Can 0.5% Sodium Hypochlorite Treat Candida-Associated Denture Stomatitis?

ABSTRACT Objective: To evaluate a 0.5% sodium hypochlorite (SH) protocol in reducing Candida spp. levels in complete dentures (CD) and palate and denture stomatitis (DS) remission. Material and Methods: Twelve CD wearers diagnosed with Candida-associated denture stomatitis (CADS) had their initial situation (Candida spp. levels and DS score) recorded (baseline). Then, participants were instructed to soak dentures once a day (10 minutes) in 0.5% SH. Candida spp. levels and DS scores were reassessed after 15, 30, and 60 days of SH denture cleanness. Biofilms from the denture base and palate were seeded in CHROMagar Candida. After incubation, colony-forming units were calculated. The palate was photographed at each time point, and DS was assessed according to Newton's classification. Data of Candida spp. levels were analyzed by 2-way repeated measures ANOVA followed by the Holm-Sidak test, and DS scores data were accessed by Friedman's 2-way ANOVA by ranks (α=0.05). Results: 0.5% SH significantly reduced Candida spp. levels after treatment compared to baseline (p<0.001) for both sites. Although at baseline, Candida spp. counts were higher on the denture base (p<0.001), no significant differences were observed between the collected areas within the other time points (p<0.05). Also, 0.5% SH effectively reduced clinical signs of DS after treatment (p<0.05). Conclusion: The protocol tested effectively decreased Candida spp. levels on the denture base and palatal mucosa and effectively reduced the signs of DS.

Efficacy of Denture Cleansers in Reducing Microbial Counts from Removable Partial Dentures: A Short-Term Clinical Evaluation

This clinical study investigated if daily immersion in denture cleansers reduces microbial counts on removable partial denture's (RPD) biofilm. Twenty-five RPD wearer volunteers were selected and instructed to complement the hygiene of their dentures by immersing them in an enzymatic peroxide-based denture cleanser (Polident® 3 minute) once a day for 3 min for a period of 15 days. The biofilm was collected from RPD surfaces with a swab immediately before (baseline) and after the experimental period. The samples were placed in sterile saline solution, sonicated at 7 W and then plated on specific culture media to quantify total microorganisms, total streptococci and Candida spp. counts. Data from both collections were compared by paired t-test (α=0.05). It was observed a significant reduction on total microorganisms' counts in RPD biofilm after denture cleanser use (p=0.007). This reduction was also observed for total streptococci (p=0.0428), but no difference was observed on Candida spp. counts. It was concluded that daily use of denture cleanser improved denture hygiene by reducing total microorganisms and total streptococci from RPD surface but had no effect on Candida spp. population.

Este estudo clínico investigou se a imersão diária de próteses parciais removíveis (PPR) em limpador químico reduz as contagens de micro-organismos no biofilme. Vinte e cinco voluntários que utilizavam PPR foram selecionados e instruídos a complementar a higiene das PPRs imergindo suas próteses em um limpador químico enzimático (Polident® 3 minute) uma vez por dia, por 3 min, durante 15 dias. O biofilme foi coletado da superfície das próteses com auxílio de um swab imediatamente antes (baseline) e após o período experimental. A amostra foi imersa em solução salina estéril, submetida a sonicação a 7 W, e semeada em meios de cultura específicos para quantificar micro-organismos totais, estreptococos totais e Candida spp. Os dados de ambas as coletas foram comparados pelo teste t pareado (α=0,05). Foi observada uma redução significativa nas contagens de micro-organismos totais no biofilme da PPR após o uso do limpador químico (p=0,007). Essa redução também foi observada para estreptococos totais (p=0,0428), mas não foi observada diferença nas contagens de Candida spp. Concluiu-se que o uso diário do limpador químico melhorou a higienização das próteses por reduzir o número de micro-organismos totais e estreptococos totais na superfície da PPR, mas não teve efeito sobre a população de Candida spp.