RESUMO
AIM: This study investigated the effectiveness of a drug-modified tissue conditioner in an animal model of denture stomatitis. METHODS AND RESULTS: Wistar rats wore a Candida albicans-contaminated palatal device for 4 days. Next, nystatin (Nys) or chlorhexidine (Chx) were added to a tissue conditioner in their raw or ß-cyclodextrin-complexed (ßCD) forms at their minimum inhibitory concentrations. As controls, one group was not subjected to any procedure (NC), one group used sterile devices, one group had denture stomatitis but was not treated (DS), and another had the devices relined with the tissue conditioner without the addition of any drug (Soft). After 4 days of treatment, treatment effectiveness was assessed visually, histologically, and through CFU count, and myeloperoxidase (MPO) and N-acetylglucosaminidase (NAG) assays. Rats from the Soft, Nys, Nys:ßCD, and Chx groups presented a significant decrease in the microbial load compared with the untreated group. Treatment groups showed lower MPO and NAG activity compared to the non-treated group. CONCLUSIONS: The addition of antifungals to a soft tissue conditioner can be a promising approach for denture stomatitis treatment.
Assuntos
Antifúngicos , Candida albicans , Clorexidina , Nistatina , Ratos Wistar , Estomatite sob Prótese , Animais , Estomatite sob Prótese/microbiologia , Estomatite sob Prótese/tratamento farmacológico , Ratos , Antifúngicos/uso terapêutico , Antifúngicos/farmacologia , Nistatina/farmacologia , Nistatina/uso terapêutico , Clorexidina/farmacologia , Candida albicans/efeitos dos fármacos , Modelos Animais de Doenças , Masculino , Contagem de Colônia Microbiana , Testes de Sensibilidade Microbiana , Candidíase Bucal/tratamento farmacológico , Candidíase Bucal/microbiologia , Peroxidase/metabolismo , Acetilglucosaminidase/metabolismo , beta-CiclodextrinasRESUMO
The association of silver nanoparticles (AgNps) to sealant agent Palaseal® can be a promising alternative for complete denture wearers who may develop denture stomatitis (DS). The study aimed to evaluate the anti-Candida and biocompatible potential of silver nanoparticles synthesized by three routes associated with denture glaze to prevent and/or treat oral candidiasis. Surface acrylic resin specimens were treated with different associations of glaze with AgNps (VER+AgUV, VER+AgTurk and VER+AgGm). As controls, specimens were treated with glaze+nystatin (VER+Nyst), glaze only (VER) or submerged in PBS (PBS). Afterwards, Candida albicans biofilm was developed for 24 h, 15 d and 30 d. Subsequently, the biofilm was quantified by CFU/mL, XTT assay and confocal laser scanning microscopy. Fibroblasts were submitted to conditioned medium with the same associations for 24, 48 and 72 h and LIVE/DEAD® viability test was carried out. Regardless of the period, there was a significant reduction (p < 0.01) of viable fungal cells load, as well as inhibition of fungal metabolic activity, in specimens treated with glaze+AgNps associations, compared to VER and PBS. The anti-Candida effects of the associations were similar to the VER+Nyst group, with emphasis on VER+AgGm, which showed the highest percentage values of non-viable fungal cells maintained over time. The associations did not prove toxicity to fibroblasts. The AgNps exerted antimicrobial activity against C. albicans biofilms and are biocompatible. The most effective results were achieved with the association of glaze+silver nanoparticles synthesized by the green chemistry method (AgGm), proving to be an innovative alternative in the management of DS.
Assuntos
Antifúngicos , Biofilmes , Candida albicans , Nanopartículas Metálicas , Prata , Estomatite sob Prótese , Prata/farmacologia , Prata/química , Nanopartículas Metálicas/química , Biofilmes/efeitos dos fármacos , Candida albicans/efeitos dos fármacos , Estomatite sob Prótese/microbiologia , Estomatite sob Prótese/tratamento farmacológico , Antifúngicos/farmacologia , Antifúngicos/química , Humanos , Dentaduras/microbiologia , Fibroblastos/efeitos dos fármacos , Candidíase Bucal/tratamento farmacológico , Candidíase Bucal/microbiologia , Testes de Sensibilidade MicrobianaRESUMO
OBJECTIVE: To assess the association between risk factors for developing denture stomatitis (DS) and oral health-related quality of life (OHRQoL) in complete denture wearers. METHODOLOGY: Participants of both sexes, wearing complete dentures, were classified using the modified Newton classification for the absence or the severity of DS and allocated to groups Normal or zero, IA, IB, II, and III. Lifestyle, oral and denture history, and medication use were assessed using specific questionnaires; clinical parameters such as anatomical characteristics of support were evaluated with the Kapur classification; salivary flow (SF) was calculated by the volume of unstimulated saliva per minute; and microbial load was determined by counting colony forming units (CFU) of target microorganisms present in the biofilm collected from dentures and palate. OHIP-EDENT assessed the OHRQoL. Kendall's tau_b and Spearman tests were applied with a significance level of 5%. RESULTS: 184 patients (143 female and 41 male) aged 65.5 ± 6.8 years were evaluated. Positive correlations were found for sex (women; p=0.013, r=0.16), individuals who started to consume alcoholic beverages as a young adult (18-27 years) (p=0.008, r=0.22), CFU of Candida spp. (p<0.001, r=0.27 denture; p<0.001, r=0.31 palate); Candida albicans (p=0.004, r=0.22 denture; p=0.003, r=0.25 palate), and Candida glabrata (p=0.004, r=0.22 denture; p=0.001, r=0.27 palate). Moreover, negative correlations with DS were found for CFU of Staphylococcus spp. (p=0.004, r=-0.20 palate) and enterobacteria (p=0.002, r=-0.24 palate), as well as a negative correlation between SF (p=0.009, r=-0.193) and DS. The CFU of Staphylococcus spp. and enterobacteria on the palate significantly correlated with OHRQoL. CONCLUSION: Being female, consuming alcoholic beverages as a young adult, CFU of Candida spp., Candida albicans, Candida glabrata, and salivary flow may be the most significant risk factors for DS. The microbial load of Staphylococcus spp. and enterobacteria seems to influence the quality of life for complete denture wearers.
Assuntos
Estomatite sob Prótese , Humanos , Masculino , Feminino , Estomatite sob Prótese/microbiologia , Estudos Transversais , Qualidade de Vida , Candida , Candida albicans , Prótese Total/efeitos adversos , Fatores de RiscoRESUMO
OBJECTIVE: The identification of Candida spp. in denture stomatitis, the clinical manifestations, and the antifungal susceptibility profile lead to a correct and individualized therapeutic management of the patients. This study is aimed at investigating the clinical manifestations and epidemiological and microbiological characteristics of Candida-associated denture stomatitis. DESIGN: The samples were obtained by swabbing the oral mucosa of the subjects and then seeded onto Sabouraud Dextrose Agar and onto CHROMagar® Candida plates. The identification at the species level was confirmed by Matrix Assisted Laser Desorption Time of Flight Mass Spectrometry. Clinical classification was performed according to the criteria proposed by Newton (1962): (i) pinpoint hyperemia, (ii) diffuse hyperemia, and (iii) granular hyperemia. For carrying out the antifungal susceptibility testing, we adopted the CLSI M27-S4 protocol. RESULTS: C. albicans was the most prevalent species in our study. Regarding non-albicans Candida species, C. glabrata was the most common species isolated from the oral mucosa (n = 4, 14.8%), while in the prosthesis, it was C. tropicalis (n = 4, 14.8%). The most prevalent clinical manifestation was pinpoint hyperemia and diffuse hyperemia. Candida albicans, C. glabrata, and C. parapsilosis were susceptible to all the tested antifungals. Concerning fluconazole and micafungin, only two strains showed dose-dependent sensitivity (minimum inhibitory concentration (MIC), 1 µg/mL) and intermediate sensitivity (MIC, 0.25 µg/mL). One C. tropicalis strain was resistant to voriconazole (MIC, 8 µg/mL). CONCLUSIONS: C. albicans was the most common species found in oral mucosa and prosthesis. The tested antifungal drugs showed great activity against most isolates. The most prevalent clinical manifestations were Newton's type I and type II.
Assuntos
Hiperemia , Estomatite sob Prótese , Humanos , Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Candida , Estomatite sob Prótese/epidemiologia , Estomatite sob Prótese/microbiologia , Hiperemia/tratamento farmacológico , Fluconazol/farmacologia , Candida albicans , Candida glabrata , Candida parapsilosis , Testes de Sensibilidade Microbiana , Farmacorresistência FúngicaRESUMO
BACKGROUND: Nystatin (Nys) is a fungicidal drug commonly prescribed for candidiasis disease in several administration routes. However, Nys is a class IV drug, according to the Biopharmaceutical Classification System, that possesses limited bioavailability and is used for local activity. OBJECTIVE: This study developed and characterized nystatin:ß-cyclodextrin (Nys:ßCD) inclusion complexes and evaluated their activity against Candida spp. METHODS: Complexes were characterized by physicochemical techniques and drug dissolution profiles. The susceptibility of C. albicans, C. krusei, C. parapsilosis, C. glabrata, C. guilliermondii, C. tropicalis, and C. auris was assessed using the broth microdilution method. The applicability of Nys:ßCD inclusion complex was evaluated by incorporating it into a temporary soft material for denture stomatitis treatment. RESULTS: Nys was better complexed in a 1:1 molar ratio by freeze-drying and spray-drying methods. The inclusion complexes show bi-exponential release, an initial burst release followed by a sustained manner, presenting higher dissolution efficiency than raw Nys. The 1:1 freeze-drying Nys:ßCD complex presents antifungal activity against all evaluated Candida strains, showing the maintenance of the drug effectiveness. The inclusion complex incorporated into a tissue conditioner material for denture stomatitis treatment effectively inhibited more than 90% of C. albicans biofilm growth during 7 and 14 days, in a half dose compared to raw Nys. CONCLUSION: This work represents a significant contribution to treating a wide variety of diseases caused by the Candida species, optimizing the drug bioavailability and compliance to the treatment due to improved drug solubility, dissolution, and sustained delivery.
Assuntos
Antifúngicos , Estomatite sob Prótese , Antifúngicos/farmacologia , Nistatina/farmacologia , Candida , Estomatite sob Prótese/tratamento farmacológico , Estomatite sob Prótese/microbiologia , Testes de Sensibilidade Microbiana , Candida albicans , Candida parapsilosisRESUMO
OBJECTIVES: This randomized clinical trial evaluated the effectiveness of an interim denture resilient liner (Trusoft) modified with minimum inhibitory concentrations (MICs) of antimicrobial agents for Candida albicans biofilm in the denture stomatitis (DS) treatment. METHODS: Forty participants with DS and maxillary complete denture (MCD) wearers were randomly assigned to one of the treatments for 14 days (n=10): nystatin oral suspension (Control-100,000IU/mL; 4 × /day), MCD relined with Trusoft either without (Tru) or with nystatin (Ny) or chlorhexidine diacetate (Chx) at MICs. Cytological smears and mycological quantitative cultures were taken from the palate and denture before treatment (baseline), at the end of treatment (day 14), and at follow-up (days 30, 45, and 60). Photographs of the palate were made at each visit. Data were analyzed by the Cochran and χ2 tests, ANOVA and the Tukey test or the Friedman and Kruskal-Wallis tests (α=0.05). RESULTS: Palatal smears of the Ny and Chx groups exhibited no mycelial Candida (0%) on day 14, and, at the 60-day follow-up, it was observed for only 1 participant from Chx group. MCD smears showed reduction in mycelial forms for all groups on day 14 (P<0.05), but this difference was maintained at follow-up only for the relined dentures (P<0.05). Unlike Tru and the control groups, Ny and Chx groups evidenced a significant reduction in CFU/mL values and DS severity throughout the trial (P<0.05). CONCLUSIONS: The addition of nystatin and chlorhexidine at MICs to an interim resilient liner is a promising treatment for DS, with better results than those for conventional therapy with nystatin suspension, including the follow-ups. CLINICAL SIGNIFICANCE: Compared with conventional topical antifungal therapy, modifying a denture reline material with antimicrobials provided a therapeutic option for denture stomatitis. This non-invasive, straightforward therapeutic approach can be easily adopted by dentists and has the advantage of not requiring patient compliance while maintaining therapeutic concentrations on the denture base.
Assuntos
Nistatina , Estomatite sob Prótese , Humanos , Nistatina/uso terapêutico , Nistatina/farmacologia , Antifúngicos , Estomatite sob Prótese/tratamento farmacológico , Estomatite sob Prótese/microbiologia , Clorexidina/uso terapêutico , Candida albicansRESUMO
Candida albicans is the main causative pathogen of denture stomatitis, which affects many complete denture patients. OBJECTIVE: To evaluate the effect of different concentrations of nanodiamonds (NDs) added to polymethyl methacrylate (PMMA) denture base material on Candida albicans adhesion as well as on surface roughness and contact angle. METHODOLOGY: Acrylic resin specimens sized 10×10×3 mm3 were prepared and divided into four groups (n=30) according to ND concentration (0%, 0.5%, 1%, 1.5% by wt). Surface roughness was measured with a profilometer, and the contact angle with a goniometer. The effect of NDs on Candida albicans adhesion was evaluated using two methods: 1) slide count and 2) direct culture test. Analysis of variance (ANOVA) and Tukey's post hoc test were used in the statistical analyses. RESULTS: Addition of NDs decreased the Candida albicans count significantly more than in the control group (p<0.05), with a lowest of 1% NDs. Addition of NDs also significantly decreased the surface roughness (p<0.05), but the contact angle remained the same. Incorporation of NDs into the PMMA denture base material effectively reduced Candida albicans adhesion and decreased surface roughness. CONCLUSION: PMMA/NDs composites could be valuable in the prevention of denture stomatitis, which is considered one of the most common clinical problems among removable denture wearers.
Assuntos
Resinas Acrílicas/química , Candida albicans/efeitos dos fármacos , Bases de Dentadura/microbiologia , Nanodiamantes/química , Nanodiamantes/microbiologia , Polimetil Metacrilato/química , Análise de Variância , Humanos , Teste de Materiais , Microscopia Eletrônica de Varredura , Valores de Referência , Reprodutibilidade dos Testes , Estomatite sob Prótese/microbiologia , Estomatite sob Prótese/prevenção & controle , Propriedades de SuperfícieRESUMO
Abstract Candida albicans is the main causative pathogen of denture stomatitis, which affects many complete denture patients. Objective: To evaluate the effect of different concentrations of nanodiamonds (NDs) added to polymethyl methacrylate (PMMA) denture base material on Candida albicans adhesion as well as on surface roughness and contact angle. Methodology: Acrylic resin specimens sized 10×10×3 mm3 were prepared and divided into four groups (n=30) according to ND concentration (0%, 0.5%, 1%, 1.5% by wt). Surface roughness was measured with a profilometer, and the contact angle with a goniometer. The effect of NDs on Candida albicans adhesion was evaluated using two methods: 1) slide count and 2) direct culture test. Analysis of variance (ANOVA) and Tukey's post hoc test were used in the statistical analyses. Results: Addition of NDs decreased the Candida albicans count significantly more than in the control group (p<0.05), with a lowest of 1% NDs. Addition of NDs also significantly decreased the surface roughness (p<0.05), but the contact angle remained the same. Incorporation of NDs into the PMMA denture base material effectively reduced Candida albicans adhesion and decreased surface roughness. Conclusion: PMMA/NDs composites could be valuable in the prevention of denture stomatitis, which is considered one of the most common clinical problems among removable denture wearers.
Assuntos
Humanos , Resinas Acrílicas/química , Candida albicans/efeitos dos fármacos , Polimetil Metacrilato/química , Bases de Dentadura/microbiologia , Nanodiamantes/microbiologia , Nanodiamantes/química , Valores de Referência , Estomatite sob Prótese/microbiologia , Estomatite sob Prótese/prevenção & controle , Propriedades de Superfície , Teste de Materiais , Microscopia Eletrônica de Varredura , Reprodutibilidade dos Testes , Análise de VariânciaRESUMO
Denture stomatitis (DS) is the most common oral fungal infection in denture wearers. Photodynamic inactivation (PDI) has been showing to be an effective technique in vivo against fungi, including fungal infections in the oral cavity. The disinfection of both oral mucosa and denture may represent a real advantage in terms of fungus control. This clinical study was designed to explore methylene blue (MB)-mediated PDI on oral mucosa and prosthesis of patients with DS. Subjects with DS were divided into two groups. One group received treatment based on the use of oral miconazole gel 2% (MIC). The other group received treatment by PDI using MB at 450⯵g/mL and a diode laser (λâ¯=â¯660â¯nm) with 100â¯mW and fluence of 28â¯J/cm2. Clinical outcome was evaluated regarding the degree of oral mucosa erythema and microbiological reduction of Candida spp. located in both palatal mucosa and prosthesis. Our results showed that PDI was significantly more effective than MIC in ameliorating inflammation after 15 days. Following 30 days, no statistically significant differences were observed between groups. Regarding the fungal burden, although the MIC group has presented more pronounced inactivation than PDI for both mucosa and prosthesis, no statistically significant differences were detected between them. This clinical study suggests that PDI can reduce fungal load and decrease the inflammation degree in patients with Candida-associated denture stomatitis.
Assuntos
Candida/efeitos dos fármacos , Dentaduras/microbiologia , Mucosa Bucal/efeitos dos fármacos , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/farmacologia , Estomatite sob Prótese/tratamento farmacológico , Idoso , Antifúngicos/farmacologia , Feminino , Humanos , Lasers Semicondutores , Masculino , Miconazol/farmacologia , Pessoa de Meia-Idade , Mucosa Bucal/microbiologia , Fotoquimioterapia/efeitos adversos , Fármacos Fotossensibilizantes/efeitos adversos , Estomatite sob Prótese/microbiologiaRESUMO
ABSTRACT The aim of this study was to isolate and identify Candida species from the oral cavity of denture wearers with denture-related stomatitis who were attended at the University Federal of Pará (Belém City, Pará State, Brazil). A total of 36 denture wearers with denture-related stomatitis were included, and type I (50%), type II (33%) and type III (17%) stomatitis were observed. Candida spp. were isolated from 89% of the cases and included five different Candida species. C. albicans was the most frequently recovered species (78% of the cases), followed by C. famata and C. tropicalis. We observed a significant association between Candida species isolation and unsatisfactory denture condition (p = 0.0017). Our results demonstrated the highly frequency of Candida species isolation in denture wearers with denture-related stomatitis and showed the relationship between these species and poor denture maintenance.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Candida/isolamento & purificação , Candidíase Bucal/microbiologia , Estomatite sob Prótese/microbiologia , Brasil , Candida/classificação , Candida/genética , Dentaduras/microbiologiaRESUMO
The aim of this study was to isolate and identify Candida species from the oral cavity of denture wearers with denture-related stomatitis who were attended at the University Federal of Pará (Belém City, Pará State, Brazil). A total of 36 denture wearers with denture-related stomatitis were included, and type I (50%), type II (33%) and type III (17%) stomatitis were observed. Candida spp. were isolated from 89% of the cases and included five different Candida species. C. albicans was the most frequently recovered species (78% of the cases), followed by C. famata and C. tropicalis. We observed a significant association between Candida species isolation and unsatisfactory denture condition (p=0.0017). Our results demonstrated the highly frequency of Candida species isolation in denture wearers with denture-related stomatitis and showed the relationship between these species and poor denture maintenance.
Assuntos
Candida/isolamento & purificação , Candidíase Bucal/microbiologia , Estomatite sob Prótese/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Candida/classificação , Candida/genética , Dentaduras/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: The aim of this study was to investigate the influence of aging on the internalization and the production of nitric oxide (NO) by peritoneal adherent cells (PAC), in response to Candida albicans (C. albicans). MATERIAL AND METHODS: PAC obtained from young and aged mice were challenged with dead or viable C. albicans by using predetermined proportions (cells:yeast) for 30 and 120 minutes. Phagocytosis was analyzed by acridine orange dye, and NO production by the Griess reaction. RESULTS: C. albicans phagocytosis by PAC from aged mice was similar to that of young mice, although the cells from older mice cells present more internalized fungi compared with matched control. In addition, a tendency towards impaired NO production by peritoneal mononuclear phagocytes from aged mice was observed. CONCLUSIONS: PAC from aged mice may capture and store many fungi, which in turn may mean that these cells are effectively unable to eliminate fungi, probably due to impaired NO production. Therefore, considering the important role of C. albicans overgrowth in the pathogenesis of DS and the aspects observed in this study, aging may favor the onset and severity of local candidosis such as DS and its systemic forms.
Assuntos
Envelhecimento/fisiologia , Candida albicans/patogenicidade , Adesão Celular/fisiologia , Óxido Nítrico/biossíntese , Fagocitose/fisiologia , Estomatite sob Prótese/metabolismo , Estomatite sob Prótese/microbiologia , Fatores Etários , Animais , Candida albicans/isolamento & purificação , Candidíase/microbiologia , Masculino , Camundongos Endogâmicos C57BL , Óxido Nítrico/análise , Peritônio/citologia , Valores de Referência , Fatores de TempoRESUMO
Abstract Elderly denture wearers are commonly affected by Candida-associated denture stomatitis (DS), an inflammatory process of the oral mucosa strongly associated with Candida spp and other microorganisms, as well as local and systemic factors. The impaired immune response against pathogens is among the inherent host factors that have been also associated with the pathogenesis of DS. Mononuclear phagocytes respond to the pathogens through phagocytosis followed by the production of several substances inside the phagosomes, among them are the reactive nitrogen species (RNS). A failure in these mechanisms may contribute to the DS development. Objective The aim of this study was to investigate the influence of aging on the internalization and the production of nitric oxide (NO) by peritoneal adherent cells (PAC), in response to Candida albicans (C. albicans). Material and methods PAC obtained from young and aged mice were challenged with dead or viable C. albicans by using predetermined proportions (cells:yeast) for 30 and 120 minutes. Phagocytosis was analyzed by acridine orange dye, and NO production by the Griess reaction. Results C. albicans phagocytosis by PAC from aged mice was similar to that of young mice, although the cells from older mice cells present more internalized fungi compared with matched control. In addition, a tendency towards impaired NO production by peritoneal mononuclear phagocytes from aged mice was observed. Conclusions PAC from aged mice may capture and store many fungi, which in turn may mean that these cells are effectively unable to eliminate fungi, probably due to impaired NO production. Therefore, considering the important role of C. albicans overgrowth in the pathogenesis of DS and the aspects observed in this study, aging may favor the onset and severity of local candidosis such as DS and its systemic forms.
Assuntos
Animais , Masculino , Fagocitose/fisiologia , Estomatite sob Prótese/metabolismo , Estomatite sob Prótese/microbiologia , Candida albicans/patogenicidade , Envelhecimento/fisiologia , Adesão Celular/fisiologia , Óxido Nítrico/biossíntese , Peritônio/citologia , Valores de Referência , Fatores de Tempo , Candida albicans/isolamento & purificação , Candidíase/microbiologia , Fatores Etários , Camundongos Endogâmicos C57BL , Óxido Nítrico/análiseRESUMO
Candida albicans biofilms play a key role in denture stomatitis, one of the most common oral pathologies in elderly people. Because biofilms are highly resistant to antifungals, new pharmacological strategies are needed. Aspirin and nitric oxide-donor molecules have both shown antibiofilm effects on C. albicans, making them promising candidates for treatment. In this study, we evaluated the antifungal/antibiofilm effect of a nitric-oxide releasing aspirin (NO-ASA) on C. albicans isolates from denture stomatitis patients in vitro. Disk diffusion assays showed that while NO-ASA had no antifungal effect, the drug potentiated fluconazole inhibition zone diameters, increasing the effect of fluconazole by 20-30% (p<0.05). The effect of NO-ASA on the morphogenesis of C. albicans was evaluated using light microscopy after inducing hyphae formation. For all clinical strains assayed, 125 µM NO-ASA significantly decreased the number of filamentous cells present (p<0.01). Adhesion to abiotic surfaces, a critical event for biofilm formation, was evaluated in 96-well polystyrene plates using crystal violet assay; 125 µM NO-ASA significantly inhibited adhesion. Biofilms were observed with scanning electron microscopy (SEM) and quantified using XTT reduction assay. NO-ASA decreased biofilm formation (IC50 ranging from 300 µM to 700 µM), consistent with SEM findings of altered biofilm microarchitecture. PGE2 and carboxy-PTIO (an NO scavenger) both blocked the antibiofilm effects of NO-ASA, suggesting that the efficacy of NO-ASA may be associated with both inhibition of PGE2 synthesis and release of NO. NO-ASA is a promising novel antibiofilm agent for treating fluconazole-resistant strains of C. albicans.
Assuntos
Aspirina/análogos & derivados , Biofilmes/efeitos dos fármacos , Candida albicans/isolamento & purificação , Nitrocompostos/farmacologia , Estomatite sob Prótese/microbiologia , Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Aspirina/farmacologia , Aspirina/uso terapêutico , Aderência Bacteriana/efeitos dos fármacos , Candida albicans/efeitos dos fármacos , Candida albicans/ultraestrutura , Dinoprostona/metabolismo , Farmacorresistência Fúngica/efeitos dos fármacos , Fluconazol/farmacologia , Fluconazol/uso terapêutico , Sequestradores de Radicais Livres/farmacologia , Humanos , Concentração Inibidora 50 , Viabilidade Microbiana/efeitos dos fármacos , Nitrocompostos/uso terapêutico , Estomatite sob Prótese/tratamento farmacológicoRESUMO
BACKGROUND: Denture-related erythematous stomatitis (DES) is a chronic biofilm-mediated disease, affecting one in every three complete denture wearers. Antifungals are the treatment most commonly prescribed by oral health professionals, based on the belief that colonization by Candida spp. is the main cause of DES. However, high recurrence rates and adverse effects are commonly observed, prompting the need for practice guidelines regarding treatment. Results from our pilot study demonstrate that palatal brushing can reduce the palatal inflammation and potentially associated Candida carriage without any need for antifungal therapy. The objective of this study is to validate these pilot results by means of a randomized controlled trial (RCT) and provide a practice guideline for clinicians. METHODS/DESIGN: A pragmatic, two-parallel-arm, multicenter RCT will be conducted in Canada, Brazil, and Chile. Fifty-two adult complete denture wearers presenting with moderate to severe DES will be allocated randomly to two groups: the Intervention arm will consist of palatal brushing and standard oral and denture hygiene measures, while the Control arm will include only standard oral and denture hygiene measures. The study outcome will be the oral Candida carriage. Participants will be assessed at baseline, and at 3 and 6 months post intervention. Descriptive, bivariate, and mixed models with repeated measures will be performed following the intention-to-treat principle. DISCUSSION: This pragmatic RCT will serve to provide a clinical practice guideline regarding the use of preventive measures in the treatment of biofilm-mediated oral diseases. Moreover, it will have a great impact on reducing the harm of antifungal overtreatment on patients suffering from DES. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02686632 . Registered on 15 February 2016.
Assuntos
Antifúngicos/uso terapêutico , Biofilmes/efeitos dos fármacos , Candidíase Bucal/tratamento farmacológico , Prótese Total/efeitos adversos , Estomatite sob Prótese/tratamento farmacológico , Biofilmes/crescimento & desenvolvimento , Brasil , Candidíase Bucal/diagnóstico , Candidíase Bucal/microbiologia , Chile , Protocolos Clínicos , Prótese Total/microbiologia , Fidelidade a Diretrizes , Humanos , Análise de Intenção de Tratamento , Guias de Prática Clínica como Assunto , Padrões de Prática Médica/normas , Quebeque , Recidiva , Projetos de Pesquisa , Método Simples-Cego , Estomatite sob Prótese/diagnóstico , Estomatite sob Prótese/microbiologia , Fatores de Tempo , Resultado do TratamentoRESUMO
Introducción: el material usado para fabricar aparatos protésicos parciales o totales es el polimetilmetacrilato, el cual forma una superficie sólida que se encuentra en íntimo contacto con la mucosa bucal del paciente, esta superfi cie puede presentar defectos (poros, grietas e irregularidades), que se producen al momento de su elaboracióny varían según la técnica de procesado, actuando como reservorios que contribuyen a la adherencia y proliferación de microorganismos,dentro de los cuales, el más frecuentemente aislado en pacientesportadores de prótesis es Candida albicans. Objetivo: Identifi car lasbacterias presentes en la superfi cie de una resina acrílica para base dedentadura (ProBase Hot®, Ivoclar, Vivadent). Material y métodos: Se seleccionaron 10 pacientes de ambos sexos, entre 25 y 30 años de edad que acudían a la clínica de prótesis. Las impresiones de alginato de los pacientes se utilizaron para crear modelos de yeso, que luegoconfeccionaron paladares de acrílico termocurado que los pacientes llevaban por un periodo de 24 horas. Una muestra del acrílico se tomóposteriormente para fi nes de identifi cación bacteriológica. El análisisestadístico consistió en estadística descriptiva con la distribución defrecuencia y porcentajes, realizando tablas de contingencia y respuestamúltiple (Programa IBM SPSS STATISTICS 21.0). Resultados: Labacteria identifi cada mayor número de veces fue Klebsiella pneumoniae,mientras que de las aisladas en menor frecuencia correspondió tanto a Escherichia coli como a Enterobacter cloacae, Pseudomonas aeruginosa en tres oportunidades, seguido de Enterococcus faecalis, Streptococcus alfa hemolítico y Streptococcus hyicus solo un par de veces. Conclusiones: La resina acrílica usada en este estudio diopositivo a diferentes especies bacterianas y las más frecuentementeaisladas pertenecen a la familia de las enterobacterias.
Introduction: the material most commonly used to make full orpartial prosthetic dental appliances is polymethyl methacrylate, whichprovides a solid surface that is in close contact with the patients oralmucosa. During the production of the dental prosthetic, defects suchas holes, cracks, and other irregularities can appear on this surface(depending on the method used), which act as reservoirs that stimulatethe proliferation of microorganisms and make it easier for these toadhere to the surface. The most frequently isolated microorganism indenture wearers is Candida albicans. Objective: To identify the bacteriapresent on the acrylic resin surface of dentures bases (ProBase Hot®,Ivoclar, Vivadent). Material and methods: 10 subjects of both sexesaged between 25 and 30 years were selected from among patientsattending a prosthodontics clinic. Alginate impressions of the patientswere used to create plaster molds, which were then used to constructheat-cured acrylic resin palatal plates that the patients wore for aperiod of 24 hours. A sample of the acrylic was subsequently takenfor bacteriological identifi cation purposes. Statistical analysis wasperformed based on a descriptive analysis of frequency distributionand percentages, and crossover and multiple response tables created(IBM SPSS STATISTICS 21.0 software). Results: The most frequentlyidentifi ed bacterium in this study was Klebsiella pneumoniae, whilethe least frequently isolated were Escherichia coli and Enterobactercloacae (once each), Pseudomonas aeruginosa (in three cases),and Enterococcus faecalis, Streptococcus alpha hemolytic andStreptococcus hyicus (two each). Conclusions: The acrylic resin usedin this study tested positive for various bacterial species, the mostfrequently isolated of these belonging to the family Enterobacteriaceae.
Assuntos
Humanos , Masculino , Adulto , Feminino , Adulto Jovem , Aderência Bacteriana , Estomatite sob Prótese/microbiologia , Resinas Acrílicas/efeitos adversos , Contagem de Colônia Microbiana , Meios de Cultura , Enterobacter/classificação , Enterobacter/crescimento & desenvolvimento , México , Interpretação Estatística de DadosRESUMO
This study examined the association between oral candidiasis in elderly users and nonusers of prosthesis and its predisposing factors. To this end, we performed a cross-sectional study where saliva samples from 48 patients were collected they used prosthesis and 43 patients (control group) who did not use. Among the 91 patients, Candida spp were isolated in 40 (83.3%) who used prosthesis and in 23 (53.5%) in the control group. A statistically significant association was determined between the two groups, the isolation of yeasts and dental prosthesis (p < 0.05, OR = 4.3). The most common etiological agent was Candida albicans (37 isolates), with 23 (62.2%) in the denture group and 14 (37.8%) (control group). Among patients who presented clinical manifestations of oral candidiasis (n = 24), 83.3% (n = 20) belonged to the group that wore dentures, while only 16.7% (n = 4) belonged to the control group. Elderly patients with diabetes had 4.4 times higher estimated risk of developing oral candidiasis when compared with individuals without this condition. There was no statistically significant association between being user prostheses and have diabetes with the onset of candidiasis. No statistically significant association was determined between xerostomia, use of prosthesis and oral candidiasis. The use of prosthetics and poor oral hygiene in elderly patients predisposes to the development of oral candidiasis.
Assuntos
Candida albicans/isolamento & purificação , Candidíase Bucal/etiologia , Prótese Dentária/efeitos adversos , Estomatite sob Prótese/microbiologia , Idoso , Idoso de 80 Anos ou mais , Candidíase Bucal/epidemiologia , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Boca/microbiologia , Saliva/microbiologia , Estomatite sob Prótese/epidemiologiaRESUMO
Candida-associated denture stomatitis (DS) is the most frequent lesion among denture wearers, especially the elderly. DS is strongly associated with Candida albicans, as well as local and systemic factors, such as impaired immune response. Monocytes are important in the protective immune response against the fungus by the production of cytokines that recruit and activate leukocytes. There are functional changes in these cells with age, and individual alterations involving monocyte response may predispose the host to developing infections by Candida spp. In this study, our aim was to evaluate the production of TNF-α, IL-6, CXCL8, IL-1ß, MCP-1 and IL-10 by monocytes from elderly denture wearers with/without DS and elderly or young non-denture wearers. We detected that monocytes from elderly denture wearers with Candida-related denture stomatitis produced lower levels of CXCL-8, IL-6 and MCP-1. This imbalance in cytokine levels was observed in spontaneous or LPS-stimulated production. Therefore, our data suggested that inherent aspects of the host, such as changes in cytokine production by monocytes, might be associated with the development and the persistence of DS irrespective of aging.
Assuntos
Candida/imunologia , Candidíase/imunologia , Citocinas/imunologia , Mediadores da Inflamação/imunologia , Monócitos/imunologia , Estomatite sob Prótese/imunologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Candida/classificação , Candida/fisiologia , Candida albicans/imunologia , Candida albicans/fisiologia , Candida tropicalis/imunologia , Candida tropicalis/fisiologia , Candidíase/metabolismo , Candidíase/microbiologia , Quimiocina CCL2/imunologia , Quimiocina CCL2/metabolismo , Citocinas/metabolismo , Ensaio de Imunoadsorção Enzimática , Feminino , Interações Hospedeiro-Patógeno/imunologia , Humanos , Mediadores da Inflamação/metabolismo , Interleucina-6/imunologia , Interleucina-6/metabolismo , Interleucina-8/imunologia , Interleucina-8/metabolismo , Masculino , Pessoa de Meia-Idade , Monócitos/metabolismo , Monócitos/microbiologia , Especificidade da Espécie , Estomatite sob Prótese/metabolismo , Estomatite sob Prótese/microbiologiaRESUMO
This study examined the influence of bacteria on the virulence and pathogenicity of candidal biofilms. Mature biofilms (Candida albicans-only, bacteria-only, C. albicans with bacteria) were generated on acrylic and either analysed directly, or used to infect a reconstituted human oral epithelium (RHOE). Analyses included Candida hyphae enumeration and assessment of Candida virulence gene expression. Lactate dehydrogenase (LDH) activity and Candida tissue invasion following biofilm infection of the RHOE were also measured. Candida hyphae were more prevalent (p < 0.05) in acrylic biofilms also containing bacteria, with genes encoding secreted aspartyl-proteinases (SAP4/SAP6) and hyphal-wall protein (HWP1) up-regulated (p < 0.05). Candida adhesin genes (ALS3/EPA1), SAP6 and HWP1 were up-regulated in mixed-species biofilm infections of RHOE. Multi-species infections exhibited higher hyphal proportions (p < 0.05), up-regulation of IL-18, higher LDH activity and tissue invasion. As the presence of bacteria in acrylic biofilms promoted Candida virulence, consideration should be given to the bacterial component when managing denture biofilm associated candidoses.
Assuntos
Bactérias , Biofilmes , Candida albicans/patogenicidade , Epitélio/microbiologia , Ácido Aspártico Proteases/genética , Candida albicans/crescimento & desenvolvimento , Proteínas Fúngicas/genética , Humanos , Hifas/crescimento & desenvolvimento , L-Lactato Desidrogenase/metabolismo , Mucosa Bucal/microbiologia , Estomatite sob Prótese/microbiologia , VirulênciaRESUMO
El 63,2% de la población chilena mayor de 65 años utiliza prótesis removible. Cuando estas pierden funcionalidad pueden producirse lesiones en la mucosa oral, siendo la más prevalente la estomatitis protésica, proceso inflamatorio de la mucosa de soporte de diversa extensión y severidad, cuyo principal factor etiológico es la infección por Candida spp. El objetivo de esta investigación fue determinar la cantidad y las especies de levaduras del género Candida y su asociación con estomatitis protésica en portadores de prótesis removible antes y después del tratamiento rehabilitador. Se realizó un estudio descriptivo cuantitativo, n = 34, en ambos géneros, edad promedio de 69 años, portadores de prótesis removible no funcionales, con y sin estomatitis protésica. Para el recuento e identificación de levaduras del género Candida se tomaron muestras de saliva antes y después del tratamiento. Las variables fueron analizadas estadísticamente. Los resultados indicaron el diagnóstico de estomatitis protésica en el 55,9% de los sujetos, de los cuales tipo I = 29,4% y tipo II = 26,5%. Los recuentos de Candida spp. fueron mayores en aquellos con estomatitis protésica, tanto antes como después del tratamiento. Al instalar prótesis funcionales el recuento disminuyó significativamente, sin embargo permaneció alto en aquellos con estomatitis protésica diagnosticada previa al tratamiento rehabilitador. La especie identificada más frecuentemente fue Candida albicans.
Almost two-thirds (63.2%) of the Chilean population aged 65 and above use removable prosthesis. When they cease to be functional, injuries may occur in the oral mucosa, with denture stomatitis being the most prevalent. This is an inflammatory process of the supportive mucosa of varying extension and severity, with its main etiologic factor being infection by Candida spp. The aim of this investigation was to determine the quantity and species of yeast of the genus Candida and their association with denture stomatitis in carriers of removable prosthesis, before and after the rehabilitation treatment. A descriptive quantitative study was conducted on 34 patients, with a mean age of 69 years, and carriers of a non-functional removable prosthesis, with and without prosthetic stomatitis. Saliva samples were taken before and after the treatment for the counting and identification of genus Candida yeast. The variables were statistically analyzed. The results showed a diagnosis of prosthetic stomatitis in 55.9% of the subjects, of which 29.4% were Type I and 26.5% were Type II. The Candida sppcount was higher in the subjects with prosthetic stomatitis both before and after the treatment. The count decreased significantly after installing a functional prosthesis. However, it remained high in those with prosthetic stomatitis. The most frequently identified species was Candida albicans.