Development of an evidence-based prosthodontic record: an action research study

This study sought to develop a database in the field of removable prosthodontics by using a participatory action research method. Data collection consisted of a comprehensive literature review, focus-group discussions, and interviews. Applying action research methods ensures consideration of the needs, perspectives, and expertise of academia in the design and implementation of an evidence/ research-based patient record, and academic educators are well placed to conduct such research.

The association of denture stomatitis and partial removable dental prostheses: a systematic review

PURPOSE

The aim of this systematic review was to analyze the evidence on the occurrence of denture stomatitis (DS) and potential risk factors in patients wearing partial removable dental prostheses (RDPs).

MATERIALS AND METHODS

MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews were searched and complemented by manual searching. Outcome measures were the presence of DS in patients wearing partial RDPs and an assessment of associated risk factors. All types of experimental and observational studies investigating an association between DS and the wearing of partial RDPs were included. Methodologic quality and level of evidence were assessed using valid scales. Two authors performed study selection, data extraction, and quality assessment independently.

RESULTS

A total of eight studies met the inclusion criteria. The prevalence of DS in partial RDP wearers ranged from 1.1% to 36.7%. Data on the potential risk factors were not consistent. Despite the heterogeneity and methodologic quality of included studies, an association between DS and the wearing of partial RDPs was found.

CONCLUSIONS

There is some evidence that the presence of DS is associated with the wearing of partial RDPs. However, because of methodologic limitations and cross-sectional designs of research studies, no cause-effect relationship could be inferred. Future research should provide higher levels of evidence to confirm the etiology of DS in partial RDP wearers.

The relationship of myceliated colonies of Candida albicans with denture stomatitis: an in vivo/in vitro study

PURPOSE

Switching from smooth to myceliated colonies, a virulent trait of Candida albicans, may be implicated in Candida-associated denture stomatitis. The purpose of this study was to verify the relationship between the presence of denture stomatitis and the frequency of myceliated colonies of C. albicans isolates in denture wearers. Prevalence of denture stomatitis and influence of putative risk factors were also investigated.

MATERIALS AND METHODS

Demographic and clinical data concerning oral and general health, smoking, denture status, diet, and hygiene habits of 40 complete maxillary denture wearers were collected from an autoevaluation questionnaire and oral examination. Detection of C. albicans in denture plaque and evaluation of hairy phenotype colonies were carried out on low nutrient media. Eleven subjects were followed-up at 1 month and 3 months after delivery of a new prosthesis. Results were statistically analyzed.

RESULTS

Prevalence of denture stomatitis was 77.5%. No statistically significant relation was found between presence of stomatitis and frequency of myceliated colonies of C. albicans or presence of yeast. However, the study confirmed a statistically significant difference between Newton types IA and IIB stomatitis in relation to yeast colony-forming units, which were more than 300 times higher in type IIB. A direct relationship was observed between the presence of C. albicans and nocturnal denture use (P = .01) and an inverse relation was observed with brushing of the palate (P = .03).

CONCLUSION

The ability of C. albicans strains isolated from dentures to produce myceliated colonies may not be directly involved in denture stomatitis.

Reassessing the presence of Candida albicans in denture-related stomatitis

OBJECTIVE

The aim of this study was to reevaluate the link between Candida albicans and denture-related stomatitis according to a modified Newton classification, which reflects the classic types of inflammation as well as the extent to which the tissue is affected.

STUDY DESIGN

Two groups of denture wearers were evaluated for denture-related stomatitis. The presence and number of yeasts on the dentures, the identification of the Candida species present, and the amount of plaque coverage were determined. Putative risk factors were included in the study. Relations between these variables and stomatitis were analyzed statistically.

RESULTS

According to Newton's classification, the presence of yeast on the denture was not linked to whether subjects had stomatitis. But with our classification, higher prevalence of yeast carriers, yeast colony number, and plaque coverage were found on the dentures of individuals with the most extensive inflammation, regardless of Newton type. Among risk factors evaluated, wearing dentures at night and smoking were associated with the most extensive inflammation. We also demonstrated that the presence of C albicans as well as the cohabitation of different Candida species was more frequent in denture-related stomatitis. The differences were statistically significant.

CONCLUSIONS

Statistical analysis of microbiologic data from different denture-related stomatitis categories according to our modified classification showed that the presence of yeast on dentures was significantly associated with the extent of the inflammation, rather than with the Newton type. Our findings suggest that the inflammatory process of stomatitis favors the colonization of Candida. These results could have new implications for diagnosis and management of the condition.