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.

Effect of Denture Hygiene Protocols on Patient Satisfaction, Oral Health-Related Quality of Life, and Salivary Parameters: A Randomized Clinical Trial.

PURPOSE: This randomized controlled trial compared four denture hygiene protocols in terms of patient satisfaction, oral health-related quality of life (OHRQoL), and salivary parameters in complete denture wearers with denture stomatitis. MATERIAL AND METHODS: For this randomized, double-blind, controlled clinical trial, 108 participants were assigned to soak their dentures in one of the following solutions: (1) 0.25% sodium hypochlorite (positive control), (2) 0.15% Triclosan, (3) denture disinfecting tablets, or (4) denture disinfecting tablets plus palatine mucosa brushing solution. The outcomes of patient satisfaction, OHRQoL, and salivary parameters (salivary flow rate and pH) were measured at baseline and after 10 days. The Kruskal-Wallis and Dunn tests (between groups), and Wilcoxon test (between times) were used to compare the results. (α = 0.05). RESULTS: After the hygiene protocols, and when compared with baseline, the overall patient satisfaction, maxillary denture satisfaction, maxillary denture comfort, and maxillary denture retention were ameliorated. A significant improvement was noted in OHRQoL in 3 of 4 domains evaluated (orofacial pain and discomfort, masticatory discomfort and disability, and psychological disability and discomfort). The salivary flow rate (unstimulated and stimulated) and salivary pH were not significantly affected at the times evaluated. CONCLUSIONS: Complete denture wearers may feel more satisfied with their complete dentures when treated for denture stomatitis. The tested treatments lead to similar improvement in terms of patient satisfaction and OHRQoL.

Experimental animal models for denture stomatitis: A methodological review.

Denture stomatitis is the most prevalent form of oral candidiasis and the most frequent oral lesion in removable prosthesis wearers. It is characterized by an inflammatory response of the denture-bearing mucosa, especially the palatal mucosa, and its clinical signs include chronic edema and erythema, and papillary hyperplasia. Despite having a multifactorial etiology, its main etiological agent is the infection by Candida albicans. Given its high treatment failure rates, an in vivo model of denture stomatitis should be established to test alternative treatments. The aim of this study is to review the existing denture stomatitis models and to provide an overview of the main methodological differences between them. Over the last 40 years, different animal models were developed in order to study denture stomatitis etiopathogenesis and to assess novel therapies. Many approaches, including the use of antibiotics and immunosuppressors, have to be further investigated in order to establish which protocol is more appropriate and effective for the development of an animal model of denture stomatitis.

Effectiveness of denture microwave disinfection for treatment of denture stomatitis: A systematic review and meta-analysis.

OBJECTIVE: The aim of this systematic review was to evaluate the effectiveness of removable complete denture disinfection using microwaves for the treatment of denture stomatitis. METHODS: This review identified studies comparing the efficacy of microwave prosthesis disinfection (I) to topical antifungal therapy (C) in the treatment of denture stomatitis (O), which included only individuals who used complete dentures and presented with denture stomatitis (P). The search was performed in six databases and identified 1524 records; after the removal of duplicates, 816 articles remained. Three articles were selected for qualitative synthesis and two for meta-analysis. Random-effects meta-analysis estimated the polled effects of microwave disinfection and antifungal therapy on the Candida counts and clinical manifestation of denture stomatitis. The GRADE approach was used to estimate the certainty of evidence. RESULTS: All included studies reported significant reductions in Candida counts and the frequency of denture stomatitis of groups subjected to microwave disinfection of dentures and topical antifungal therapy with nystatin. Significative differences between treatments were only detected for Candida quantification in the palate, within 90 days follow-up period (SMD = 0.47, 95% CI = 0.02-0.91). Meta-analyses did not show any further differences between treatments (p > .05), considering the Candida quantification in dentures and the frequency of clinical signs of denture stomatitis. The certainty of the evidence was considered as low, according to GRADE approach. CONCLUSION: Microwave disinfection of complete dentures can be considered as efficient as antifungal therapy for the treatment of denture stomatitis. However, further well-designed studies are necessary to confirm such evidence.

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)

The effects of three disinfection protocols on Candida spp., denture stomatitis, and biofilm: A parallel group randomized controlled trial.

STATEMENT OF PROBLEM: Antifungals are used to treat Candida infections. However, because of increased antifungal resistance and the length of antifungal therapy, Candida spp. infections can be prevented using the prosthesis hygiene method. Therefore, establishing efficient, safe, and low-cost hygiene protocols for complete denture wearers is necessary. PURPOSE: The purpose of this clinical trial was to compare 10% Ricinus communis (RC10%) and 0.5% chloramine-T (CT0.5%) with negative (water) and positive (0.25% sodium hypochlorite [SH0.25%]) controls to establish a protocol to treat denture stomatitis (DS), remove denture biofilm, reduce overall microbiota, and decrease Candida spp. on the palate and denture bases. MATERIAL AND METHODS: This randomized, double blind, controlled clinical trial allocated 60 DS-positive participants in parallel groups: RC10%, CT0.5%, negative control, and SH0.25%. All participants brushed their palate and dentures and applied 1 of the solutions only to the denture. The following outcomes were assessed at baseline and after 7 and 37 days: Candida spp. counts, frequency of species by presumptive identification, DS severity, and photographic quantification of biofilm. The Kruskal-Wallis and Friedman tests with stepwise step-down post hoc test compared the anticandidal effect and the DS score (between groups and time). ANOVA and the Tukey post hoc test were used for biofilm removal comparison (α=.05). RESULTS: Microbial counts were solution- and time-dependent for dentures, with C. albicans, C. tropicalis, and C. glabrata being the most prevalent species. RC10% presented similar results to baseline and control after 7 and 37 days. CT0.5% reduced the CFU/mL compared with the baseline. SH0.25% was the most effective. DS reduced in all groups, independent of the solution. SH0.25% reduced biofilm the most, followed by RC10%. CT0.5% was similar to the control. CONCLUSIONS: SH0.25% demonstrated potential for Candida spp. control in denture wearers with DS. The other protocols showed intermediate activity and might be more suitable for longer immersion periods.

Hygiene protocols for the treatment of denture-related stomatitis: local and systemic parameters analysis - a randomized, double-blind trial protocol.

BACKGROUND: Denture-related stomatitis (DS) is chronic multifactorial inflammation, strongly related to the presence of the biofilm that is the complex structure formed by microorganisms held together by a mucus-like matrix of carbohydrate that adheres to different surfaces, including the denture surface. DS has recently been correlated with deleterious cardiovascular alterations. The potential effect of hygiene protocols in the control of DS and randomized clinical trials that address this oral condition with cardiovascular complications are important in clinical decision-making. MATERIAL/DESIGN: A clinical trial, randomized, double-blind, and with parallel groups, will be conducted in Brazil The sample will consist of 100 patients without teeth in both arches, users of at least maxillary complete dentures, and diagnosed with DS, who will be allocated to groups (n = 25 per group) according to the different hygiene protocols: (1) brushing of the palate and immersion of the prosthesis in 0.25% sodium hypochlorite solution (positive control); (2) brushing of the palate and immersion of the prosthesis in 0.15% triclosan solution; (3) brushing of the palate and immersion of the prosthesis in lactose monohydrate; or (4) brushing the palate with citric acid and immersing the prosthesis in lactose monohydrate. The response variables will be heart rate variability and alteration of blood pressure (systemic level), remission of DS, removal of biofilm, reduction of microbial load (colony-forming units (CFU)), mouth and prosthesis odor level, expression of MUC1, proinflammatory cytokines, C-reactive protein (CRP), viscosity, pH and salivary flow (locally); patient-centred qualitative analysis will also be undertaken. Measurements will be performed at baseline and 10 days after the interventions. The results obtained will be statistically analyzed as pertinent, with a level of significance of 0.05. DISCUSSION: This study will provide a guideline for clinical practice regarding the use of hygiene protocols in the treatment of oral diseases (DS) mediated by biofilm. Also, it may provide evidence of correlation of oral manifestation with cardiac risk. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials, RBR-4hhwjb. Registered on 9 November 2018.

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)

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.

Efectividad del Oleozón® tópico en la estomatitis subprótesis / 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)

Uso del oleozón® en la estomatitis subprótesis / Use of oleozón® in denture stomatitis

Introducción: existe un alto porcentaje de pacientes aquejados de estomatitis subprótesis, lo que constituye un serio problema de salud, por esto se hace necesario buscar opciones para su tratamiento. Objetivo: determinar la eficacia del oleozón en el tratamiento de la estomatitis subprótesis grado I y II. Diseño metodológico: se realizó un estudio cuasi-experimental del tipo antes y después sin grupo control a 55 pacientes portadores de prótesis dental que acudieron al servicio de estomatología del Policlínico Bayamo-Oeste, Granma, de abril a junio 2017, con diagnóstico de estomatitis subprótesis grado I o II. La información primaria se obtuvo mediante: historias clínicas individuales, observación y exploración clínica. Se confeccionó una planilla de recolección de datos, los resultados se presentaron en tablas estadísticas y se empleó como medida resumen el porcentaje. Resultados: el 63.6 por ciento de los pacientes estuvo afectado por estomatitis subprótesis grado II, el grupo de edad de 60-69 años fue el más afectado con un 50.9 por ciento. El sexo femenino representó un 76.4 por ciento. El 54.5 por ciento de los pacientes curados resolvieron con 5-10 aplicaciones. El 40.0 por ciento de pacientes curó en el tiempo de 11-14 días. Solo 2 pacientes refirieron sentir ardor y calor en una ocasión. Conclusiones: la estomatitis subprótesis afecta más al sexo femenino y al grupo de edad de 60-69 años, fue más frecuente la de grado II. La mayoría de los pacientes resolvieron con 5 a 10 aplicaciones en un periodo de 11 a 14 días. La ozonoterapia produce muy pocos efectos adversos(AU)

Introduction: there is a high percentage of patients suffering from denture stomatitis, which is a serious health problem, so it is necessary to seek options for their treatment. Objective: to determine the effectiveness of oleozón in the treatment of grade I and II denture stomatitis. Methodological design: a quasi-experimental study of the before and after type without control group was performed on 55 patients with dental prostheses who attended the stomatology service of Bayamo-Oeste Polyclinic, Granma, from April to June 2017, with a diagnosis of grade I or II denture stomatitis. The primary information was obtained through: individual clinical histories, observation and clinical exploration. A data collection form was prepared, the results were presented in statistical tables and the percentage was used as a summary measure.Results: the 63.6 percent of patients were affected by grade II denturestomatitis, the age group of 60-69 years was the most affected with 50.9 percent. The female sex represented 76.4 percent. The 54.5 of the cured patients resolved with 5-10 applications; 40.0 percent of patients cured in the time of 11-14 days. Only 2 patients reported burning and heat on one occasion(EU)

Management of denture stomatitis: a narrative review.

Candida albicans is a typical commensal microorganism of the oral cavity that can become virulent in certain conditions and cause denture stomatitis (DS). Many conditions can predispose for DS, including local and systemic alterations. The therapeutical approach to DS is various and both topical and systemic alternatives can be considered. Azoles molecules are the most common used, both topically and systemically, but in recent years various alternatives have been proposed. This review aims to examine the scientific literature to evaluate the effectiveness of conventional therapies and the potential of the new ones.

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)

Eficácia do diacetato de clorexidina incorporado a um reembasador macio no tratamento da estomatite protética: um ensaio clínico randomizado / Efficacy of chlorhexidine diacetate incorporated into a soft liner rebase in the treatment of denture stomatitis: a randomized clinical trial

O objetivo deste estudo piloto foi comparar a eficácia de um reembasador acrílico macio com ou sem diacetato de clorexidina a 1% no tratamento de pacientes com estomatite protética. As hipóteses testadas foram: (I) o eritema seria melhorado (IIa): a contagem de unidades formadoras de colônias seria reduzida, (IIb): a predominância de um tipo morfológico de Candida seria correlacionada com características clínicas e, (IIc) se uma concentração inibitória mínima do antimicrobiano, poderia ser capaz de atuar sobre o crescimento do fungo. Dezesseis pacientes desdentados totais, portadores de prótese e com estomatite protética foram distribuídos aleatoriamente para os grupos controle (reembasamento com Trusoft) e grupo teste (reembasamento com Trusoft contendo 1% de clorexidina) sendo acompanhados por exames clínicos e laboratoriais por 14 dias. Os parâmetros analisados nas duas consultas de acompanhamento foram: avaliação clínica (exame e fotos) e avaliações microbiológicas (esfregaços e culturas de palato e prótese total). Este estudo foi um ensaio clínico randomizado, duplo-cego,controlado.Os resultados obtidos demonstraram que a superfície do eritema foi significativamente reduzida, mas não diferiu significativamente entre os dois grupos (P> 0,05), assim como a redução da contagem de Candida durante o tratamento entre os grupos (P> 0,05). O tipo de Candida não pôde ser correlacionado ao estágio clínico alcançado. Os resultados dos testes de concentração inibitória mínima, revelaram que uma concentração de 0,05 µg/ml de clorexidina já é capaz de inibir o crescimento de 85% das cepas de testadas.A hipótese principal foi confirmada, o que pode ser interpretado como uma remissão clínica acelerada em ambas as terapias propostas. Embora as hipóteses secundárias não tenham sido confirmadas, a persistência de Candida pode ser apenas a colonização, e a plasticidade morfológica de Candida parece ser fortemente influenciada pela virulência fúngica. Sendo assim, os resultados da análise de concentração inibitória mínima sugerem que uma concentração subinibitória de clorexidina possa estar atuando na virulência da Candida spp. No entanto, não foram encontrados resultados para confirmar a eficácia clínica do diacetato de clorexidina a 1% incorporado ao reembasador macio testado no tratamento da estomatite protética.

The aim of this pilot study was to compare the efficacy of rebase using soft acrylic liner with or without 1% chlorhexidine diacetate in denture stomatitis patients. It was hypothesised that: (I) erythema would be improved (IIa): colony forming unit count would be reduced, (IIb): the predominance of a morphological type of Candida would be correlated with clinical features and, (IIc) a minimum inhibitory concentration of the antimicrobial, could be able to act on the growth of the fungus.Sixteen patients who wearing removable dentures and diagnosed with denture stomatitis were randomly assigned to the control groups (rebase with resilient liner) and test group (rebase with resilient liner containing 1% of chlorhexidine), followed by clinical and laboratory tests for 14 days. The analyzed parameters at two follow-up were: clinical evaluation (examination and photos) and microbiological evaluations (smears and cultures of palates and dentures). This study was a randomized, double-blind, controlled clinical trial. The results obtained showed that the erythema surface was significantly reduced, but did not differ significantly between the two groups (P> 0.05), as did the reduction of colony forming unit during treatment between the groups (P> 0.05) . The Candida type could not be correlated to the achieved clinical stage. The minimum inhibitory concentration test results showed that a concentration of 0,05 µg/ml chlorhexidine is already able to inhibit the growth of 85% of the tested strains. The primary hypothesis was confirmed, which can be interpreted as an accelerated clinical remission in both proposed therapies. Although secondary hypotheses have not been confirmed, Candida's persistence may be just colonization, and the morphological plasticity of Candida seems to be strongly influenced by fungal virulence. Thus, the results of the minimum inhibitory concentration analysis suggest that a subinhibitory concentration of chlorhexidine may be acting on the virulence of Candida spp. However, no results were found to confirm the clinical efficacy of 1% chlorhexidine diacetate incorporated into the soft liner in denture stomatitis.

Efectividad del Oleozón® tópico en la estomatitis subprótesis / Effectiveness of topical Oleozón® in the stomatitis sub-prosthetic

Se realizó un estudio de evaluación de una intervención terapéutica para 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, 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. El tratamiento con Oleozón® tópico fue efectivo al lograr erradicar o disminuir en grado la estomatitis subprótesis por tanto es factible su aplicación(AU)

Came true a study of evaluation of a therapeutic intervention to determine the effectiveness of the commonplace Oleozón® in the treatment of Stomatitis sub-prosthesises in patients of the Policlínico Hermanos Martinez Tamayo of the municipality Baracoa, Guantánamo in the period understood from Junio 2015-2016. The universe of study was constituted for 80 patients with clinical diagnosis of Estomatitis sub-prosthesises. You got the sign from intentional form, getting constituted by 40 patients. Case utilized a design itself control: I study to the group To the commonplace his Oleozón® applied itself and to the group control the B applied allopathic medicine consisting of hanging nistatina itself. The treatment with commonplace Oleozón® the cash was going to manage to eradicate or to decrease in grade the Stomatitis, therefore his application in the stomatitis sub-prosthetic is feasible(AU)

Efectividad del Oleozón® tópico en la estomatitis subprótesis / Effectiveness of topical Oleozón® in the stomatitis sub-prosthetic

Se realizó un estudio de evaluación de una intervención terapéutica para 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, 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. El tratamiento con Oleozón® tópico fue efectivo al lograr erradicar o disminuir en grado la estomatitis subprótesis por tanto es factible su aplicación(AU)

Came true a study of evaluation of a therapeutic intervention to determine the effectiveness of the commonplace Oleozón® in the treatment of Stomatitis sub-prosthesises in patients of the Policlínico Hermanos Martinez Tamayo of the municipality Baracoa, Guantánamo in the period understood from Junio 2015-2016. The universe of study was constituted for 80 patients with clinical diagnosis of Estomatitis subprosthesises. You got the sign from intentional form, getting constituted by 40 patients. Case utilized a design itself control: I study to the group to the commonplace his Oleozón® applied itself and to the group control the B applied allopathic medicine consisting of hanging nistatina itself. The treatment with commonplace Oleozón® the cash was going to manage to eradicate or to decrease in grade the Stomatitis, therefore his application in the stomatitis sub-prosthetic is feasible(AU)

Denture Stomatitis: Causes, Cures and Prevention.

Removable dentures are worn by 20% of the UK population and two thirds of these individuals have denture stomatitis. Poor oral hygiene is commonplace among this group, as is smoking and xerostomia, which also contribute to the development of denture stomatitis. A complex polymicrobial biofilm is able to proliferate on the surface of denture materials and matures to form visible denture plaque. This denture plaque biofilm stimulates a local inflammatory process that is detectable clinically as erythema, and hyperplasia. Systemically, denture plaque represents a potential risk factor for systemic disease, in particular aspiration pneumonia. Respiratory pathogens have been detected in the denture plaque and overnight denture wear has been linked to an increased risk of aspiration pneumonia. There is a general lack of evidence on the adequate management of denture stomatitis and we present a protocol for use in the primary care setting.

Efectividad del tratamiento con oleozón versus crema de aloe en la estomatitis subprotésica / Effectiveness of the treatment with oleozón versus aloe cream in the subprosthesis stomatitis

Fundamento: la estomatitis subprótesis es una enfermedad inflamatoria que afecta la mucosa oral que se encuentra en contacto con las prótesis dentales.Objetivo: establecer la efectividad terapéutica del oleozón y la crema de aloe al 25 porciento en el tratamiento de la estomatitis subprótesis.Métodos: se realizó un estudio experimental de evaluación de alternativas terapéuticas, en un universo de 96 pacientes con diagnóstico de estomatitis subprótesis tipo I y II en la Clínica Estomatológica Municipal Manuel Sánchez, Manzanillo, Granma, en el primer semestre del año 2016.Resultados: la estomatitis subprótesis tipo II fue identificada en los pacientes de ambos grupos de tratamiento. Solo se registró un paciente con una reacción adversa leve, consistente con ardor a la aplicación del oleozón. A los 10 días de seguimiento el oleozón resultó en un 100 porciento de efectividad terapéutica en los tipos IA y IB de estomatitis subprótesis mientras que en el tipo II fue un poco más baja. En este mismo periodo de tiempo la efectividad de la crema de aloe al 25 porciento fue efectiva en los tipos IA y IB mientras que en el tipo II esta efectividad fue de apenas de un porcentaje más bajo.Conclusiones: la estomatitis subprótesis es más prevalente en el sexo femenino donde el oleozón es una alternativa terapéutica efectiva y con resultados terapéuticos muy superiores, al mismo tiempo, el uso de crema de aloe al 25 porciento(AU)

Background: the denture stomatitis is an inflammatory pathology that affects the mucous oral that is contact with the dental prosthesis.Objective: to establish the therapeutic effectiveness of the oleozón and the aloe cream to 25 percent in the treatment of the denture stomatitis.Methods: a experimental study of evaluation of therapeutic alternatives in an universe of 96 patients with diagnostic of denture stomatitis type I and II in the Manuel Sánchez Municipal Stomatolgical Clinic, Manzanillo, Granma, in the first semester of the year 2016.Results: the denture stomatitis type II were identified in 39,58 percent of the patients in both treatment groups. Alone a patient registered with a consistent light adverse reaction with ardor to the application of the oleozón. To the 10 days of pursuit the oleozón was in 100 percent of effectiveness therapeutic in the types IA and IB of denture stomatitis while in the type II this it was of 84,21 percent. In this same period of time the effectiveness of the aloe cream to 25 percent was 94,12 percent and 91,67 percent in the types IA and IB respectively while in the type II this effectiveness was of hardly 68,42 percent.Conclusions: the denture stomatitis continues being more prevalent in the female sex being the oleozón a highly effective therapeutic alternative and with very superior therapeutic results, in the time, to the use of aloe cream to 25 percent(AU)

Ozonoterapia en la estomatitis subprótesis, 2016 / Ozonetherapy in subprosthesis stomatitis, 2016

Se realizó un estudio experimental, ensayo clínico fase III, abierto, secuencial y controlado; a 202 pacientes portadores de prótesis dental que acudieron al servicio de estomatología del Policlínico Bayamo Oeste, Granma, abril 2015 - diciembre 2016, con estomatitis subprótesis grado I o II, con el objetivo de determinar la eficacia de la ozonoterapia en la estomatitis subprótesis. La información primaria se obtuvo mediante historias clínicas individuales, observación y exploración clínica. Se confeccionó una planilla de recolección de datos, los resultados se presentaron en tablas estadísticas, se empleó como medida resumen el porcentaje. Se obtuvo como resultado: 67.33 por ciento de los pacientes estuvo afectado por estomatitis subprótesis grado II, 60-69 años fue el grupo etario más afectado (41.09 por ciento). El sexo femenino representó un 79.21 por ciento. El 63.86 por ciento de los pacientes resolvieron con menos de 10 aplicaciones. El 57.43 por ciento curó en el tiempo de 2-7 días. Solo 2 pacientes refirieron sentir ardor y calor en una ocasión. La estomatitis subprótesis afecta más al sexo femenino y al grupo etario 60-69 años, fue más frecuente la de grado II. La mayoría de los pacientes resolvieron con 5 a 10 aplicaciones en un periodo de 11 a 14 días. La ozonoterapia produce muy pocos efectos adversos(AU)

An experimental study was conducted: phase III clinical trial, open, sequential and controlled; to 202 patients with dental prosthesis who came to the odontology service at Bayamo Oeste Polyclinic, Granma, April 2015 - December 2016, with grade I or II substomatitis, with the objective of determining the efficacy of ozone therapy in subprosthesis stomatitis. Primary information was obtained through individual clinical records, observation and clinical examination. A data collection form was prepared, the results were presented in tables, and the percentage was used as a summary measure. The result was: 67.33 percent of the patients were affected by stomatitis grade II subprosthesis, 60-69 years was the most affected age group (41.09 percent). The female sex represented 79.21 percent; 63.86 percent of the patients resolved with less than 10 applications. The 57.43 percent cured in the time of 2-7 days. Only 2 patients reported having heat and burning on one occasion. The subprosthesis stomatitis affects more female sex and the age group 60-69 years, was more frequent the degree II. The majority of patients resolved with 5 to 10 applications in a period of 11 to 14 days. Ozone therapy produces very few adverse effects(EU)

Interventions for the Management of Denture Stomatitis: A Systematic Review and Meta-Analysis.

OBJECTIVES: To assess the effectiveness of different interventions for treating or preventing denture stomatitis (DS). DESIGN: Systematic review. SETTING: Randomized controlled trials (RCTs) comparing any agent or procedure prescribed to treat or prevent DS in adults. PARTICIPANTS: Older adults with denture stomatitis. MEASUREMENTS: There were two main outcomes reported in the trials included in this review: clinical signs of DS and remaining presence of yeast. There were no restrictions regarding language or date of publication. The search period was up to February 2016. RESULTS: Thirty-five studies were included in the systematic review, with 32 judged as having high risk of bias. Three RCTs compared nystatin with placebo and found a significant effect on the reduction of clinical signs of stomatitis (risk ratio (RR) = 0.51, 95% confidence interval (CI) = 0.36-0.72), four RCTs compared nystatin with placebo and found a significant effect on mycological assessment (RR = 0.61, 95% CI = 0.46-0.80). Five studies of disinfectant agents also showed a significant effect in comparison with an inactive agent (RR = 0.52, 95% CI = 0.30-0.92) in clinical assessment. No evidence was found of an effect of miconazole, amphotericin, or imidazolic drugs. No RCT evaluated the effectiveness of preventive approaches. CONCLUSION: The results are supportive of the use of nystatin and disinfecting agents in the treatment of DS, but clinicians need to be aware that individual studies had high risk of bias and that the overall quality of the individual reports was judged to be low.