RESUMO
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.
Assuntos
Satisfação do Paciente , Estomatite sob Prótese , Retenção de Dentadura , Prótese Total/psicologia , Humanos , Higiene , Saúde Bucal , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Estomatite sob Prótese/terapiaRESUMO
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.
Assuntos
Candidíase Bucal , Estomatite sob Prótese , Animais , Candida albicans , Candidíase Bucal/complicações , Candidíase Bucal/patologia , Modelos Animais de Doenças , Mucosa Bucal/patologia , Estomatite sob Prótese/etiologia , Estomatite sob Prótese/patologia , Estomatite sob Prótese/terapiaRESUMO
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.
Assuntos
Micro-Ondas , Estomatite sob Prótese , Candida , Prótese Total , Desinfecção , Humanos , Estomatite sob Prótese/terapiaRESUMO
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)
Assuntos
Humanos , Masculino , Idoso , Estomatite sob Prótese , Prótese Dentária , Estomatite , Estomatite sob Prótese/diagnóstico , Estomatite sob Prótese/terapia , Candidíase BucalRESUMO
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.
Assuntos
Candida , Estomatite sob Prótese , Biofilmes , Candida albicans , Contagem de Colônia Microbiana , Desinfecção , Humanos , Hipoclorito de Sódio , Estomatite sob Prótese/terapiaRESUMO
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.
Assuntos
Higiene Bucal , Ensaios Clínicos Controlados Aleatórios como Assunto , Estomatite sob Prótese/terapia , Biofilmes , Método Duplo-Cego , Frequência Cardíaca , Humanos , Estomatite sob Prótese/fisiopatologiaRESUMO
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)
Assuntos
Humanos , Ozônio/uso terapêutico , Estomatite sob Prótese/terapia , Resultado do Tratamento , Saúde de Gênero , Epidemiologia Descritiva , Estudos TransversaisRESUMO
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.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Própole/uso terapêutico , Estomatite sob Prótese/terapia , Candidíase/terapia , Avaliação de Eficácia-Efetividade de Intervenções , Apiterapia , MelRESUMO
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)
Assuntos
Humanos , Adulto , Ozônio/uso terapêutico , Estomatite sob Prótese/terapia , Avaliação de Eficácia-Efetividade de IntervençõesRESUMO
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)
Assuntos
Humanos , Ozônio/uso terapêutico , Estomatite sob Prótese/terapia , Avaliação de Eficácia-Efetividade de Intervenções , Medicina TradicionalRESUMO
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.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Estomatite sob Prótese/terapia , Clorexidina/farmacologia , Resultado do Tratamento , Prótese Total/efeitos adversos , Reembasadores de Dentadura , Método Duplo-Cego , Ensaio Clínico Controlado Aleatório , Estatísticas não ParamétricasRESUMO
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.
Assuntos
Estomatite sob Prótese/terapia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de RiscoRESUMO
PURPOSE: Photodynamic therapy (PDT) appears to be an effective method for the in vitro and in vivo inactivation of Candida spp., but no clinical trials in this context have yet been conducted. The aim of this study was to compare the effect of oral miconazole gel to PDT combined with low-power laser (LPL) therapy in the treatment of denture stomatitis. MATERIALS AND METHODS: Forty participants with clinical and microbiological diagnoses of type II denture stomatitis were randomly allocated to two treatment groups (PDT and miconazole gel), each with 20 individuals. The PDT group was submitted to one session of methylene blue-mediated PDT plus two sessions of low-laser therapy twice a week for 15 days. The miconazole group was submitted to the drug four times a day for 15 days. RESULTS: Forty percent of the patients achieved clinical and microbiological resolution of denture stomatitis after methylene blue-mediated photodynamic inactivation followed by low-laser therapy. The cure rate associated with miconazole was 80% (p < 0.05). Fifteen days after the end of treatment, the recurrence rate was 25% in patients treated with PDT combined with LPL therapy and 12.5% in patients treated with miconazole. CONCLUSION: Miconazole gel provides better results than a protocol combining methylene blue-mediated PDT and LPL therapy in the treatment of type II denture stomatitis.
Assuntos
Antifúngicos/uso terapêutico , Terapia a Laser , Miconazol/uso terapêutico , Estomatite sob Prótese/terapia , Candida , Humanos , Azul de Metileno/uso terapêuticoRESUMO
BACKGROUND: Microorganisms of the genus Candida have been recovered from complete dentures made of acrylic resin, with high numbers of colony forming units and species diversity, which can act as infectious agents causing chronic atrophic candidiasis (denture stomatitis). OBJECTIVE: The objective of this paper is present a treatment protocol for chronic atrophic candidiasis (denture stomatitis). MATERIALS AND METHODS: The work describes three cases of totally edentulous patients presenting palate stomatitis who were submitted for treatment associating denture rebasing with chemically-activated acrylic resin, night immersion in 2.5% sodium hypochlorite and use of topical antifungals for two weeks. RESULTS: In all cases, remission of the inflammatory process occurred. CONCLUSION: The proposed treatment protocol proved to be to be effective.
Assuntos
Estomatite sob Prótese/terapia , Resinas Acrílicas/química , Administração Tópica , Antifúngicos/administração & dosagem , Antifúngicos/uso terapêutico , Protocolos Clínicos , Desinfetantes de Equipamento Odontológico/uso terapêutico , Materiais Dentários/química , Reembasamento de Dentadura , Prótese Total/microbiologia , Feminino , Seguimentos , Humanos , Masculino , Metilmetacrilatos/química , Pessoa de Meia-Idade , Antissépticos Bucais/uso terapêutico , Nistatina/administração & dosagem , Nistatina/uso terapêutico , Hipoclorito de Sódio/uso terapêuticoRESUMO
O aumento da resistência aos antifúngicos convencionais e os possíveis efeitos colaterais destes fármacos têm estimulado pesquisas sobre produtos naturais com potencial antimicrobiano e baixa toxicidade. Assim, o objetivo desta pesquisa foi realizar uma avaliação clínica e laboratorial do tratamento da estomatite protética (EP) através de produtos naturais, por meio de cultura micológica quantitativa, de microscopia confocal e de análise das propriedades superficiais de uma resina acrílica. Em todas as avaliações, os grupos experimentais foram divididos de acordo com as seguintes substâncias: G1 - água destilada estéril; G2 - nistatina; G3 - extrato alcoólico de própolis a 20%; G4 - gel de Punica granatum Linné; G5 - gel de Uncaria tomentosa (Imuno-Max Gel). Para a cultura micológica quantitativa, 30 pacientes diagnosticados com EP utilizaram os seus respectivos medicamentos três vezes por dia, durante 14 dias, associados à escovação das próteses com dentifrício. Nas avaliações, foram coletados materiais das áreas eritematosas da mucosa palatina e das áreas correspondentes na prótese total superior. Este procedimento foi realizado antes do tratamento (T0), após 14 dias do início do tratamento (T1) e 30 dias após a suspensão do uso dos medicamentos (T2). Os dados obtidos foram submetidos ao teste não-paramétrico de Friedman para comparações intragrupos e ao teste de Kruskal-Wallis para comparações intergrupos. Para análise através de microscopia confocal, 30 espécimes de uma resina acrílica termopolimerizável foram inoculados com C. albicans para a formação do biofilme e, em seguida, imersos em sua respectiva droga. Os biofilmes remanescentes sobre os espécimes foram corados através de fluorocromos indicadores de viabilidade celular. Os dados obtidos foram analisados através do teste não paramétrico de Kruskal-Wallis e do pós-teste de comparação múltipla de Dunn. Para análise das propriedades superficiais, 50 espécimes de uma resina acrílica termopolimerizável...
The increased resistance to conventional antifungal drugs and their possible side effects have stimulated research on natural products with antimicrobial activity and low toxicity. This study comprised a clinical and laboratory evaluation of the treatment of denture stomatitis (DS) using natural products by quantitative mycological culture, confocal microscopy and analysis of surface properties of an acrylic resin. In all evaluations, the experimental groups were divided according to the following substances: G1 - sterile distilled water; G2 - nystatin (Micostatin); G3 - 20% propolis alcoholic extract; G4 - P. granatum Linné gel; G5 - Uncaria tomentosa gel (Imuno-Max Gel). For quantitative mycological culture, 30 patients diagnosed with DS used their respective medicines three times a day for 14 days, associated with denture brushing with dentifrice. For the analysis, material was collected from erythematous areas of the palatal mucosa and from corresponding areas on the maxillary denture. This procedure was performed before treatment (T0), at 14 days after treatment onset (T1) and 30 days after interrupting the use of drugs (T2). Data were analyzed by the non-parametric Friedman test for intragroup comparisons and Kruskal-Wallis test for intergroup comparisons. For analysis by confocal microscopy, 30 specimens of a polymerized acrylic resin were inoculated with C. albicans for biofilm development and then immersed in the respective drugs. The remaining biofilms on the specimens were stained using fluorochrome indicators of cell viability. Data were analyzed by non-parametric Kruskal-Wallis test and Dunn's multiple comparison post-hoc test. For the analysis of surface properties, 50 specimens of polymerized acrylic resin were fabricated, polished and tested for initial verification of roughness and microhardness (T0). Then, the specimens were individually immersed in the respective drugs for 24 hours. After 14 days of immersion (T1), the surfasse...
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Prótese Dentária , Estomatite sob Prótese/terapia , Produtos Biológicos/uso terapêutico , Resinas Acrílicas/química , Testes de Dureza , Microscopia Confocal , Propriedades de Superfície , Fatores de Tempo , Resultado do TratamentoRESUMO
O aumento da resistência aos antifúngicos convencionais e os possíveis efeitos colaterais destes fármacos têm estimulado pesquisas sobre produtos naturais com potencial antimicrobiano e baixa toxicidade. Assim, o objetivo desta pesquisa foi realizar uma avaliação clínica e laboratorial do tratamento da estomatite protética (EP) através de produtos naturais, por meio de cultura micológica quantitativa, de microscopia confocal e de análise das propriedades superficiais de uma resina acrílica. Em todas as avaliações, os grupos experimentais foram divididos de acordo com as seguintes substâncias: G1 - água destilada estéril; G2 - nistatina; G3 - extrato alcoólico de própolis a 20%; G4 - gel de Punica granatum Linné; G5 - gel de Uncaria tomentosa (Imuno-Max Gel). Para a cultura micológica quantitativa, 30 pacientes diagnosticados com EP utilizaram os seus respectivos medicamentos três vezes por dia, durante 14 dias, associados à escovação das próteses com dentifrício. Nas avaliações, foram coletados materiais das áreas eritematosas da mucosa palatina e das áreas correspondentes na prótese total superior. Este procedimento foi realizado antes do tratamento (T0), após 14 dias do início do tratamento (T1) e 30 dias após a suspensão do uso dos medicamentos (T2). Os dados obtidos foram submetidos ao teste não-paramétrico de Friedman para comparações intragrupos e ao teste de Kruskal-Wallis para comparações intergrupos. Para análise através de microscopia confocal, 30 espécimes de uma resina acrílica termopolimerizável foram inoculados com C. albicans para a formação do biofilme e, em seguida, imersos em sua respectiva droga. Os biofilmes remanescentes sobre os espécimes foram corados através de fluorocromos indicadores de viabilidade celular. Os dados obtidos foram analisados através do teste não paramétrico de Kruskal-Wallis e do pós-teste de comparação múltipla de Dunn. Para análise das propriedades superficiais, 50 espécimes de uma resina acrílica termopolimerizável...
The increased resistance to conventional antifungal drugs and their possible side effects have stimulated research on natural products with antimicrobial activity and low toxicity. This study comprised a clinical and laboratory evaluation of the treatment of denture stomatitis (DS) using natural products by quantitative mycological culture, confocal microscopy and analysis of surface properties of an acrylic resin. In all evaluations, the experimental groups were divided according to the following substances: G1 - sterile distilled water; G2 - nystatin (Micostatin); G3 - 20% propolis alcoholic extract; G4 - P. granatum Linné gel; G5 - Uncaria tomentosa gel (Imuno-Max Gel). For quantitative mycological culture, 30 patients diagnosed with DS used their respective medicines three times a day for 14 days, associated with denture brushing with dentifrice. For the analysis, material was collected from erythematous areas of the palatal mucosa and from corresponding areas on the maxillary denture. This procedure was performed before treatment (T0), at 14 days after treatment onset (T1) and 30 days after interrupting the use of drugs (T2). Data were analyzed by the non-parametric Friedman test for intragroup comparisons and Kruskal-Wallis test for intergroup comparisons. For analysis by confocal microscopy, 30 specimens of a polymerized acrylic resin were inoculated with C. albicans for biofilm development and then immersed in the respective drugs. The remaining biofilms on the specimens were stained using fluorochrome indicators of cell viability. Data were analyzed by non-parametric Kruskal-Wallis test and Dunn's multiple comparison post-hoc test. For the analysis of surface properties, 50 specimens of polymerized acrylic resin were fabricated, polished and tested for initial verification of roughness and microhardness (T0). Then, the specimens were individually immersed in the respective drugs for 24 hours. After 14 days of immersion (T1), the surfasse...
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Prótese Dentária , Estomatite sob Prótese/terapia , Produtos Biológicos/uso terapêutico , Resinas Acrílicas/química , Testes de Dureza , Microscopia Confocal , Propriedades de Superfície , Fatores de Tempo , Resultado do TratamentoRESUMO
O objetivo deste estudo preliminar foi obter padrões metodológicos para viabilizar a utilização de um dispositivo acrílico intra-oral adaptável à mucosa palatina de ratos e passível de reembasamento com material resiliente temporário (Trusoft) modificado com antimicrobianos em suas mínimas concentrações inibitórias (MCIs) para biofilme de Candida albicans. Para delinear essa adequação, foram determinados parâmetros em relação à dieta e alojamento dos animais enquanto usuários desses dispositivos. A amostra total dos ratos (n=115) foi dividida em seis grupos: Controle Negativo (CN): sem dispositivo acrílico intra-oral; Controle Geral (CG): dispositivo acrílico sem reembasamento; Controle Positivo (CP): dispositivo reembasado com Trusoft sem fármaco; Diacetato de Clorexidina (CLO): dispositivo reembasado com Trusoft contendo clorexidina (0,064 g/mL); Cetoconazol (CET): dispositivo reembasado com Trusoft contendo cetoconazol (0,128 g/mL) e Nistatina (NIS): dispositivo reembasado com Trusoft contendo nistatina (0,032 g/mL). Os animais foram eutanasiados após 7 ou 14 dias da instalação dos dispositivos intraorais. As adaptações para a obtenção dos dispositivos incluíram a técnica de moldagem, método de reembasamento e formas de retenção à mucosa palatina dos animais. Para proporcionar a análise histopatológica descritiva padronizada, foram estabelecidos critérios em relação à obtenção das amostras histológicas, à seleção da região de interesse (RI) da análise e aos determinantes utilizados na descrição. Foi observado que a dieta pastosa e o alojamento em gaiolas com piso aramado sobre base de maravalha e papel craft possibilitaram melhores condições de sobrevivência aos animais. Os dispositivos intra-orais confeccionados individualmente e retidos via amarrilhos com fios ortodônticos nos incisivos e molares se mantiveram satisfatoriamente em posição durante todo o experimento para a maioria dos animais (72,6%), sobretudo no período inicial de 7 dias...
The purpose of this study was to produce preliminary methodological standards to allow the use of an intraoral acrylic device adjusted to the palatal mucosa of rats and capable of relining with temporary resilient material (Trusoft) modified with antimicrobial agents in the minimum inhibitory concentrations (MICs) for Candida albicans biofilm. To design this adjustment, parameters were determined in relation to the diet and housing of animals as users of these devices. The total sample (n=115) was divided into six groups: Negative control (NC): without an acrylic intraoral device; Overall Control (OC): device without relining; Positive Control (PC): device relined with Trusoft without the addition of drugs; Chlorhexidine diacetate (CHL): device relined with Trusoft containing chlorhexidine diacetate (0.064 g/mL); Ketoconazole (KET): device relined with Trusoft containing ketoconazole (0.128g/mL); and Nystatin (NYT): acrylic device relined with Trusoft containing nystatin (0.032 g/mL). The animals were sacrificed after 7 or 14 days from the installation ofthe intra-oral devices. The adaptations for obtaining the devices included the impression technique, the reline method and the means of retaining in the palatal mucosa of animals. To obtain the standard descriptive histopathological analysis, criteria had been established in relation to obtaining the histological samples,selecting the region of interest (RI) of analysis and the criteria utilized in the description. It was observed that a paste diet and housing in cages with a wired fence floor with an additional base of wood shavings and craft paper enabled the best possible survival conditions for the animals. The individually made intra-oral devices retained with stainless steel wires at the incisors and molars remained satisfactorily in position throughout the experiment for most animals (72.6%), mainly in the initial period of 7 days. The procedure for the relining of the devices ...
Assuntos
Animais , Masculino , Ratos , Reembasadores de Dentadura/microbiologia , Resinas Acrílicas/química , Resinas Acrílicas/uso terapêutico , Biofilmes , Estomatite sob Prótese/terapia , Palato/patologia , Ratos Wistar , Reprodutibilidade dos Testes , Fatores de Tempo , Resultado do TratamentoRESUMO
OBJECTIVE: The aim of this study was to compare the effectiveness of denture microwave disinfection and antifungal therapy on treatment of denture stomatitis. STUDY DESIGN: Sixty denture wearers with denture stomatitis (3 groups; n = 20 each), were treated with nystatin or denture microwave disinfection (1 or 3 times/wk) for 14 days. Mycologic samples from palates and dentures were quantified and identified with the use of Chromagar, and clinical photographs of palates were taken. Microbiologic and clinical data were analyzed with the use of a series of statistical tests (α = .05). RESULTS: Both treatments similarly reduced clinical signs of denture stomatitis and growth on palates and dentures at days 14 and 30 (P > .05). At sequential appointments, the predominant species (P < .01) isolated was C. albicans (range 98%-53%), followed by C. glabrata (range 22%-12%) and C. tropicalis (range 25%-7%). CONCLUSIONS: Microwave disinfection, at once per week for 2 treatments, was as effective as topical antifungal therapy for treating denture stomatitis.
Assuntos
Antifúngicos/uso terapêutico , Prótese Total/microbiologia , Desinfecção/métodos , Micro-Ondas , Micoses/microbiologia , Micoses/terapia , Nistatina/uso terapêutico , Estomatite sob Prótese/microbiologia , Estomatite sob Prótese/terapia , Adulto , Idoso , Análise de Variância , Distribuição de Qui-Quadrado , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Higiene Bucal , Fumar/efeitos adversos , Resultado do Tratamento , Xerostomia/complicaçõesRESUMO
PURPOSE: The aim of this randomized clinical trial was to compare the effectiveness of microwave denture disinfection and nystatin in the treatment of well-controlled type 2 diabetic patients with denture stomatitis in terms of microbiologic and clinical outcomes. MATERIALS AND METHOD: Diabetic patients wearing maxillary complete dentures with denture stomatitis (n = 40) were divided into two groups: NYS (patients treated with topical nystatin 4 times/day for 14 days) and MW (patients who had their dentures microwaved [650 W for 3 minutes] 3 times/week for 14 days). Mycologic samples were taken from the palates and dentures of the patients for quantification and identification of Candida, and standardized photographs of the palates were taken for clinical analysis. Evaluations were repeated at baseline, the end of treatment (day 14), and throughout follow-up (days 30, 60, and 90). Microbiologic data were evaluated by analysis of variance using a random effects statistical model, Tukey post hoc test, and chi-square test (α = .05). Clinical results were analyzed using Mann-Whitney and Fisher exact tests (α = .05). RESULTS: Both treatments were considered successful in reducing the clinical signs of denture stomatitis and significantly reduced the values of colony-forming units/mL from the palates and dentures at days 14 and 30. In addition, 40% of treated patients were cured by the end of treatment. No significant differences in the microbiologic and clinical outcomes were revealed between the two groups (P > .05). C albicans was the most predominant species isolated (P < .01), followed by C tropicalis and C glabrata. CONCLUSION: Denture microwave disinfection was as effective as nystatin for the treatment of diabetic patients with denture stomatitis.
Assuntos
Antifúngicos/uso terapêutico , Prótese Total/microbiologia , Desinfecção/métodos , Micro-Ondas , Nistatina/uso terapêutico , Estomatite sob Prótese/terapia , Administração Tópica , Idoso , Análise de Variância , Antifúngicos/administração & dosagem , Candida/isolamento & purificação , Distribuição de Qui-Quadrado , Contagem de Colônia Microbiana , Prótese Total/efeitos adversos , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Funções Verossimilhança , Masculino , Pessoa de Meia-Idade , Nistatina/administração & dosagem , Palato Duro/microbiologia , Método Simples-Cego , Estomatite sob Prótese/complicações , Estomatite sob Prótese/etiologia , Estomatite sob Prótese/microbiologiaRESUMO
A candidose é a doença de origem fúngica oral mais comum em seres humanos e apresenta uma variedade de características clínicas. Sendo causada principalmente pelo fungo Candida albicans, ela é considerada uma infecção oportunista, afetando principalmente indivíduos que são debilitados por outras doenças. Os avanços da medicina levaram ao prolongamento da sobrevida de pacientes imunocomprometidos, como aqueles pacientes irradiados de cabeça e pescoço que apresentam neoplasias...