The effect of nanodiamonds on candida albicans adhesion and surface characteristics of PMMA denture base material - an in vitro study

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.

Isolation of Candida spp. from denture-related stomatitis in Pará, Brazil

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.

Phagocytosis and nitric oxide production by peritoneal adherent cells in response to Candida albicans in aging: a collaboration to elucidate the pathogenesis of denture stomatitis

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.

Identificación bacteriana en superficies de resina acrílica / Bacterial identification on acrylic resin surfaces

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 patient’s 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.

Ocurrencia de levaduras del género Candida y estomatitis protésica antes y después del tratamiento rehabilitador basado en prótesis removible / Occurrence of genus Candida yeast and prosthetic stomatitis before and after rehabilitation treatment based on removable prosthesis

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.

Resposta imune inata na estomatite protética: interação in vitro entre células epiteliais de palato humano e Candida albicans / Innate imune response in denture stomatitis: in vitro interaction between human palatal epithelial cells and Candida albicans

A presença de Candida albicans nos biofilmes microbianos da superfície interna das próteses totais superiores está relacionada com uma doença inflamatória no palato, a estomatite protética. Constituinte da defesa inata do hospedeiro, o epitélio bucal, por sua vez, tem a capacidade de reconhecer e reagir aos fatores fúngicos a fim de evitar a invasão pelo microrganismo. O objetivo deste trabalho foi avaliar in vitro o efeito direto e indireto de C. albicans viável sobre as células epiteliais de palato humano (CEPH) ao longo do tempo. Objetivamos correlacionar os eventos de agressão, apoptose e invasão das CEPH provocados pelo fungo, com as respostas de defesa epitelial mediante produção de óxido nítrico (NO) e expressão gênica do peptídeo antimicrobiano β-defensina 2 (hBD-2). Material e Métodos: As CEPH foram obtidas, parte pelo método explante e parte pelo método enzimático, e mantidas em co-cultivo sobre uma camada de sustentação feederlayer (fibroblastos gengivais humanos mitoticamente inativados). Após desafios das CEPH com C. albicans ATCC 90028 por contato direto fungo-epitélio (D.D.) e indireto pelo sobrenadante da cultura do fungo hifal (D.I.), proporções de desafio de 0,01/1; 0,025/1 e 0,1/1 levedura/queratinócito (FUN/EPI) e tempos experimentais de 3, 6 e 10 h foram determinados; via ensaios de viabilidade celular por imunofluorescência (LIVE/DEAD), e análise qualitativa da invasão celular pelo fungo por meio do método colorimétrico com laranja de acridina. A apoptose epitelial foi determinada pela marcação nuclear fluorescente com Hoechtst 33258. A produção de óxido nítrico (NO) e a expressão de RNAm de hBD-2 foram avaliados por reação colorimétrica de Griess e RT-qPCR, respectivamente. Os resultados foram expressos como média ± desvio padrão e submetidos aos testes estatísticos ANOVA Fatorial, Teste de Contraste; ou Teste de Mann-Whitney (p<0,05). Resultados: Em 3 h, foi detectado aumento da apoptose das células epiteliais em relação ao...

The presence of the fungus Candida albicans in the microbial biofilm underlying maxillary prosthesis is related to an inflammatory reaction of the palatal mucosa, the denture stomatitis. As a component of the host innate defense, the oral epithelium has the ability to recognize and react to fungal factors in order to prevent the microrganism invasion. The aim of this study was to in vitro evaluate the direct and indirect effect of viable C. albicans on the human palatal epithelial cells (HPEC) over time. The aggressive events, such as apoptosis and HPEC invasion by the fungus, were correlated with epithelial defense responses through the nitric oxide (NO) production and antimicrobial peptides β-defensin (hBD-2) mRNA expression. Methods: The HPEC were obtained by explant and enzymatic methods, and were maintained in co-culture on a feeder-layer support (mitotically inactivated human gingival fibroblasts). After the HPEC challenges with C. albicans ATCC 90028 by direct contact fungus-epithelium (D.D.) and indirect contact by supernatant from hyphal fungus (D.I.), defiance ratios of 0.01/1, 0.025/1 and 0.1/1 yeast/keratinocyte (FUN/EPI) and experimental times of 3, 6 and 10 h were determined. These conditions were standardized by cell viability immunofluorescence assay (LIVE/DEAD), and cell invasion qualitative analysis (colorimetric method with acridine orange). The apoptotic cells were determined by fluorescent nuclear staining with Hoechtst 33258. The nitric oxide (NO) production and hBD-2 gene expression were evaluated by Griess colorimetric reaction and RT-qPCR, respectively. The results were expressed as mean ± standard deviation and were analyzed using the factorial ANOVA, Contrast Test; or Mann-Whitney Test (p<0,05). Results: At 3 h, the apoptotic epithelial cells under 0.1/1 FUN/EPI increased compared to epithelium unchallenged (p<0,05) that remained over time with increasing concentration and independent of D.D. and D.I. The onset...

Effectiveness of mechanical brushing with different denture cleansing agents in reducing in vitro Candida albicans biofilm viability

The adhesion of Candida albicans to surfaces is the prerequisite for occurrence of denture stomatitis, a common disease diagnosed among denture wearers. A routine of denture cleansing is essential to prevent biofilm formation and the onset of this infection. The aim of this study was to investigate the effectiveness of combining brushing and cleansing agents in killing C. albicans biofilm. Disks of acrylic resin were made, sterilized, and inoculated with C. albicans (10(7) cfu/mL). After incubation (37°C/48 h), specimens were randomly assigned to 10 experimental groups (n=9): 5 subjected to brushing with distilled water or cleansing agents - dentifrice slurry, 2% chlorhexidine gluconate (CHX), 1% sodium hypochlorite (NaOCl), and Polident fresh cleanse® (combined method) - and 4 exposed to the cleansing agents without brushing (immersion). Non-cleansed specimens were used as positive controls. The viability of cells was evaluated by XTT reduction method. Results were analyzed by Mann-Whitney and Kruskal-Wallis tests (α=0.05). The combined method was significantly more effective (p<0.0001) in reducing biofilm viability than the immersion. Brushing with CHX and NaOCl resulted in 100% removal of the biofilm. Immersion in the agents reduced significantly (p<0.0001) the biofilm viability, with CHX being the most effective (p<0.0001). The use of the combined method of brushing with cleansing agents is an effective method to reduce C. albicans biofilm, being CHX and NaOCl the most effective solutions.

A adesão de Candida albicans às superfícies é o primeiro passo para o desenvolvimento da estomatite protética, uma infecção frequente diagnosticada entre os usuários de próteses. Uma adequada higienização é essencial para prevenir a formação de biofilme microbiano e o início desta infecção. O objetivo deste estudo foi avaliar a efetividade da escovação com diferentes soluções na eliminação de biofilme de C. albicans. Para isso, discos de resina acrílica foram confeccionados, esterilizados e inoculados com uma suspensão de 10(7) células/mL de C. albicans. Após incubação (37°C/48 h), os espécimes foram aleatoriamente divididos em 10 grupos experimentais (n=9): 5 submetidos à escovação com água ou agentes de limpeza (água destilada, dentifrício, digluconato de clorexidina (CHX) a 2%, hipoclorito de sódio (NaOCl) a 1% e Polident fresh cleanse®) e 4 apenas imersos nos agentes de limpeza. Espécimes não submetidos à higienização foram utilizados como controle positivo. A viabilidade celular foi verificada pelo teste de redução do XTT. Os resultados obtidos foram analisados pelos testes de Mann-Whitney e Kruskal-Wallis (α=0,05). A escovação com todos os agentes de limpeza apresentou redução significativamente superior (p<0,0001) na viabilidade do biofilme quando comparada à exposição dos espécimes às soluções. Escovação com CHX a 2% e NaOCl a 1% resultaram em 100% de inativação do biofilme. A exposição aos agentes de limpeza resultou em redução significativa (p<0,0001) na viabilidade celular, com CHX a 2% sendo o mais efetivo (p<0,0001). A utilização de agentes de limpeza em associação ao método de escovação provou ser efetivo para reduzir biofilme C. albicans, sendo as soluções de CHX e NaOCl as mais efetivas.

In vivo efficacy of alkaline peroxide tablets and mouthwashes on Candida albicans in patients with denture stomatitis

OBJECTIVE: Effective cleaning of dentures is important for the maintenance of good oral hygiene for denture stomatitis patients. The in vivo efficacy of three different brands of alkaline peroxide tablets (Polident, Efferdent, and Fittydent) and two mouthwashes (CloSYS II and Corsodyl) to eliminate Candida albicans on dentures was evaluated in this in vivo study. MATERIAL AND METHODS: Ninety denture wearers with clinical evidence of denture stomatitis were randomly divided into 5 test groups and 1 control group. Each group was further divided into three subgroups in which the dentures were subjected to 15-, 30-, and 60-min disinfection procedures. The dentures of each test group were treated with one of the cleaners, while those of the control group were treated with distilled water. Swab samples from the palatal surfaces (2 cm x 2 cm template delimited area) of the upper dentures were obtained before and after 15, 30, and 60 min periods of cleaner use and examined mycologically. RESULTS: The reduction in the number of colony-forming units (CFU) of C. albicans before, and after 15, 30, and 60 min of use of CloSYS II and Corsodyl was significantly greater than that of the control group (p<0.05). Moreover, there was no statistically significant difference (p>0.05) among Polident, Efferdent and the control group in any of the treatment periods. Dentures treated with Fittydent appeared to have a significantly greater reduction in the number of Candida spp. only after 60 min of treatment. CONCLUSIONS: The results of this study showed that the use of mouthwashes significantly reduced the number of microorganisms on dentures.

Atividade antifúngica de uma pomada à base de chamomilla recutita sobre candida albicans / Antifungal activity of chamomilla recutita based pomade on candida albicans

O objetivo do estudo foi avaliar a atividade antifúngica de uma pomada à base de [Chamomilla recutita (L) Rauschert] (camomila) sobre espécies do gênero Cândida. Vinte e seis isolados clínicos Cân- dida (e. a/bicans, e. dub/iniensis, e. krusei, e. parapsi/osis) e três cepas de referência foram semeadas em ágar Sabouraud dextrose a 3rC/24h antes da realização do experimento. Foi realizada a diluição seriada do produto nas concentrações de 500f0, 250f0, 12,5%, 6,25%, 3,12%, 1,56% e 0,78% em ágar RPMI tamponado com MOPS. Foram obtidas suspensões padronizadas na escala 5 de McFarland em solução fisiológica esterilizada (NaCI 0,9%) de cada isolado a ser avaliado. Posteriormente, as suspensões dos microrganismos foram semeadas em placas de Petri contendo o produto teste + ágar RPMI através de replicador de Steers e incubadas em estufa bacteriológica a 3rC/24h. Um controle de crescimento foi incluído no estudo e os testes foram realizados em duplicata. O resultado foi avaliado através da observação da presença ou ausência de crescimento de colônias no ágar. Os testes mostraram que das 26 amostras avaliadas, 14 amostras (53,9%) foram inibidas na concentração de 500f0, 11 amostras (42,3%) foram inibidas na concentração de 25%, uma amostra (3,9%) foi inibida na concentração de 12,5%. A pomada não teve efeitos inibitórios sobre a cepa de referência e. krusei. A partir dos resultados obtidos, concluiu-se que o produto testado apresentou atividade antifúngica in vitro sobre a maioria dos isolados de Cândida avaliados.

The aim of this study was to evaluate the antifungal activity of a chamomile [Chamomilla recutita (L) Rauschert] based ointment. Twenty-six clinical isolates of Candida (e. a/bicans, e. dub/iniensis, e. krusei, e. parapsi/osis) and three reference strains were spread onto Sabouraud dextrose agar and incubated under 37°C/24 h before the experiment. The ointment was serially diluted (500f0, 25%, 12.5%, 6.25%,3.12%, 1.56% and 0.78%) in RMPI agar buffered with MOPS. Standardized suspensions of each strain were prepared in saline solution (NaCl 0.9%) based on scale 5 of McFarland. Next, the suspensions of each microorganism were plated on Petri using a Steers replicator and incubated at 37°C/24 h. A positive control was included and the tests were performed in duplicate. The result was evaluated by the observation the presence or absence the colonies on the agar. The tests showed that from the 26 isolates evaluated, 14 (53,9%) were inhibited by the concentration of 500/0, 11 strains (42,3%) were inhibited by the concentration of 25%, one strain (3.9%) were inhibited by the concentration of 12.5%. The ointment did not show inhibitory effects on e. krusei reference strain. Based on the results obtained, we concluded that the product evaluated showed antifungal activity in vitro on the majority of the tested isolates.

Estudo da função dos neutrófilos nos mecanismos de defesa contra a estomatite por dentadura em indivíduos idosos / Study of neutrophils from elderly in the defense mechanisms against Candida-related denture stomatitis

Os neutrófilos são as primeiras células a migrar para sítios de infecção e desempenham importante papel na defesa contra vários patógenos, especialmente Candida albicans. A função dos neutrófilos envolve fagocitose e destruição de leveduras e formas filamentosas do fungo, além de produção de citocinas e quimiocinas, capazes de ativar outras células envolvidas na eliminação de C. albicans. Recentemente, tem sido mostrado que estas células apresentam prejuízos com o avanço da idade e estes fenômenos fazem parte de uma área da Imunologia conhecida como Imunossenescência. A estomatite protética é a lesão oral mais verificada em idosos e a sua persistência é diretamente relacionada com a presença de espécies de Candida, principalmente C. albicans, nas lesões e na superfície interna de próteses, especialmente totais superiores (PTS). Com o objetivo de avaliar possíveis alterações em neutrófilos que poderiam predispor usuários de prótese total superior à estomatite protética, foram analisados neutrófilos de sangue e de saliva de idosos e jovens com estomatite protética associada à Candida (EPC), bem como de indivíduos controles. No primeiro capítulo foi avaliada a positividade de Candida e as diferentes espécies deste patógeno em lesões de estomatite protética e superfície interna de PTS. C. albicans foi a espécie mais detectada em lesões de EP e na PTS. No segundo capítulo, os neutrófilos do sangue dos indivíduos da pesquisa foram caracterizados quanto ao fenótipo ex vivo, função fagocítica e produção de citocinas e quimiocinas após desafio com C. albicans. Neutrófilos do sangue de indivíduos com EPC, bem como de idosos sem EPC, apresentaram características relacionadas com suscetibilidade às doenças causadas por C. albicans. No terceiro capítulo, os neutrófilos salivares dos indivíduos foram caracterizados quanto ao fenótipo ex vivo e função fagocítica após desafio com C. albicans. Além disso, níveis de citocinas e quimiocinas relacionadas com resposta imune de...

Neutrophils are the first line of immune cells to migrate into infection sites, playing an important role against pathogens, especially Candida albicans. These cells phagocytose and destroy yeasts or filamentous forms of this fungus, beyond secrete cytokines and chemokines that activate other immune cells to eliminate C. albicans. Nowadays, it has been shown that the ageing damages neutrophil function and such events are described as part of Imunosenescence. Denture stomatitis is the most oral lesion present in elderly, and its persistence is related to Candida species, especially C. albicans, in the lesions and prosthesis fitting surface, particularly maxillary prosthesis (MP). In order to evaluate possible neutrophil alterations predisposing denture wearers to Candida- related denture stomatitis (DS), blood and salivary neutrophils from elderly and younger individuals with DS, as well control ones, were analyzed. Thus, the first chapter addresses the presence of Candida species on the denture stomatitis lesions and MP fitting surface. C. albicans was the most species detected in DS lesions and MP. On the second chapter, blood neutrophils from the individuals were characterized about ex vivo phenotype, phagocytic function, and cytokines and chemokines production after challenged with C. albicans. Blood neutrophils from DS individuals, as well elderly without DS, presented characteristics of susceptibility to C. albicans diseases. On the third chapter, salivary neutrophils from the individuals were characterized about ex vivo phenotype and phagocytic function against C. albicans. In addition, salivary cytokines and chemokines involved with resistance or susceptibility to C. albicans infection were detected. Results indicated differences in salivary neutrophils and soluble components from patients with DS. In addition, alterations observed in neutrophils by immunosenescence could facilitate Candida...

Vinegar as an antimicrobialagent for control of Candida spp. in complete denture wearers

The use of denture is known to increase the carriage of Candida in healthy patients, and the proliferation of Candida albicans strains can be associated with denture-induced stomatitis. The aim of this study was to evaluate the use of vinegar as an antimicrobial agent for control of Candida spp. in complete upper denture wearers. Fifty-five patients were submitted to a detailed clinical interview and oral clinical examination, and were instructed to keep their dentures immersed in a 10%vinegar solution (pH less than 3) overnight for 45 days. Before and after the experimental period, saliva samples were collected for detection of Candida, counting of cfu/mL and identification of species by phenotypical tests (germ tube formation, chlamidoconidia production, and carbohydrate fermentation and assimilation). The results were analyzed using Spearman's correlation and Student's t-test (p£0.05). Candida yeasts were present in 87.3% of saliva samples before the treatment. A significant reduction was verified in CFU/mL counts of Candida after treatment. A positive correlation between Candida and denture stomatitis was verified, since the decrease of cfu/mL counts was correlated with a reduction in cases of denture stomatitis. Although it was not able to eliminate C. albicans, the immersion of the complete denture in 10% vinegar solution, during the night, reduced the amounts (cfu/mL) of Candida spp. in the saliva and the presence of denture stomatitis in the studied patients.

Estomatitis subprótesis: estudio clínico y microbiológico de candida / Denture stomatitis: clinical and microbiological study of candida

La estomatitis subprótesis es una patología asociada al uso de prótesis dentales removibles. Su diagnóstico es fundamentalmente clínico y se basa en el reconocimiento de sus lesiones, siendo una de la clasificación de Newton una de las más aceptadas. Además, el diagnóstico debe ser confirmado por la observación microscópica de Candida en las muestras orales. El objetivo de este estudio fue determinar las especies de Candida más frecuentes en la mucosa del paladar y determinar la susceptibilidad in vitro de estas cepas a Nistatina y a Fluconazol. Se examinaron un total de 100 pacientes portadores de prótesis removibles determinando la presencia o ausencia de ES según la clasificación de Newton. A cada paciente se le tomó una muestra de la zona palatina y se le realizó el examen microbiológico. El 75 por ciento de los pacientes presentó alteraciones en la mucosa palatina compatibles con ES (33 por ciento presentó ES tipo I, 42,7 por ciento tipo II y 24 por ciento tipo III; mientras que un 25 por ciento presentó una mucosa sana. EL 53,3 por ciento de los pacientes con ES presentó cultivo positivo para Candida, mientras que un16 por ciento en la mucosa normal. Las especies de Candida albicans fueron las más frecuentemente aislada (75 por ciento), seguida por la C. tropicallis (15 por ciento) y en el resto de los cultivos se presentaron ambas especies (10 por ciento). El 100 por ciento de las cepas estudiadas fueron sensibles a Nistatina y Fluconazol, lo que se evidenció por la formación de un halo de inhibición amplio entre las levaduras. Existe una correlación positiva entre la ES y la presencia del género Candida, siendo la especie C. albicans quien se aisló conmayor frecuencia desde la mucosa palatina de pacientes con ES y sin ella. Todas las levaduras encontradas fueron susceptibles a Nistatina y Fluconazol in vitro, demostrando su efectividad fungicida ante especies del género Candida.

Denture stomatitis (DS) is a condition associated with the use of removable dentures. Its diagnosis is mainly clinical and based in recognition of their injuries, being the Newton’s one of the most accepted classifications. It stresses that the diagnosis should be confirmed by microscopic observation of Candida in oral samples. The aim of this study was to determine the species of Candida more frequent in the palatal mucosa and determine in vitro susceptibility to Nystatin and Fluconazole of these isolated strains. A total of 100 patients were examined by identifying the removable prosthesis presence or absence of DS according to the classification of Newton. Each patient had a complete sample of the area and palate was carried out microbiological examination. 75 percent of patients had abnormalities in the palate mucosa compatible with DS (33 percent presented DS type I, type II 42.7 percent and 24 percent Type III), while 25 percent filed a healthy mucosa. In 53.3 percent of patients with DS presented positive culture for Candida, only 16% had positive culture in the normal mucosa. The species of Candida albicans were the most frequently isolated (75 percent ), followed by C. tropicallis (15 percent ) and the rest of the crops were presented both species (10 percent ). 100 percent of the strains were sensitive to Nistatina and Fluconazole, which was evidenced by the formation of inhibition area in yeast. There is a positive correlation between the DS and the presence of Candida, being C. albicans the kind who was isolated most frequently from the mucosa of patients with DS palate and healthy patients. All yeast were found susceptible to Nystatin and Fluconazole in vitro, demonstrating its effectiveness in Candida.

Development of Candida-associated denture stomatitis: new insights: [review]

Despite therapeutic progress, opportunistic oral fungal infectious diseases have increased in prevalence, especially in denture wearers. The combination of entrapment of yeast cells in irregularities in denture-base and denture-relining materials, poor oral hygiene and several systemic factors is the most probable cause for the onset of this infectious disease. Hence colonization and growth on prostheses by Candida species are of clinical importance. The purpose of this review is to critically discuss several key factors controlling the adhesion of Candida species which are relevant to denture-associated stomatitis. Although there is some consensus on the role of surface properties, studies on several other factors, as the use of denture liners, salivary properties and yeast-bacterial interactions, have shown contradictory findings. A comprehensive fundamental understanding is hampered by conflicting findings due to the large variations in experimental protocols, while other factors have never been thoroughly studied. Surface free energy and surface roughness control the initial adherence, but temporal changes have not been reported. Neither have in vivo studies shown if the substratum type is critical in dictating biofilm accumulation during longer periods in the oral environment. The contribution of saliva is unclear due to factors like variations in its collection and handling. Initial findings have disclosed that also bacteria are crucial for the successful establishment of Candida in biofilms, but the clinical significance of this observation is yet to be confirmed. In conclusion, there is a need to standardize experimental procedures, to bridge the gap between laboratory and in vivo methodologies and findings and - in general - to thoroughly investigate the factors that modulate the initial attachment and subsequent colonization of denture-base materials and the oral mucosa of patients subjected to Candida infections. Information...

Detección de Cándida albicans en pacientes con estomatitis subprotésica, medicados con anfotericina tópica / Detection of Candida albicans in patients with denture stomatitis medicated with topical amphotericin

La administración de diversos agentes antifúngicos como la anfotericina tópica, ha sido de suma utilidad en el tratamiento de la estomatitis subprotésica inducida por Cándida. No obstante, se ha informado la presencia de levaduras pertenecientes al género Candida, principalmente Candida albicans, tanto en paladar como en las dentaduras de estos pacientes, luego de varios días de tratamiento con el antimicótico antes mencionado. El propósito de este estudio fue detectar C. albicans en pacientes con E.S.P. medicados con anfotericina tópica (Vencidin)(R). Los resultados de este trabajo indicaron que C. albicans se encontró en una alta proporción de las muestras tomadas de prótesis de los pacientes con E.S.P. tratgados con esta droga, luego de 15 días de tratamiento, no así en las muestras tomadas del paladar. Estos resultados conllevan a la necesidad de implementar distintas medidas terapéuticas dirigidas a la eliminación de la E.S.P. inducida por Cándida, bien sea incrementando la dosis o la frecuencia de administración de la anfotericina tópica o mediante el empleo de otros medicamentos antifúngicos efectivos, tanto al paladar infectado como a la prótesis.

Relación entre la placa dental y la estomatitis subprotÚsica / Relationship between dental plaque and denture stomatitis

En el presente artÝculo se hace una revision sobre diversos aspectos inherentes a la placa dental que se localiza sobre la superficie interna de las prótesis como agente etiológico de estomatitis subprotÚsica, y se mencionan los principales microorganismos que pueden encontrarse en dicha placa

Mecanismos de defensa del hospedero en estomatitis subprotÚsica inducida por Cßndida / Host defense mechanisms in Candida-induced denture stomatitis

La estomatitis subprotÚsica (E.S.P.) es una entidad que se localiza principalmente en la mucosa del paladar que se encuentra por debajo de la superficie de ajuste de las prótesis removibles parciales y totales. Esta patologÝa es mßs común en hombres que en mujeres y se observa mßs frecuentemente en sujetos con edades comprendidas entre 25 a 90 años. Diversos estudios han revelado que la E.S.P. estß asociada con la deteccion de especies de Cßndida y otros microorganismos, mientras que otros factores tales como trauma, ciertas enfermedades sistÚmicas y alteraciones del sistema inmune pueden estar involucrados, por lo que el hospedero responde mediante ciertos mecanismos ante la presencia de esta enfermedad. De allÝ que se han propuesto dos lÝneas de defensa ante la presencia de E.S.P. inducida por Cßndida; la primera de Ústas incluye entre otros: 1) factores fÝsicos, donde se destaca el papel que juegan las membranas mucosas bucales como barreras anatómicas; 2) compuestos salivales como la lisozima, lactoferrina e histatinas que inhiben el crecimiento de Cßndida y la interferencia de la microbiota bucal, la cual limita el sobrecrecimiento de este hongo, en tanto que la segunda destaca bßsicamente los mecanismos de inmunidad celular y humoral a nivel de los tejidos, haciendo Únfasis en la capacidad por parte de los polimorfonucleares y de los leucocitos eosinófilos de fagocitar a Cßndida, asÝ como el rol que juegan los anticuerpos como mecanismos de defensa contra esta enfermedad

Algunas consideraciones sobre el tratamiento de la estomatitis subprotÚsica de origen infeccioso / Some considerations on the treatment of denture stomatitis of infectious origin

En el presente artÝculo se hace una revisión bibliogrßfica sobre las diferentes modalidades de tratamiento de la estomatitis subprotÚsica, particularmente en aquellos tipos de lesiones donde el agente etiológico principal es de origen microbiano, particularmente debido a los microorganismos del gÚnero Cßndida y en especial Cßndida albicans

Detección de especies de Cándida en pacientes con estomatitis subprotésica / Detection of Candida species in patients with denture stomatitis

La estomatitis subprotésica (E.S.P.) es una de las patologías que se presentan con más frecuencia a nivel mundial en la población total y parcialmente edéntula portadora de prótesis dental removible. Se han señalado diversos agentes involucrados en la etiología de esta entidad, entre otros: alergia, estrés, trauma y factores endógenos relacionado con enfermedades sistémicas, pero cobra especial importancia como agente etiológico la infección producida por microorganismos del género Cándida, principalmente C. albicans. No obstante, algunos autores cuestionan el hecho de que C. albicans sea el único agente implicado en la etiología de la E.S.P. y refieren que otras especies de Cándida también se encuentran implicadas en la etiología y desarrollo de esta afección. El objetivo de este estudio fue detectar las especies de Cándida presentes en pacientes con E.S.P. que acudieron al Servicio de Clínica Estomatológica de la Facultad de Odontología UCV. Se seleccionaron 40 pacientes, los cuales fueron divididos en 2 grupos: 1) grupo experimental, conformado por 30 pacientes con E.S.P. y 2) grupo control, conformado por 10 pacienrtes sin E.S.P. La identificación de las especies de Cándida se basó en la observación de las colonias, en la visualización de las levaduras, tubos germinales y clamidosporas, así como en la realización de pruebas rápidas de asimiliación de carbohidratos mediante el sistema API 20 C AUX (Biomerieux). Los resultados de este estudio demostraron que C. albicans fue la especies más frecuentemente detectada en los pacientes con E.S.P. tanto a partir de muestras tomadas de paladar como de prótesis, en tanto que otras 6 especies de C. se encontraron en una baja porporción de pacientes con esta lesión. De igual forma, C. albicans se identificó en algunos de los pacientes del grupo control a partir de muestras tomadas de paladar

Estudio de la eficacia del miconazol tópico (Daktarin jalea oral) en pacientes con estomatitis subprotésica inducida por Cándida / Study of the effectiveness of topical miconazole (Daktarin oral) on patients with Candida-induced denture stomatitis

La estomatitis subprotésica (E.S.P.) describe cambios patógenos encontrados en los tejidos de soporte de la dentadura. Dichos cambios se caracterizan por la presencia de un eritema, debido entre otros factores a la proliferación de un microorganismo del género Cándida. El objetivo del presente trabajo fue comprobar la eficacia del miconazol tópico en forma de gel o jalea oral (Daktarin) sobre la mucosa afectada de un grupo de pacientes con diagnóstico de E.S.P. inducida por Cándida. En esta investigación se seleccionaron 30 de los 41 pacientes que acudieron al Servicio de Clínica Estomatológica "Magadalena Matta de Henning" con diagnóstico presuntivo de E.S.P.; éstos fueron divididos en 3 grupos de 10 pacientes cada uno: grupo A: los cuales fueron medicados con Daktarin jalea oral 4 veces al día, tanto en el paladar como en la prótesis, durante 21 días; grupo B, quienes fueron medicados con Daktarin jalea oral 3 veces al día, en paladar y prótesis, durante 21 días; grupo C, a quienes se les administró un placebo 4 veces al día, en paladar y prótesis, durante 21 días. De igual manera, se les dictaron instrucciones a todos los pacientes en relación con el mantenimiento de una adecuada higiene bucal, previa administración del tratamiento antibótico.. En este estudio se demostró que el tratamiento antimicótico con Daktarin jalea oral es eficaz contra la E.S.P. inducida por Cándida

Factores determinantes de patogenicidad en relación a la ecología de Cándida albicans en cavidad bucal / Factors determining the pathogenicity in relation with the ecology of Candida albicans in the oral cavity

En este artículo se hace referencia a los factores determinantes de patogenicidad que influyen en la boca para que Cándida albicans, como residente habitual de la misma, pase de saprófito a patógeno. Se hace referencia a las prótesis odontológicas, así como a lesiones producidas por las mismas asociadas a Cándida