Minimally Invasive Semiconductor Laser Surgery Combined with 5-ALA Photodynamic Therapy for a Chronic Hyperplastic Candidiasis Patient Who Is Ineffective to Antifungal Therapy.

Background: Chronic hyperplastic candidiasis (CHC) is a chronic oral mucosal infection caused by Candida, which has potential for malignant transformation. Diagnosing CHC can be challenging due to its various manifestations. In addition, fungal treatments often prove to be ineffective, highlighting the urgent need for a new safe and efficient treatment approach. Given the potential of CHC to transform into malignancy, it is crucial to emphasize dynamic monitoring and follow-up after treatment. Objective: We attempted to investigate the effect of semiconductor laser pretreatment combined with 5-amino-levulinic acid (5-ALA) photodynamic therapy (PDT) for CHC. Methods: We presented the successful treatment of CHC with mild dysplasia in a 30-year-old man using semiconductor laser and 5-ALA PDT after antifungal therapy proved ineffective. Toluidine blue staining, autofluorescence imaging, and DNA image cytometry were combined to dynamically monitor the progress of the disease. Results: We have obtained positive outcomes with the use of laser combined with PDT treatment. The patients experienced only mild adverse reactions after the treatment, and there was no indication of recurrence or malignant transformation during the subsequent follow-up period, as observed through various auxiliary examinations. Conclusions: This case report suggests that semiconductor laser surgery combined with PDT could be a promising treatment option for patients with CHC who do not respond to antifungal therapy. In addition, the use of combined noninvasive examinations might provide a more accurate assessment of malignant transformation in patients with CHC.

A well child with prolonged oral thrush: an unexpected diagnostic journey.

Oral thrush is a familiar presentation in both general practice and paediatrics, and is usually responsive to treatment in the community. Here, we present the diagnostic journey of a previously well boy aged 3 years who presented with treatment-resistant thrush and describe how 'unexpected' results led to eventual diagnosis and management. This intriguing case was managed jointly by district hospital general paediatric team and tertiary hospital specialist teams.

Palatal brushing for the treatment of denture stomatitis: A multicentre randomized controlled trial.

PURPOSE: To determine the effectiveness of palatal brushing in the treatment of denture-related erythematous stomatitis (DES) in complete denture wearers. METHODS: This two-parallel-arm RCT was conducted in three university clinics in Brazil, Canada, and Chile. Participants (n=77) were randomly allocated to receive (i) instructions for palatal brushing and standard oral/denture hygiene ("intervention"); or (ii) standard oral/denture hygiene instructions only ("control"). Data collection was carried out at the baseline and at 3 and 6 months after intervention. Outcomes included the magnitude of oral Candida carriage and the degree of inflammation of denture-bearing tissues. Groups were compared using generalized estimating equations and chi-square test (α=0.05). RESULTS: Palatal inflammation levels were reduced significantly in the "intervention" compared to "control" group at 6 months (intervention: 70%, control: 40%; chi-square, p=0.04). There was no between-group significant difference in the Candida count from denture and palatal biofilms; however, a subgroup analysis restricted to baseline Candida carriers showed further reduction with the intervention at 6 months. No adversity was observed by trialist or reported by participants. CONCLUSIONS: Including palatal brushing in oral instructions for denture wearers has positive impact on DES-related mucosal inflammation. Thus, our findings endorse the inclusion of palatal brushing in standard oral hygiene instructions to treat DES.

Chronic Oral Lesions.

Chronic oral mucosal lesions can be associated with several mucocutaneous diseases. This article reviews the autoimmune and immune-mediated, reactive, genetic, and infectious diseases that may present with chronic oral and/or cutaneous manifestations and provides a rational approach to diagnosis and management.

[Oral complications following allogeneic hematopoietic cell transplantation: Recommendations of the Francophone Society of Bone Marrow transplantation and cellular Therapy (SFGM-TC)]. / Complications stomatologiques dans le contexte de l'allogreffe de cellules hématopoïétiques : recommandations de la Société francophone de greffe de moelle et de thérapie cellulaire (SFGM-TC).

Stomatological complications of allogeneic hematopoietic stem cell transplantation (HSCT) are frequent and very uncomfortable for patients. The primary complication is the graft versus host disease reaction. Other side effects of the procedure include infections, taste disorders and carcinogenic risks. Various local treatments are used but remain imperfect. Within the framework of the 10th workshop of practice harmonization of the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) held in Lille in September 2019, diagnostic approaches and treatments of tongue and oral complications following allogeneic HSCT were reviewed according to the analysis of published studies.

Eficácia antimicrobiana da terapia fotodinâmica no tratamento da candidíase oral em pessoas vivendo com HIV/Aids / Antimicrobial efficacy of photodynamic therapy on the treatment of oral candidiasis in people living with HIV/Aids / Eficacia antimicrobiana de la terapia fotodinámica en el tratamiento de la candidiasis bucal en personas viviendo con VIH/Sida

Objetivo: avaliar a eficácia antimicrobiana da terapia fotodinâmica no tratamento da candidíase oral em pessoas vivendo com HIV/aids. Método: estudo experimental, qualitativo e descritivo com 18 pessoas vivendo com HIV/aids que manifestavam a candidíase oral, maiores de 18 anos, que estavam em tratamento no Hospital Universitário Gaffrée e Guinle. Este grupo subdividiu-se em um grupo controle, composto por sete pessoas, que recebeu tratamento com a terapia fotodinâmica e antifúngicos, e um grupo experimental, com 11, que recebeu apenas a terapia fotodinâmica. A evolução do tratamento de cada participante foi acompanhada por registros fotográficos em duas consultas, inicial e final. Esta pesquisa foi aprovada pelo Comitê de Ética em Pesquisa do hospital, parecer número 2.431.107. Resultados: a maioria dos participantes apresentou melhora clínica, ainda que discreta, e em apenas um houve piora clínica. Conclusão: a terapia fotodinâmica antimicrobiana pode ser eficaz no tratamento da candidíase oral em pessoas vivendo com HIV/Aids

Objective: evaluate the antimicrobial efficacy of photodynamic therapy in the treatment of oral candidiasis in people living with HIV/ aids. Method: experimental, qualitative and descriptive study with 18 people living with HIV/aids who presented oral candidiasis, over 18 years of age, who were being treated at the Gaffrée and Guinle University Hospital. This group was subdivided into a control group, composed of seven people, who received treatment with photodynamic and antifungal therapy, and an experimental group, with 11, who received only the photodynamic therapy. The evolution of the treatment of each participant was followed by photographic registers in two appointments, initial and final. This research was approved by the Research Ethics Committee from the hospital, dictum number 2.431.107. Results: most of the participants showed clinical improvement, albeit discrete, and in only one there was clinical worsening. Conclusion: antimicrobial photodynamic therapy may be effective in the treatment of oral candidiasis in people living with HIV/Aids

Objetivo: evaluar la eficacia antimicrobiana de la terapia fotodinámica en el tratamiento de la candidiasis bucal en personas que viven con VIH/sida. Método: estudio experimental, cualitativo y descriptivo con 18 personas viviendo con VIH/sida que manifestaban la candidiasis bucal, mayores de 18 años, que estaban en tratamiento en el Hospital Universitario Gaffrée y Guinle. Este grupo se subdividió en grupo control, compuesto por siete personas, que recibió tratamiento con la terapia fotodinámica y antifúngicos, y un grupo experimental, con 11, que recibió sólo la terapia fotodinámica. La evolución del tratamiento de cada participante fue acompañada por registros fotográficos en dos consultas, inicial y final. La investigación fue aprobada por el Comité de Ética en Investigación del lugar, dictamen número 2.431.107. Resultados: la mayoría de los participantes presentó mejoría clínica, aunque discreta, y en apenas uno hubo empeoramiento clínico. Conclusión: la terapia fotodinámica antimicrobiana puede ser eficaz en el tratamiento de la candidiasis bucal en personas que viven con el VIH/Sida

Effects of Streptococcus salivarius K12 with nystatin on oral candidiasis-RCT.

OBJECTIVE: To evaluate the efficacy and safety of Streptococcus salivarius K12 as an adjuvant in treating oral candidiasis. METHODS: A total of 56 patients were participated in the randomized, double-blinded, placebo-controlled clinical trial. The S. salivarius K12 or placebo lozenges plus nystatin tablets were given for up to 4 weeks at 1-week interval and then followed up for 1 week thereafter. We collected and analyzed the mycological and clinical data, treatment course, and safety data. RESULTS: At the end of the treatment, significant differences were found in the mycological cure rates between K12 group and control group (90.48% and 55.56%, respectively, p = 0.008). Survival analysis demonstrated no statistical difference in overall cure rates comprehensively considering mycological cure, clinical improvement, and recurrence (p = 0.078), while statistical difference was found in mycological cure (p = 0.013) between the two groups. The median treatment courses of K12 group and control group were 3 weeks and 4 weeks, respectively. No severe events were reported during the study. CONCLUSION: Streptococcus salivarius K12 exhibited potential efficacy and safety as an adjuvant in treating oral candidiasis by enhancing mycological cure and shortening the treatment course of conventional antifungal therapy in this randomized, double-blinded, placebo-controlled clinical trial. Further large-scale clinical studies are desired to accumulate more evidence for its clinical applications.

Enfermedades de la mucosa oral en pacientes geriátricos con aerosolterapia: revisión bibliográfica / Oral mucosal diseases in geriatric patients with aerosol therapy: bibliographic review

Introducción y objetivos: El presente estudio se plantea describir las actividades a implementar para mejorar el tratamiento, tales como la prevención de lesiones orales, en especial, la micosis oral, en la población geriátrica en tratamiento con aerosolterapia. Metodología: Se ha llevado a cabo un proceso de revisión bibliográfica en diferentes bases de datos electrónicas nacionales (CUIDEN) e internacionales (Cochrane y PubMed), que se ha completado con una búsqueda manual de guías de práctica clínica y motores de búsqueda, y con una búsqueda secundaria de artículos. Se han admitido publicaciones realizadas entre enero de 2013 y marzo de 2018. Resultados: La disminución de las dosis de aerosolterapia, la correcta higiene bucodental y la adecuada limpieza de los dispositivos de aerosolterapia se encuentran como actividades para el tratamiento y la prevención de las lesiones bucales, principalmente las candidiasis orales. Conclusiones: Se considera necesario realizar estudios homogéneos y centrados en la población geriátrica, sobre todo en la prevención de estas patologías, superando las limitaciones metodológicas encontradas

Introduction and objectives: This study aims to describe the activities to implement to improve the treatment as the prevention of oral disease, especially oral mycosis, in the geriatric population with aerosol therapy. Methodology: A bibliographic review process has been carried out in different national (CUIDEN) and international (Cochrane and PubMed) electronic databases, completing it with a manual search in clinical practice guides and search engines, and with a secondary search of articles. Publications published between January 2013 and March 2018 have been accepted. Results: The reduction of aerosol therapy doses, the correct oral hygiene and the adequate cleaning of the aerosol therapy devices are found as activities for the treatment and prevention of oral lesions, mainly oral candidiasis. Conclusions: It is considered necessary to conduct homogeneous studies focused on the geriatric population, especially in the prevention of these pathologies, overcoming the methodological limitations found

Probiotics for oral and vulvovaginal candidiasis: A review.

Dermatologists commonly prescribe medications such as antibiotics and corticosteroids that can increase the risk for candidiasis. Though conventional antifungals are often effective against candidiasis, they are not without side effects and species of Candida are gaining resistance. Probiotics help treat conditions such as post-antibiotic diarrhea and infectious diarrhea, and thus have the potential to help with Candida infections, as well. For this reason, we provide an overview of therapies prescribed in dermatology that may increase the risk for candidiasis, and we review the literature on whether probiotics are useful in the treatment and prevention of oral and vulvovaginal candidiasis to help dermatologists treating the condition be better informed about their supplemental use with conventional antifungals.

Severity of Candida-associated denture stomatitis is improved in institutionalized elders who consume Lactobacillus rhamnosus SP1.

BACKGROUND: This study aimed to determine the effect of the consumption of a probiotic on the clinical characteristics of Candida-associated denture stomatitis (DS) and to determine the impact of a protocol of self-care measures in oral/prosthetic hygiene in institutionalized elders that wear removable prostheses (RP). The current treatment for DS is the systemic use of antifungals, as well as the replacement of these devices together with oral/prosthetic hygiene instructions. METHODS: This study was a randomized, controlled and triple-blind trial. Thirty-six elders presenting DS of different severity and who carried RP consumed milk with/without the probiotic L. rhamnosus SP1. The prevalence and severity of DS and prevalence of Candida were determined and all participants/caregivers were trained in oral/prosthetic hygiene. RESULTS: In both groups a decrease in the prevalence of DS was observed (P < 0.05) but only the group that consumed probiotic throughout the trial had a significant reduction in the severity of DS and reduced Candida counts (P < 0.05). Educational instruction in oral/prosthetic hygiene was relevant for the participants, regarding the prevalence of this lesion. CONCLUSIONS: The frequent consumption of Lactobacillus rhamnosus SP1 and the establishment of a protocol of oral/prosthetic hygiene drastically reduced the severity of DS in institutionalized elders who wore RP.

Os produtos naturais são uma alternativa para o tratamento da candidose oral? Uma revisão de ensaios clínicos / Are natural products an alternative for the treatment of oral candidosis? A review of clinical trials / ¿Los productos naturales son una alternativa para el tratamiento de la candidiasis oral? Una revisión de los ensayos clínicos

Introdução: a candidose oral é uma doença oportunista que acomete principalmente pacientes imunossuprimidos e usuários de prótese dentária total. Apesar da eficácia terapêutica dos antifúngicos utilizados atualmente para o tratamento desta doença, essas drogas apresentam muitos efeitos adversos relacionados à dose. Além disso, tem-se observado um aumento da resistência microbiana para esses agentes. Baseado nisso, uma fonte de busca promissora de princípios ativos alternativos para o tratamento da candidose oral são os produtos naturais. Objetivo: revisar a literatura sobre ensaios clínicos com produtos naturais para o tratamento da candidose oral, a fim de responder se existe evidência que os produtos naturais podem ser utilizados como tratamento alternativo para esta doença. Material e método: foi realizada uma síntese de todos os ensaios clínicos com produtos naturais para tratamento da candidose indexados banco de dados Pubmed. Resultado: seguindo os critérios de inclusão e exclusão entraram nesta revisão 6 estudos. Os estudos avaliaram a eficácia dos produtos naturais quanto aos parâmetros clínicos e micológicos e grau de satisfação do paciente. Conclusão: apesar da pouca quantidade de ensaios clínicos nesta temática, há evidência de que os produtos naturais podem ser usdos para tratar a candidose oral, especialmente alho, mamona, româ e melaleuca(AU)

Introduction: oral candidiasis is an opportunistic disease that mainly affects immunosuppressed patients and users of total dental prosthesis. Despite the therapeutic efficacy of currently used antifungals for the treatment of this disease, these drugs have many dose related adverse effects. In addition, an increase in microbial resistance has been observed for these agents. Based on this, a promising source of alternative active principles for the treatment of oral candidosis are the natural products. Objective: to review the literature on clinical trials with natural products for the treatment of oral candidosis in order to answer if there is evidence that natural products can be used as an alternative treatment for this disease. Material and method: a synthesis of all clinical trials with natural products for the treatment of candidiasis indexed Pubmed database was performed. Results: following the inclusion and exclusion criteria, 6 studies were included in this review. The studies evaluated the efficacy of the natural products regarding clinical and mycological parameters and degree of patient satisfaction. Conclusion: despite the limited amount of clinical trials on this subject, there is evidence that natural products can be used to treat oral candidosis, especially garlic, castor oil, pomegranate, and melaleuca(AU)

Introducción: la candidose oral es una enfermedad oportunista que afecta principalmente a los pacientes inmunosuprimidos ya los usuarios de prótesis dentales totales. A pesar de la eficacia terapéutica de los antifúngicos utilizados actualmente para el tratamiento de esta enfermedad, estos medicamentos presentan muchos efectos adversos relacionados con la dosis. Además, se ha observado un aumento de la resistencia microbiana para estos agentes. En base a esto, una fuente de búsqueda prometedora de principios activos alternativos para el tratamiento de la candidiasis oral son los productos naturales. Objetivo: revisar la literatura sobre ensayos clínicos con productos naturales para el tratamiento de la candidiasis oral, a fin de responder si existe evidencia que los productos naturales pueden ser utilizados como tratamiento alternativo para esta enfermedad. Material y método: se realizó una síntesis de todos los ensayos clínicos con productos naturales para el tratamiento de la candidose indexada base de datos Pubmed. Resultado: siguiendo los criterios de inclusión y exclusión entraron en esta revisión 6 estudios. Los estudios evaluaron la eficacia de los productos naturales en cuanto a los parámetros clínicos y micológicos y grado de satisfacción del paciente. Conclusión: a pesar de la poca cantidad de ensayos clínicos en esta temática, hay evidencia de que los productos naturales pueden ser utilizados para tratar la candidose oral, especialmente ajo, ricino, granada y melaleuca(AU)

Antimicrobial Photodynamic Therapy Mediated by Curcumin-Loaded Polymeric Nanoparticles in a Murine Model of Oral Candidiasis.

Antimicrobial photodynamic therapy (aPDT) has been proposed as an alternative method for oral candidiasis (OC), while nanocarriers have been used to improve the water solubility of curcumin (CUR). The aim of this study is to encapsulate CUR in polymeric nanoparticles (NPs) and to evaluate its photodynamic effects on a murine model of OC. Anionic and cationic CUR-NP is synthesized using poly-lactic acid and dextran sulfate and then characterized. Female mice are immunosuppressed and inoculated with Candida albicans (Ca) to induce OC. aPDT is performed by applying CUR-NP or free CUR on the dorsum of the tongue, followed by blue light irradiation for five consecutive days. Nystatin is used as positive control. Afterward, Ca are recovered and cultivated. Animals are euthanized for histological, immunohistochemical, and DNA damage evaluation. Encapsulation in NP improves the water solubility of CUR. Nystatin shows the highest reduction of Ca, followed by aPDT mediated by free CUR, which results in immunolabelling of cytokeratins closer to those observed for healthy animals. Anionic CUR-NP does not show antifungal effect, and cationic CUR-NP reduces Ca even in the absence of light. DNA damage is associated with Ca infection. Consecutive aPDT application is a safe treatment for OC.

Atividade in vitro do extrato etanólico de própolis e do digluconato de clorexidina sobre as espécies de Candida isoladas da mucosa bucal de pacientes internados em Unidade de Terapia Intensiva (UTI) / In vitro activity of ethanolic extract of propolis and chlorhexidine digluconate on Candida species isolated from the oral mucosa of patients hospitalized in the Intensive Care Unit (ICU)

Avaliou-se a atividade dos extratos de própolis e digluconato de clorexidina em Candida sp isoladas da mucosa bucal de pacientes em UTI. Foram determinadas as concentrações fungicidas mínimas (CFM) e comparadas, nas doses sub-inibitórias, à produção de exoenzimas proteinase e fosfolipase e formação de franjas. Em 72 isolados foram avaliadas a atividade antifúngica pela técnica de microdiluição em série, na “base 2”, a produção das exoenzimas proteinase e fosfolipase, e a formação de franjas, antes e após a exposição às própolis e clorexidina. Dos 72 isolados, 53 eram C. albicans, 11 C. tropicalis, quatro C. guilhermondii e quatro sugestivas de C. dubliniensis. CFM 90% do extrato de própolis foi de 5% para C. albicans, 20% C. tropicalis, 0,625% C. guilhermondii e 0,312% sugestivas de C. dubliniensis. CFM 90% da clorexidina foi de 0,0018% para C. albicans, 0,012% C. tropicalis, de 0,0018% C. guilhermondii e de 0,00375% sugestivas de C. dubliniensis. Ocorreu inibição das exoenzimas e franjas, em ambos os produtos. Apesar da inibição da clorexidina ser menor que a da própolis, seu uso diário não causa efeitos colaterais indesejáveis como manchas nos dentes e na língua, perda do paladar e sensação de queimação na mucosa bucal.

The activity of propolis extract and chlorhexidine digluconate on Candida sp isolated from oral mucosa of patients in ICU was evaluated. The minimum fungicidal concentrations (MFC) were determined, and also the production of proteinase and phospholipase exoenzymes and the fringe formation. Seventy-two isolates were used and identified by the API 20C AUX® System. The antifungal activity was evaluated by “at base 2” serial microdilution technique. Also the exoenzymes production (proteinase and phospholipase), the fringes formation, before and after being exposed to propolis and chlorhexidine, were analysed. Of 72 isolates, 53 were C. albicans, 11 C. tropicalis, four C. guilhermondii and four suggestive C. dubliniensis. The MFC 90% of propolis extract was 5% C. albicans, 20% C. tropicalis, 0.625% C. guilhermondii; and 0.312% suggestive of C. dubliniensis. MFC 90% of chlorhexidine was 0.0018% C. albicans, 0.012% C. tropicalis, 0.0018% C. guilhermondii and 0.00375% suggestive of C. dubliniensis. The inhibition of exoenzymes and fringes occurred in the both products. Although the inhibition of chlorhexidine is lower than that showed by propolis, its daily use neither cause undesirable side effects as blemishes on the teeth and tongue, nor the loss of the taste and the burning sensation in the oral mucosa.

Diagnosis and management of oral candidosis.

Candida is a fungus (yeast) that is generally regarded as a normal and harmless member of the oral microbiome in humans. Should host defences against these commensals be compromised in any way then Candida can cause clinical signs and symptoms, which manifest as distinct forms of oral candidosis (candidiasis). Candida albicans is the most frequently isolated candidal species from the oral cavity, although a range of non-C. albicans Candida species are being increasingly encountered. The basic principle of the management of candidosis is to identify and eliminate any underlying host predisposing factor. However, in many cases, antifungal therapy will also be required as part of initial management. This article will provide an overview of the isolation, identification and pathogenicity of Candida species encountered within the mouth and relate these to clinical management of oral candidosis.

Ecological Therapeutic Opportunities for Oral Diseases.

The three main oral diseases of humans, that is, caries, periodontal diseases, and oral candidiasis, are associated with microbiome shifts initiated by changes in the oral environment and/or decreased effectiveness of mucosal immune surveillance. In this review, we discuss the role that microbial-based therapies may have in the control of these conditions. Most investigations on the use of microorganisms for management of oral disease have been conducted with probiotic strains with some positive but very discrete clinical outcomes. Other strategies such as whole oral microbiome transplantation or modification of community function by enrichment with health-promoting indigenous oral strains may offer more promise, but research in this field is still in its infancy. Any microbial-based therapeutics for oral conditions, however, are likely to be only one component within a holistic preventive strategy that should also aim at modification of the environmental influences responsible for the initiation and perpetuation of microbiome shifts associated with oral dysbiosis.

The potential management of oral candidiasis using anti-biofilm therapies.

Candida albicans is a minor component of the oral microbiota and an opportunistic pathogen that takes advantage of the immunocompromised host and causes oral mucositis and oral candidiasis. This organism is able to undergo phenotypic modification from a yeast to hyphae growth phase, one of the key arsenals for immune cell evasion, tissue invasion and biofilm formation. The latter property coupled with overgrowth and immune compromising factors such as HIV/AIDS, cancer treatments, organ transplantation, diabetes, corticosteroid use, dentures, and broad-spectrum antibiotic use have modified the fungus from a normal component of the microflora to a foe of an oral cavity and resulting in reduced sensitivity towards commonly utilised antifungal agents. Hence, the need for alternative therapy to curb this plight is of importance. Making use of biomolecules produced by Streptococcus mutans, application of lactoferrin which is a nonspecific host defense factor found in saliva with metal chelating and broader antimicrobial properties, use of probiotics which have the capacity to boost the host immunity through eliciting Immunoglobulin A synthesis, and perturbing the pathogen's environment via competition of space and food, and application of photodynamic therapy can help to manage the burden of oral candidiasis.

Children Undergoing Chemotherapy: Is It Too Late for Dental Rehabilitation?

Children undergoing cancer therapy encounter a diverse spectrum of oral changes that generally are attributed to immunosuppression and bleeding tendencies caused by the therapeutic agents. Therefore, providing oral health instructions and dental rehabilitation before the initiation of cancer therapy is encouraged. In this article, we discuss the general dental management of pediatric patients with cancer actively undergoing cancer therapy, or for whom it is planned. We also describe the dental rehabilitation performed on a child while he was undergoing chemotherapy for neuroblastoma, using an unconventional approach that varied from the standard management protocol used by King Abdulaziz University Hospital. The importance of close collaboration between the medical and dental teams is highlighted.

Adjuvant antifungal therapy using tissue tolerable plasma on oral mucosa and removable dentures in oral candidiasis patients: a randomised double-blinded split-mouth pilot study.

Extended use of antimycotics in oral candidiasis therapy gives rise to problems related to fungal drug resistance. The aim of this pilot study was to investigate the efficacy of tissue tolerable plasma (TTP) in denture stomatitis patients. It was hypothesised that (I): erythema and (IIa): complaint remission would be accelerated and (IIb): colony forming unit (CFU) reduction would be improved. The halves of the upper jaws of eight patients were randomly assigned to control (nystatin, chlorhexidine and placebo treatment) and test sides (nystatin, chlorhexidine and TTP administered six times each 7 days). The patients and the investigators, who were different from the therapists, were both blinded. Compared to the control sides, the erythema surface was reduced significantly more extensively on the test sides between 2 and 6 weeks of antifungal therapy (P ≤ 0.05). Visual analogue scale values and the frequency of moderate or heavy growth of Candida post-treatment did not differ significantly between both sides (P > 0.05). The primary hypothesis was confirmed, which may be interpreted as an accelerated remission. As drug therapy is usually limited to the time in which signs of infection are present, TTP might help reducing antifungal use. Even though the secondary hypotheses were not confirmed, persistence of Candida might be only colonisation.