density values of IL-17 and TNF-α, were found to be greater in the infection group than in the other three treatment groups (P < 0.05). On the 7th day after treatment, these values were significantly higher in the infection group than in the PAD-2 and NYS groups (P < 0.05). Importantly, there were no differences between the infection and PAD-1 groups nor between the PAD-2 and NYS groups (P > 0.05). Conclusions: PAD effectively reduced the fungal load and the expressions of IL-17 and TNF-α in the palate and denture of diabetic DS rats. The efficacy of multiple-light treatments was superior to that of single-light treatments and similar to that of NYS.

Different wavelengths of laser: are they significant for treatment of denture stomatitis?: an in-vitro study.

BACKGROUND: Denture stomatitis (DS) is an inflammatory disorder that affects the mucosal surface underneath the dentures and frequently causes oral mucosal irritation, discomfort, and altered taste perception, which prevents people from consuming enough nutrients. One of the main causes of DS is an overgrowth of the fungus Candida albicans (C. albicans). A possible alternative treatment for Candida infections is thought to be laser therapy. The aim of this study was to evaluate how different wavelengths of laser would affect growth and pathogenic properties of Candida albicans. METHODS: A concentration of 106 viable cells/ml of Candida albicans were used in the preparation process. Four groups were created from the specimens. Culturing of the control group was completed with no intervention. The other 3 groups received laser radiation for 60 seconds at a power of 1W. The 2nd and 3rd groups were irradiated with diode laser at a wavelength of 940 nm and 980 nm respectively. The 4th group was irradiated with Nd-YAG laser at a wavelength of 1064 nm. Turbidimetric growth was defined as variations in the optical density of fungal growth. These measures were made at three different times: baseline, 48 hours, and 72 hours. RESULTS: In both groups of diode laser, the growth of Candida albicans showed no remarkable differences at baseline, after 48 and 72 hours using a power of 1 W and duration of 60 seconds. The Nd-YAG group showed significant increase in optical density after 48 hrs then significant decrease after 72 hrs. The optical density values in the control group showed no notable difference between the control and diode study groups at different time periods. However, the Nd:YAG group showed a statistically significant difference compared to the control and the 2 diode laser groups. CONCLUSIONS: Different laser parameters have a different effect on growth and pathogenic properties of Candida albicans. Diode laser therapy with wavelengths 940 and 980 nm used in continuous mode with power of 1 W for duration of 60 seconds can result in proliferation of Candida albicans instead of destroying them. Nd:YAG laser, used in pulsed mode, with power of 1 W for a duration of 60 seconds can be used to destroy Candida albicans and therefore, can be used as an effective treatment for denture stomatitis.

Role of laser or photodynamic therapy in treatment of denture stomatitis: A systematic review.

STATEMENT OF PROBLEM: Denture stomatitis (DS) is an inflammatory oral lesion that occurs mostly in elderly denture wearers and that can negatively affect their quality of life. The conventional treatment plan for DS is topical or systemic fungicidal drug therapy, which are not without side effects. PURPOSE: The purpose of this systematic review was to evaluate the clinical outcomes of using low-level laser therapy (LLLT) or photodynamic therapy (PDT) in the treatment of DS by reviewing high-quality published articles. MATERIAL AND METHODS: The Cochrane Library, Web of Science, Google Scholar, PubMed, ProQuest, Scopus, Embase, and Ovid databases were searched using appropriate key words. Related titles and abstracts published up to May 2017 were screened and selected based on defined inclusion criteria. The full texts of all selected articles were read, and citation lists were checked for missing references. All randomized controlled trials (RCT) were subjected to quality assessments. RESULTS: A total of 760 articles were included in the study after the initial search. Six studies were selected for assessment of eligibility, and 4 of them were sufficiently reliable in methodology and randomization to be included in the study. The applied wavelength varied from 455 nm to 830 nm. Also, the highest energy patients were exposed to was 122 J/cm2, and the lowest was 1 J/cm2. Exposure times ranged from 10 seconds to 26 minutes in the reviewed studies. CONCLUSIONS: Based on the available RCTs, LLLT has a significant role in the clinical treatment of DS. However, the results of PDT were similar to those of conventional antifungal therapies.

Salivary levels of TNF-alpha and IL-6 in patients with denture stomatitis before and after laser phototherapy.

OBJECTIVE: The aim of this study was to monitor therapeutic response by determining the level of proinflammatory cytokines TNF-alpha and IL-6 in whole unstimulated saliva in patients with denture stomatitis (DS), before and after laser phototherapy (LPT). BACKGROUND: DS is an inflammatory condition that occurs in subjects who wear dentures, and it is a common oral mucosal lesion. A potential noninvasive treatment for DS patients is LPT. MATERIALS AND METHODS: A sample consisting of 40 consecutive subjects was selected on a voluntary basis from patients who presented for the diagnosis and treatment of DS at the Oral Medicine Unit of the Medical Faculty at the University of Rijeka. A clinical examination was performed according to the standard clinical criteria. Lesions described as palatal inflammation were diagnosed as Newton type II denture stomatitis. The patients were randomly assigned to either an experimental group (20 patients receiving real LPT) or a control group (20 patients receiving inactive/placebo laser treatment). In order to determine the salivary levels of TNF-alpha and IL-6, ELISA (Sigma Immunochemicals, St Louis, MO) was performed. RESULTS: Following treatment with LPT for 4 wk, the levels of TNF-alpha and IL-6 decreased significantly (p < 0.001) and were significantly different from controls (p < 0.001). CONCLUSION: The results of this study suggest that LPT may be an efficacious choice of therapy.

Effectiveness of microwave disinfection of complete dentures on the treatment of Candida-related denture stomatitis.

UNLABELLED: The effectiveness of microwave disinfection of maxillary complete dentures on the treatment of Candida-related denture stomatitis was evaluated. Patients (n = 60) were randomly assigned to one of four treatment groups of 15 subjects each; CONTROL GROUP: patients performed the routine denture care; Mw group: patients had their upper denture microwaved (650 W per 6 min) three times per week for 30 days; group MwMz: patients received the treatment of Mw group in conjunction with topical application of miconazole three times per day for 30 days; group Mz: patients received the antifungal therapy of group MwMz. Cytological smears and mycological cultures were taken from the dentures and the palates of all patients before treatment at day 15 and 30 of treatment and at follow-up (days 60 and 90). The effectiveness of the treatments was evaluated by Kruskal-Wallis and Mann-Whitney tests. Microbial and clinical analysis of the control group demonstrated no significant decrease in the candidal infection over the clinical trial. Smears and cultures of palates and dentures of the groups Mw and MwMz exhibited absence of Candida at day 15 and 30 of treatment. On day 60 and 90, few mycelial forms were observed on 11 denture smears (36.6%) from groups Mw and MwMz, but not on the palatal smears. Miconazole (group Mz) neither caused significant reduction of palatal inflammation nor eradicated Candida from the dentures and palates. Microwaving dentures was effective for the treatment of denture stomatitis. The recurrence of Candida on microwaved dentures at follow-up was dramatically reduced.

Effect of low-level laser therapy on Candida albicans growth in patients with denture stomatitis.

OBJECTIVE: The purpose of our report is to present the effect of low-level laser therapy on Candida albicans growth and palatal inflammation in two patients with denture stomatitis. BACKGROUND DATA: The most common oral mucosal disorder in denture wearers is denture stomatitis, a condition that is usually associated with the presence of the yeast Candida albicans. Different treatment methods have been suggested to treat this symptom, none of which is proven to be absolutely effective. METHODS: Two denture-wearing patients, both with palatal inflammation diagnosed as Newton type II denture stomatitis were treated with low-power semiconductor diode laser (BTL-2000, Prague, Czech Republic) at different wavelengths (685 and 830 nm) for 5 d consecutively. In both patients, palatal mucosa and acrylic denture base were irradiated in noncontact mode (probe distance of 0.5 cm from irradiated area) with different exposure times-5 min (830 nm, 3.0 J/cm2, 60 mW) and 10 min (685 nm, 3.0 J/cm2, 30 mW). The effect of laser light on fungal growth in vivo was evaluated after the final treatment using the swab method and semiquantitative estimation of Candida albicans colonies growth on agar plates. The severity of inflammation was evaluated using clinical criteria. RESULTS: After lowlevel laser treatment, the reduction of yeast colonies on the agar plates was observed and palatal inflammation was diminished. CONCLUSION: LLLT is effective in the treatment of denture stomatitis. Further placebo controlled studies are in progress.

Effect of low-energy laser application in the treatment of denture-induced mucosal lesions.

STATEMENT OF PROBLEM: Mucosal inflammation under dentures causes problems for prosthodontists and patients. PURPOSE OF STUDY: This study evaluated the effectiveness of a low-energy laser used in the treatment of denture-induced mucosal lesions in comparison with other conventional methods. MATERIAL AND METHODS: Eighteen men were selected and divided into three groups of six according to the treatment applied: denture removal, relined dentures with temporary tissue treatment, and application of laser irradiation for the lesions while continuing to wear the dentures. Oral hygiene and nutrition were maintained during the study. Clinical, histologic, and densitometric assessments were used to evaluate the three treatment methods. RESULTS: The results revealed that lesions in the group treated with laser irradiation were clinically superior in healing when compared with the other groups. Histologic evidence of the therapeutic effect of lasers in healing denture-induced mucosal lesions was demonstrated. Densitometric evaluation showed an increase in the optical density of alveolar bone underneath the irradiated lesions compared with untreated lesions. CONCLUSION: These findings suggest the effect of therapeutic laser treatment on both soft tissue and bone with subsequent improvement of denture foundation after treatment of denture-induced mucosal lesions.

[Studies on the therapeutic efficacy of a HeNe laser]. / Untersuchung zur therapeutischen Wirksamkeit eines He-Ne-Lasers.

Numerous manufactures recommend He-Ne-Lasers for a wide range of applications in medicine and dentistry. An athermal biostimulating mechanism of action is postulated to result in rapid reduction of pain and accelerated wound healing. The efficacy of a commercially available He-Ne-Laser in the treatment of alveolitis, solitary aphthae, ulcers caused by dentures, herpes simplex labialis, marginal periodontopathy and pericoronitis was investigated in 90 cases. Except for a placebo effect no reproducible therapeutic effects could be seen. Nevertheless, there is a high degree of acceptance for laser application by most of patients.