A Systematic Review of Denture Stomatitis: Predisposing Factors, Clinical Features, Etiology, and Global Candida spp. Distribution.

Denture stomatitis (DS) is a very common disease in wearers of removable complete and partial dentures with a worldwide prevalence in the range of 20-67%. Both industrially developed and impoverished nations are affected by the illness. DS is often associated with ill-fitting dentures or a fungal infection with Candida spp. Candida is normally found in the oral cavity microbiota, but it can be harmful to the health of elderly people with underlying diseases. Therefore, the purpose of the present study is to offer the most recent information about the epidemiology, etiology, and global distribution of Candida species associated with DS through a systematic review. Several databases, including Medline, Web of Science, and Scopus, were used to conduct an extensive search of the literature published in the previous 20 years. The selection of studies was performed by two authors. The extracted data were as follows: author, year of publication, country, sample, frequency of DS, method of diagnosing stomatitis, species of Candida, risk factors, and etiology of the disease. The JBI Critical appraisal tools were used to assess the quality of the studies. Eventually, twenty-eight studies were included in the systematic review. Twenty-one studies investigated DS, while seven studies examined Candida colonization in patients using removable dentures. The results show that the main causes of DS include the type of dentures, continuous wearing of dentures, and the formation of a Candida biofilm, which is facilitated by poor dental hygiene. Additionally, previous studies have pinpointed the significance of the salivary flow, saliva composition, and salivary pH. The findings of the current review indicate that it is crucial to monitor denture wearers for the appearance of DS, especially the patients whose immunity has been impaired due to a systemic condition. Finally, frequent follow-ups should include a clinical examination and microbial swabs of the palatal mucosa and the mucosal surface of the denture.

The use of digital texture image analysis in determining the masticatory efficiency outcome.

The mixture level of gum samples consisting of two colours can be assessed visually, using the electronic colorimetric method, employing digital image processing techniques and specially designed software. The study investigates the possibility of an alternative method called "digital texture image analysis" (DTIA) to assess improvement of masticatory efficiency in denture wearers. The objectives were i) to evaluate whether DTIA discriminates changes in the colour mixing ability within a group over time; ii) to determine whether DTIA can be used to detect improvement in chewing ability; iii) to select the most appropriate DTIA feature that sufficiently describes masticatory efficiency in CDs wearers. The study was designed as an intra-individual evaluation of masticatory efficiency, which was assessed in participants with new dentures in three follow-up times. A set of four texture features was used in the current study. Uniformity, Contrast, Homogeneity and Entropy of the obtained chewing-gum samples were correlated to the degree of gum comminution. A statistically significant difference in masticatory efficiency was observed based on the values of the analysed DTIA variables of gum samples-Uniformity, Contrast, Homogeneity, and Entropy-have changed in the participants during the observation period. The improvement of the masticatory function in relation to the mixing ability of two-coloured chewing gum could be traced by monitoring changes in the values of DTIA variables. The most increasement of masticatory efficiency was observed by monitoring DTIA parameters such as contrast, and homogeneity.

Laboratory-Based Investigation of Denture Sonication Method in Patients with Candida-Associated Denture Stomatitis.

PURPOSE: Denture stomatitis (DS) is a disease characterized by inflammation and erythema of the oral mucosa areas covered by the denture. Multifactorial etiological factors contribute to DS, but it seems that Candida plays the key role. The aim of the study was to evaluate the denture sonication method to: (i) increase the possibility of diagnosing patients with Candida-associated DS; (ii) detect and identify the mixed Candida spp., and (iii) determine the Candida colony forming units (CFU) and its possible relationship with DS severity, based on Newton's classification. MATERIALS AND METHODS: The cross-sectional study conducted at the Clinic for Dental Prosthetics, Belgrade (Serbia) from June 2013 to December 2014 enrolled edentulous patients with dentures (n = 250). Patients without DS (n = 20) were the control group (CG). The patients' data were collected, and patients with DS (study group/SG) were selected and divided into SG Candida+ and SG Candida-. Based on severity of DS, the SG patients were classified in 3 groups (Newton's classification). Four sampling methods were applied to detect patients with Candida-associated DS: mucosa swab, denture swab, oral rinse, and denture sonication method. The sensitivity and specificity of denture sonication method were shown using the receiver operating characteristic (ROC) curve and the area under the curve (AUC). RESULTS: In 97 (38.8%), out of 250 clinically examined patients, DS was diagnosed. In 82 (84.5%), out of 97 mycologically examined patients, Candida-associated DS was detected when denture sonication method was applied. Additionally, using the denture sonication method we observed: (i) the largest number of Candida positive patients compared to other sampling methods (p < 0.0001); (ii) the highest number of Candida CFU/ml (105 ), and (iii) the possibility to detect mixed Candida cultures. The largest number of patients with Candida-associated DS showed type II (60%) DS, followed by type I (21%), and type III (19%) DS. CONCLUSION: The denture sonication method is easy, accurate, and sensitive, and increases the possibility of diagnosing patients with Candida-associated DS. Additionally, yeast quantification, mixed Candida spp., and non-albicans Candida were detectable when cultivation on Candida CHROMagar was performed. It was not possible using conventional methods, such as swab or oral rinse.

Development and validation of mathematical models for testing antifungal activity of different essential oils against Candida species.

OBJECTIVE: The upward trend in using plant materials introduced essential oils (EOs) as a valuable, novel, bioactive antifungal agent and as an alternative to standard treatment protocol of denture stomatitis caused by Candida species. Therefore, the aim was to evaluate the antifungal activity of different EOs and to present the response surface methodology (RSM) and artificial neural network (ANN) as possible tools for optimizing and predicting EOs antifungal activity. METHODS: Minimum inhibitory concentration (MIC) and Minimum fungicidal concentration (MFC) of the EOs against 3 species Candida spp. (C. albicans, C. tropicalis, C. glabrata) isolated in patients with DS were determined, together with optimization and prediction based on non-terpene and terpene content in EOs, using two mathematical models RSM and ANN-GA. RESULTS: The highest concentrations of EO M. alternifolia inhibited (1.6-2.8 µg/ml) and fungicided (3.5-6.0 µg/ml) all three investigated Candida spp. while the lowest concentrations of EO C. limon inhibited (0.2 - 0.5 µg/ml) and fungicided (0.6-1.1 µg/ml). Among the three types of Candida, C. glabrata was the most sensitive. The RSM modelling proved that MICs and MFCs statistically depend on non-terpene and terpene content in different EOs (<0.0001). Both models showed that a citrus oil (EO C. limon) with 89% content of terpenes and limonene as major constituent was more antifungal efficient. CONCLUSIONS: The investigated EOs showed a broad spectrum of anticandidal activity, also confirmed using the RSM and ANN-GA models. Since EOs can be cytotoxic in higher concentrations, models may be used for qualitative and quantitative dosage predictions of the antifungal activity of EOs.

The severity of denture stomatitis as related to risk factors and different Candida spp.

OBJECTIVES: 1) To select patients with Candida-related denture stomatitis (DS) and to study possible risk factors associated with DS, 2) to evaluate the severity of DS according to Newton's classification, and 3) to investigate the association between the presence of non-albicans Candida spp. (NAC) or mixed Candida spp. and the severity of DS. STUDY DESIGN: Eighty-two patients with Candida-positive DS have undergone 1) filling in the interview questionnaire, 2) clinical examination, and 3) microbiologic examination. RESULTS: A total of 113 Candida spp. isolates were obtained from Candida-positive DS patients: C. albicans (as a single species) in 47/82 (57%) patients (study group A [SG_A]) and NAC/mixed Candida spp. in 35/82 (43%) patients (SG_B). Univariate logistic regression analysis showed that older age, longer age of the mandibular denture, and ex-smoker status were associated with SG_A. A multivariate model revealed no significant predictor of DS severity. Patients from SG_A were 3 times as likely to have DS type I, while patients from SG_B were 4.9 times as likely to have DS type III. CONCLUSIONS: Our results show the association between type III of DS (by Newton's classification) and the presence of NAC or mixed Candida spp. in denture wearers.

Self-perception and satisfaction with dental appearance and aesthetics with respect to patients' age, gender, and level of education.

Introduction: Patient's subjective evaluation of dental appearance and aesthetics is becoming an increasingly important factor in aesthetic treatments and prosthetic therapy. Objective: The aim of this study was to investigate the influence of age, education level, gender, and different dental status and the appearance of the upper anterior teeth (color, size, shape, position and alignment of the anterior teeth) on the satisfaction of the respondents with dental appearance and aesthetics of their upper anterior teeth and their desire for improvement. Methods: The study encompassed 480 people aged 20 to 50 years with an average age of 30.84 years. There were 236 male and 244 female subjects. The respondents were interviewed using a questionnaire specially designed for the purpose of this research. For the study, the subjects were divided into the following three age groups: the younger age group (20­30 years of age), the middle age group (31­40 years of age), and the older age group (41­50 years of age). Results: The conducted study did not reveal statistical significance with respect to gender in any of the examined parameters (p > 0.05). A little more than one half of the respondents in each age group were satisfied with their dental appearance and aesthetics (60.3% of the respondents in the age group of 20­30 years, 55.7% in the age group of 31­40, and 53.7% in the age group of 41­50 years of age). Satisfaction with dental appearance and aesthetics increases linearly with the increase in the level of education and was the highest among the respondents with university degree (33.3%). Conclusion: Female respondents were more dissatisfied with their dental appearance and aesthetics as compared with male respondents, but the difference was found to be non-significant. Patients with higher education level were more satisfied with their dental appearance and aesthetics than those with lower education.

[Concept of "long centric"]. / Koncept "long centric".

The objective of this paper was to show the historical perspective of the "long centric" occlusal concept and its importance in the modern dentistry, especially from the gnathological aspect. The "long centric" concept represents therapeutic modality used in modern dentistry and occlusal adjustment in all patients showing differences in strong and weak closure of the lower jaw starting from the position of physiological rest. "Long centric" concept is applied only for anterior teeth and occlusal movements from rather than toward the center. Whenever the "long centric" parameters are not adequate, occlusal disturbance, resulting from the "wedge" effect during the initial closure of the lower jaw, is present. Different degrees of abrasion or hypermobility of the teeth are often the result of the above-mentioned occlusal disturbances and can potentially trigger bruxism and malfunction. Modus procedendi should be the regular approach of every dentist to any occlusion, because only the built-in "long centric" efficiently contributes to the occlusal stability of the anterior portion of the dentition. All occlusions should be routinely tested regarding their need for "long centric", especially when the extensive therapeutic interventions (conservative, prosthetics) of the occlusal complex are required.