Conventional and alternative antifungal therapies to oral candidiasis.

Candida-associated denture stomatitis is the most common form of oral candidal infection, with Candida albicans being the principal etiological agent. Candida adheres directly or via an intermediary layer of plaque-forming bacteria to denture acrylic. Despite antifungal therapy to treat denture stomatitis, infection is reestablished soon after the treatment ceases. In addition, many predisposing factors have been identified as important in the development of oral candidiasis, including malnourishment, common endocrine disorders, such as diabetis mellitus, antibacterial drug therapy, corticosteroids, radiotherapy and other immunocompromised conditions, such as acquired immunodeficiency syndrome (AIDS). These often results in increased tolerance to the most commonly used antifungals. So this review suggests new therapies to oral candidiasis.

Effect of monomer blend and chlorhexidine-adding on physical, mechanical and biological properties of experimental infiltrants.

OBJECTIVES: The aim of the study was to evaluate antimicrobial inhibition zone, degree of conversion (DC) and Knoop hardness (KH) of experimental infiltrants. Experimental low viscosity monomer blends were prepared and chlorhexidine diacetate salt (CHX) (0.1% or 0.2%) was added comprising the groups: G1) TEGDMA; G2) TEGDMA/0.1CHX; G3) TEGDMA/0.2CHX; G4) TEGDMA/UDMA; G5) TEGDMA/UDMA/0.1CHX; G6) TEGDMA/UDMA/0.2CHX; G7) TEGDMA/BISEMA; G8) TEGDMA/BISEMA/0.1CHX; G9) TEGDMA/BISEMA/0.2CHX. Icon® was used as control group. METHODS: Specimens of resin blends were made (n=9) to accomplished DC and KH. Pour plate was accomplished to evaluate antimicrobial groups' activity against Streptococcus mutans (SM) and Lactobacillus acidophilus (LA). Data obtained were submitted to two-way ANOVA and Tukey tests for blends comparisons and Dunnett's test for comparisons between experimental infiltrants and Icon® (p<0.05). RESULTS: In relation to antimicrobial effect, uncured blends showed higher antibacterial activity than cured ones for the most of blends. After polymerization, G5 showed the highest inhibition zone against SM and, G3 and G6 against LA. Concerning KH, TEGDMA/UDMA-based blends showed the highest values of KH number and it was influenced by monomeric base, regardless CHX concentration. DC was not affected by monomer blend composition, neither for CHX concentration. The antimicrobial activity was affected by monomeric base, CHX concentration and polymerization. Experimental infiltrants presented similar or higher performance than Icon® for the properties evaluated. SIGNIFICANCE: White spot lesion infiltration with low viscosity monomer blends (infiltrants) is an alternative to stop initial caries lesions progression. The incorporation of an antimicrobial agent as chlorhexidine diacetate salt in infiltrants composition could enhance the performance of these materials.

Evidências científicas da colonização de Candida spp. em bolsas periodontais / Scientific evidence of Candida spp. colonization in periodontal pockets

Objetivo: o objetivo do presente trabalho é apresentar uma breve revisão de literatura a respeito da colonização de Candida spp. em bolsas periodontais, seus principais fatores de virulência e possível influência sobreas doenças periodontais. Revisão de Literatura: Apesar de a mucosa bucal ser considerada o principal reservatóriode Candida spp, este micro-organismo pode estar coagregado a bactérias do biofilme dental, sendo considerado um fator importante para o processo decolonização de bolsas periodontais. Além disso, possui vários fatores de virulência relevantes na patogênese dadoença periodontal, tais como a capacidade de aderir ao epitélio e invadir o tecido conjuntivo gengival. Também pode inibir a função de neutrófilos polimorfonucleares, bem como produzir enzimas como colagenases e proteinases, que são capazes de degradar imunoglobulinas.Considerações finais: Os fatores de virulência de Candida spp. associada à suscetibilidade do hospedeiro poderiam desempenhar um papel importante nasalterações inflamatórias associadas com as doenças periodontais destrutivas

Conventional and alternative antifungal therapies to oral candidiasis

Candida-associated denture stomatitis is the most common form of oral candidal infection, with Candida albicans being the principal etiological agent. Candida adheres directly or via an intermediary layer of plaque-forming bacteria to denture acrylic. Despite antifungal therapy to treat denture stomatitis, infection is reestablished soon after the treatment ceases. In addition, many predisposing factors have been identified as important in the development of oral candidiasis, including malnourishment, common endocrine disorders, such as diabetis mellitus, antibacterial drug therapy, corticosteroids, radiotherapy and other immunocompromised conditions, such as acquired immunodeficiency syndrome (AIDS). These often results in increased tolerance to the most commonly used antifungals. So this review suggests new therapies to oral candidiasis.

Evidence of Heterokaryon compatibility on Candida albicans biofilm

Aims: Candida species, especially Candida albicans, are frequently found associated with biomaterials and immunosuppressed patients, and have been described as the most virulent yeasts in human fungi diseases. These yeasts have recently been isolated from periodontal pockets, revealing the penetration of hyphae into the periodontal connective tissue. Methods: In this study, 7 periodontal C. Albicans strains were applied individually in biofilm development on titanium discs and the samples were thereafter analyzed as for the number of colony forming units per milliliter (CFU/mL), dry-weight and scanning electron microscopy (SEM). Results: Counting of CFU/ mL and determination of dry-weight showed that all samples formed biofilm. SEM analysis showed the development of a polymorphic network in the biofilms and the presence of hyphal anastomosis in the sites where fusion between the hyphae occurred. Conclusion: periodontal C. albicans strains present heterokaryon compatibility.

Susceptibility of Candida spp. Oral isolates for azolic antifungals and amphotericin B

Aims: Among the oral infections, candidosis may be considered the most frequent, and C. albicans the most prevalent species. Meanwhile, the non-albicans species may also be related to other infections processes and be able to affect the oral cavity, including periodontal disease. In this sense, understanding the relationship between Candida spp. and host, it is necessary and justified the search of mechanisms modulators of infections and treatments against diseases associated with these yeasts. Methods: Nineteen patients with periodontal disease were involved in this study. The aim was evaluate the susceptibility to azoles antifungals fluconozole, itraconazole, ketoconazole and the polienic anfotericin B against Candida spp isolated from three different sites of the oral cavity from these patients (periodontal disease, being periodontal pocket, oral mucosa and ridge gingival), by the minimum inhibitory concentration method – MIC. Results: Among the samples of C. albicans, 88% showed susceptibility depending on the concentration (SCD) and 3.6 % were resistant to at least one antifungal azole studied. Among the others species, 57% presented SDC and 42.8% showed resistance to at least one of the antifungal azole tested. Regarding to Anfotericin B, 90% of the C. albicans isolates and 3% of the nonalbicans showed resistance. There was no occurrence of resistance to the fluconazole and only 3.6% of C. albicans and 40% of the non-albicans were SDC to this antifungal. Conclusions: Patients with periondontal disease showed relevant levels of colonization by Candida spp, mainly at the oral mucosa and periodontal pocket showing important occurrence of SDC and resistance to the antifungals drugs tested.