(1/47) Serum itraconazole concentrations and clinical responses in Candida-associated denture stomatitis patients treated with itraconazole solution and itraconazole capsules.
The aim of this study was to compare the concentrations of itraconazole in serum and saliva after treatment with itraconazole cyclodextrin solution or itraconazole capsules in Candida-associated denture stomatitis patients without evidence of immunodeficiency. Forty patients were randomly assigned to receive either itraconazole cyclodextrin solution or itraconazole capsules, both at a dosage of 100 mg bd for 15 days. On completion of treatment palatal erythema was assessed and an oral rinse and imprint cultures were collected. Serum and saliva samples were collected at the same time and itraconazole concentrations measured using reverse-phase high-performance liquid chromatography. Itraconazole susceptibilities of Candida albicans and Candida glabrata strains isolated at baseline were measured by a broth microdilution method. Serum itraconazole concentrations achieved did not differ significantly between the two preparations (P = 0.39) although a significantly higher number of patients in the itraconazole cyclodextrin group (P < 0.001) had detectable levels of itraconazole in their saliva compared with the capsule group. Mycologically cured patients had slightly, though not significantly (P = 0.28), higher serum itraconazole concentrations than those from whom yeasts were not eradicated. It was concluded that both formulations of itraconazole were equally effective in treatment of denture stomatitis. Among immunocompetent patients, the absorption of the liquid preparation is no greater than that of the capsules. Therapeutic success in this group was achieved with lower serum itraconazole concentrations than have been reported for immunocompromised groups. (+info)
(2/47) Efficacy of the cyclodextrin liquid preparation of itraconazole in treatment of denture stomatitis: comparison with itraconazole capsules.
This study investigated the efficacy of a cyclodextrin solution of itraconazole in the treatment of Candida-associated denture stomatitis. It was found that the liquid and capsule preparations of itraconazole were equally effective adjuncts in the treatment of this condition. However, the side effect profile indicates that capsules are the preferred formulation. (+info)
(3/47) Denture plaque and adherence of Candida albicans to denture-base materials in vivo and in vitro.
The aim of this paper is to review our understanding of the mechanisms and clinical significance of adhesion of C. albicans to denture-base materials in relation to denture plaque and denture-related stomatitis. Earlier reports in the literature of a 65% prevalence level of denture-related stomatitis seem to be exaggerated. More recent studies indicate that denture-related stomatitis is considerably less common, particularly in normal healthy subjects. The etiology of the condition is discussed in this review, and although much of the literature supports the view that the condition is strongly associated with C. albicans, this is not always so. In some subjects, the cause appears to be related to a non-specific plaque. This review also considers the role of denture plaque in the pathogenesis of denture-related stomatitis, the sequential development of denture plaque, and its colonization by Candida organisms. Designing controlled in vivo studies is difficult, and as a consequence, many investigators have had to resort to in vitro studies. The majority of these studies have attempted to investigate the hydrophobicity of C. albicans, relating the surface free-energy of denture-base materials, particularly acrylic resin, to that of the organism. Surprisingly little work has been directed at surface roughness and how it affects retention of organisms. Further, no attention has been paid to the properties and character of the surface, other than average surface roughness, as it affects adhesion. A comparison of results from in vitro studies on the effect on adhesion of pre-coating the surfaces of denture-base materials with saliva has produced equivocal conclusions. This is largely due to little standardization of experimental protocols between studies, particularly in the collection and handling of the saliva used. In conclusion, the review strongly supports the suggestion that adherence of C. albicans to denture-base materials in vitro is related to the hydrophobicity of the organism. The clinical significance of the observation and the mechanisms for the development and maturation of denture plaque are yet to be understood. There is a clear need for further investigation of other factors that may moderate the adhesion of organisms and subsequent colonization of denture-base materials. (+info)
(4/47) Initial prosthetic treatment.
This article describes measures designed to provide short-term solutions to existing RPD problems and to establish an optimum oral environment for the provision of definitive prostheses. (+info)
(5/47) Discuss before fabricating: communicating the realities of partial denture therapy. Part II: clinical outcomes.
The premise of this review is that patients' satisfaction (and hence compliance) with partial denture therapy may be better if they are more fully informed about the limitations of the prosthesis they are to receive. Neither the dentist nor the patient should assume that all of their respective expectations will be mutually understood and inherently met. By discussing patient-centred issues and predictable clinical outcomes, both dentist and patient will be better prepared to determine whether a removable prosthesis is appropriate. Searches of the Cochrane Collaboration and MEDLINE databases were conducted to identify issues pertaining to patient compliance in wearing cast removable partial dentures. In addition to the 2 most frequent patient concerns, esthetics and mastication, discussed in the first article of this series, additional aspects of concern to the dentist and the patient when considering a removable partial denture include overeruption, post-insertion care, comfort, longevity of the prosthesis, effect on speech and biologic consequences are discussed here. (+info)
(6/47) Isolation of Candida dubliniensis in a teenager with denture stomatitis.
OBJECTIVES: Test several methods that allow the differentiation between Candida albicans and Candida dubliniensis, in an attempt to assess whether C. dubliniensis can be recovered from the oral cavity of teenagers wearing orthopedic oral prostheses. MATERIAL AND METHODS: Twelve Candida strains were isolated from the prosthesis as well as the palatal mucosa in contact with the dental prosthesis from 12 teenager patients wearing orthopedic oral prostheses. Differentiation between C. albicans and C. dubliniensis was achieved by a number of phenotypic tests (carbon assimilation by the commercially available ID 32C test, growth at 45 grades C on Sabouraud glucose agar, abundant chlamydospore production on Casein agar, and reactivity with a C. dubliniensis antiserum) and the polymerase chain reaction (PCR). Serotyping of C. albicans was performed with monoclonal antibody B9E. RESULTS: All 12 patients studied presented a Newton s type 2 denture stomatitis and in every patient the same Candida species were isolated from the prosthesis and the palatal mucosa in contact with the dental prosthesis. CHROMagar Candida and the germ tube test allowed the differentiation of isolates giving green colonies and a positive germ tube test from those giving violet colonies and a negative germ tube test. Only the isolate from patient 8 was stained by the C. dubliniensis antiserum and showed abundant chlamydospore production on Casein agar. Eight isolates did not grow at 45 grades C. Identification of all isolates was obtained by the ID 32C test. C. albicans was identified in 75% of patients, C. glabrata in 16,6% and C. dubliniensis in 8,3%. By using specific primers for typing C. dubliniensis, PCR allowed the identification of patient s 8 isolate as C. dubliniensis genotype 1. CONCLUSION: C. dubliniensis can be isolated from the oral cavity of teenagers wearing orthopedic oral prostheses and it is possible and technically amenable, the differentiation between C. albicans y C. dubliniensis using the ID 32C test, the observation of abundant chlamydospore production on Casein agar, the reactivity with a C. dubliniensis antiserum and the PCR. (+info)
(7/47) Comparison of two cleansing pastes for the removal of biofilm from dentures and palatal lesions in patients with atrophic chronic candidiasis.
The efficacy of 2 oral hygiene products, an experimental toothpaste specific for complete denture cleansing and a regular standard toothpaste, was compared in terms of denture biofilm removal and cure of palatal lesions in patients with atrophic chronic candidiasis. The degree of correlation between presence of biofilm and mucosa erythema was also evaluated. Twenty-four complete denture wearers (45-80 years old) were divided into 2 groups: experimental paste and standard toothpaste (Sorriso-Kolynos, Brazil). Both groups received soft toothbrushes. The internal surfaces of upper dentures were stained using 1% sodium fluorescein and photographed at a 45 masculine angle at 0, 15, 30 and 60 days. The slides were scanned and the areas of interest (denture total area and biofilm area) were measured (Image Tool software). The degree of erythema was evaluated on slides according to the Prosthesis Tissue Index. There was a significant reduction (1%) in the degree of biofilm (ANOVA/Tukey) between the two initial visits (0 and 15 days) and the two final visits (30 and 60 days), and in the average erythema scores (Kruskal-Wallis) between 0 and 60 days, in both groups. The Mann-Whitney test showed a significant difference (1%) between pastes in terms of biofilm degree, but no difference was found for the erythema score. Correlation values between biofilm and erythema degree were 0.3801 (experimental paste) and (0.3678 (standard toothpaste). We may therefore conclude that the experimental product was efficient for the removal of denture plaque biofilm. (+info)
(8/47) Candida albicans, Staphylococcus aureus and Streptococcus mutans colonization in patients wearing dental prosthesis.
BACKGROUND: Denture stomatitis is associated to Candida albicans, different bacteria and other co-factors such as an acid pH, a carbohydrate ingestion increase, different systemic illnesses and pharmacological treatments. OBJECTIVE: The aim of this study was to determine Candida albicans, Staphylococcus aureus and Streptococcus mutans prevalence in the mucous membrane and prosthesis of patients with and without atrophic denture stomatitis and its relationship with other potential clinical co-factors. STUDY DESIGN: Saliva was collected from 105 patients (62 female and 43 male) wearing dental prosthesis in order to measure their pH. Oral samples of the mucous membrane and the internal surface of dental prosthesis were taken with sterile cotton to proceed with the microbiological study. The identification of the isolated microorganisms was performed using conventional microbiological methods. RESULTS: Diabetes and Hypertension were the most frequent systemic illnesses. High carbohydrate ingestion was observed in numerous patients. Atrophic denture stomatitis was reported in 50 patients and the pH average in saliva was of 5.2. The presence of C albicans, S. aureus and S. mutans in the mucous membrane and prosthesis was of 51.4%, 52.4% and 67.6%, respectively. C. albicans was isolated in 66.7% from the prosthesis, whereas S. aureus and S. mutans were isolated in 49.5% of those same prosthesis. C. albicans was isolated in 86% of the patients with atrophic denture stomatitis and S. aureus was isolated in a similar percentage (84% of patients). The isolation of S. mutans was less frequent, and it was observed in 16% of the oral samples of these patients. CONCLUSIONS: C. albicans, S. aureus and S. mutans frequently colonize the oral mucous of patients wearing dental prosthesis. This illness-bearing condition is more frequent in patients with denture stomatitis, even though dental prosthesis colonization is lower than in the oral mucous. (+info)