nystatin-a1 and Stomatitis--Denture

To evaluate the effectiveness of microwave disinfection in treating Candida-associated denture stomatitis (CADS).. The PubMed/MEDLINE, Embase, and Scopus databases were searched for reports on randomized clinical trials (RCTs) published in English until May 2020 (PROSPERO CRD42020192062) that evaluated the treatment of CADS by using microwave disinfection. The main outcomes were the improvement of clinical signs and/or the decrease in the residual yeast present on the dentures and palatal mucosa. The mean differences, standard deviations, risk ratio, and 95% confidence interval were calculated by using the random-effects model. Heterogeneity was assessed by using Cochran's Q test and I. Five RCTs with 245 participants were included. The descriptive investigations demonstrated that microwave disinfection was as effective (p > 0.05) as 0.2% chlorhexidine, 0.02% sodium hypochlorite, and topical nystatin (100.000 IU/mL), and was superior to topical miconazole in treating CADS. The metaanalysis did not show a statistical difference between microwave disinfection and nystatin (100.000 IU/mL) treatment in terms of mycological counts, cure, and recurrence rates (p > 0.05).. Microwave disinfection showed comparable results with those of conventional therapies for treating CADS. In addition, treatment with 650 W for 3 min once a week for 14 days had better cost-effect results, indicating both the prevention and treatment of CADS.. Our findings provide evidence regarding the treatment of CADS using microwave disinfection, and also indicating the best cost-effective option for this treatment modality.

Topics: Candida; Disinfection; Humans; Microwaves; Nystatin; Stomatitis, Denture

Topics: Amphotericin B; Candidiasis, Oral; Denture, Complete; Denture, Partial; Disease Susceptibility; Humans; Miconazole; Nystatin; Stomatitis, Denture

This randomized clinical trial evaluated the effectiveness of an interim denture resilient liner (Trusoft) modified with minimum inhibitory concentrations (MICs) of antimicrobial agents for Candida albicans biofilm in the denture stomatitis (DS) treatment.. Palatal smears of the Ny and Chx groups exhibited no mycelial Candida (0%) on day 14, and, at the 60-day follow-up, it was observed for only 1 participant from Chx group. MCD smears showed reduction in mycelial forms for all groups on day 14 (P<0.05), but this difference was maintained at follow-up only for the relined dentures (P<0.05). Unlike Tru and the control groups, Ny and Chx groups evidenced a significant reduction in CFU/mL values and DS severity throughout the trial (P<0.05).. The addition of nystatin and chlorhexidine at MICs to an interim resilient liner is a promising treatment for DS, with better results than those for conventional therapy with nystatin suspension, including the follow-ups.. Compared with conventional topical antifungal therapy, modifying a denture reline material with antimicrobials provided a therapeutic option for denture stomatitis. This non-invasive, straightforward therapeutic approach can be easily adopted by dentists and has the advantage of not requiring patient compliance while maintaining therapeutic concentrations on the denture base.

Topics: Antifungal Agents; Candida albicans; Chlorhexidine; Humans; Nystatin; Stomatitis, Denture

The aim of the present randomized clinical study was to compare the efficacies of photodynamic inactivation (PDI) to nystatin (NST) in terms of prevalence of Candida species in cases with denture stomatitis (DS).. Thirty-six patients were randomly divided into two groups; 18 in PDI and 18 in NST. Irradiation was carried out by using the GaA1As diode laser with wavelength, mode of transmission, laser output and energy density were standardized at 660 nm, continuous mode, 100 mW power and 28 J/cm2 respectively. The PDI was applied twice a week, with an interval of at least 48 h among the sessions during four weeks. Topical nystatin oral suspension 100,000 IU was used four times daily for 15 days. The existence of Candida spp. was confirmed by employing the microbiological culture technique. Candida colony counts from the palates and dentures surfaces, quantified as colony forming unit (CFU)/mL, measured at baseline, at the end of treatments (day 15), and at follow-up (days 30 and 60) and the prevalence of Candida spp. were identified in the two groups of treatments.. The overall CFU/mL values were higher in the dentures of the patients of both the groups than those from the palates. During all time periods of the study, the CFU/mL values obtained from both NST and PDI groups showed no significant differences. For dentures and palates, a significant reduction in mean CFU/mL values was observed on day 15 compared with baseline (day 0) in both NST and PDI groups. It can be seen that the effect size of treatments was large for the palates of patients in the NST group (1.79) and moderate for the palates of patients in the PDI group (0.63). On the other hand, the effect size was very large for the dentures for both groups (NST group = 3.01; PDI group = 1.58). C. albicans was the most common species on both dentures and palates of patients throughout the study period followed by C. tropicalis and C. glabrata.. Out of all the Candida spp., C. albicans showed the highest prevalence among all species. In addition, PDI was equally effective as nystatin for the treatment of DS.

Topics: Antifungal Agents; Candida; Humans; Lasers, Semiconductor; Mouthwashes; Nystatin; Photochemotherapy; Stem Cells; Stomatitis, Denture

Candida species have an influence in the pathogenesis of denture stomatitis. The current study aimed to investigate the efficacy of indocyanine green (ICG)-mediated photodynamic therapy (PDT) in combination with nystatin mouthwash (PDT + nystatin) for the treatment of denture stomatitis in comparison with routine antifungal therapy with nystatin alone.. In this double-blind randomized clinical trial, 66 patients were randomly assigned into PDT + nystatin (n = 33) and nystatin (n = 33) groups, both groups were treated 3-times a day (15 days) with nystatin mouthwash, and PDT was performed twice once a week for the PDT + nystatin group. Briefly, ICG was applied on the palatal lesion and laser irradiation was performed using a diode laser (810 nm, 56 J/cm. Patient treatment with nystatin or PDT + nystatin reduced the lesions extension. Candida species were isolated from all patients and the number of Candida CFU in both groups showed a significant reduction at each post-treatment visit; however, the mean reduction achieved in the PDT + nystatin group was significantly higher than nystatin alone.. ICG-mediated PDT in combination with nystatin mouthwash can improve the clinical feature of denture stomatitis with no adverse effects; therefore, it could be used as an alternative to the currently available antifungal therapy using nystatin alone.

Topics: Aged; Antifungal Agents; Candidiasis, Oral; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Indocyanine Green; Lasers, Semiconductor; Male; Middle Aged; Nystatin; Photochemotherapy; Photosensitizing Agents; Stomatitis, Denture

This study investigated the antifungal effects of low-molecular-weight chitosan solution on Candida albicans in denture stomatitis in comparison with nystatin suspension. This randomized, sing-leblind clinical trial included 40 patients diagnosed with denture stomatitis. Patients were divided into two groups, wherein one was treated with chitosan and the other with nystatin for 2 weeks. Changes in the erythematous area were recorded during and after treatment. A palatal smear was obtained for each patient before and after treatment to determine the number of blastospores and mycelia of C. albicans. The results were compared using the Mann-Whitney U test, revealing that the chitosan solution significantly decreased the erythematous surface area, burning sensation, time required for clinical improvement, and number of blastospores and mycelia. The antifungal efficacy of chitosan along with its inherent biocompatibility makes it a promising candidate for use as an antifungal mouthwash.

Topics: Antifungal Agents; Candida albicans; Chitosan; Humans; Molecular Weight; Nystatin; Single-Blind Method; Stomatitis, Denture

This study compared the effectiveness of Ricinus communis (RC) with Nystatin (NYS) and Miconazole (MIC) in the treatment of institutionalised elderly with denture stomatitis (DS). They (n = 30) were randomly distributed into three groups: MIC, NYS or RC. Clinical and mycological evaluations were performed prior to the use of the antifungal (baseline) and repeated after 15 and 30 days of treatment. The sample was clinically examined for oral mucosal conditions. Standard photographs were taken of the palate, and the oral candidiasis was classified (Newton's criteria). Mycological investigation was performed by swabbing the palatal mucosa, and Candida spp. were quantified by counting the number of colony-forming units (cfu mL⁻¹). The clinical and mycological data were analysed, respectively by Wilcoxon and Student's t-test (α = 0.05). Significant improvement in the clinical appearance of DS in the MIC and RC groups was observed between the 1st and 3rd collections (MIC - P = 0.018; RC - P = 0.011) as well as between the 2nd and 3rd collections (MIC - P = 0.018; RC - P = 0.011). Neither groups showed a statistically significant reduction in cfu mL⁻¹ at any time. Although none of the treatments decreased the cfu mL⁻¹, it was concluded that Ricinus communis can improve the clinical condition of denture stomatitis in institutionalised elderly patients, showing similar results to Miconazole.

Topics: Administration, Topical; Aged; Aged, 80 and over; Antifungal Agents; Candida; Candidiasis, Oral; Colony Count, Microbial; Denture, Complete; Denture, Partial, Removable; Female; Follow-Up Studies; Humans; Institutionalization; Male; Miconazole; Middle Aged; Mouthwashes; Nystatin; Oral Hygiene; Phytotherapy; Plant Preparations; Ricinus; Stomatitis, Denture; Treatment Outcome

Denture stomatitis (DS) is the most common form of chronic oral candidiasis. The standard treatment for DS is nystatin, which is accompanied with complications such as a bitter taste. The aim of this study was to compare the effect of garlic with nystatin in DS.. This randomised clinical trial study was performed on 40 patients with DS. After obtaining written consent, patients were divided into two groups while members of each group were given either nystatin or garlic extract for 4 weeks. The length and width of erythema area was measured at the end of the first, second, third, and the fourth weeks using a calliper. Data were analysed by SPSS and statistical tests including variance analysis with anova repeated measures, chi-square, and least square differences.. The changes in the length and width of erythema at different times according to the type of treatment were found to be significant while an accelerated recovery was demonstrated for nystatin (p < 0.001). Both regimens resulted in significant recovery (p < 0.0001). Greater satisfaction with the use of garlic rather than nystatin was mentioned (p < 0.0001).. Considering the efficacy of garlic and lack of side effects for this compound and also regarding the nystatin-associated complications, garlic extract can be introduced as a substitution for standard treatment in DS.

Topics: Aged; Antifungal Agents; Candidiasis, Oral; Diarrhea; Double-Blind Method; Erythema; Female; Garlic; Humans; Male; Mouthwashes; Nausea; Nystatin; Patient Satisfaction; Phytotherapy; Plant Extracts; Stomatitis, Denture; Taste Disorders

In this randomized clinical trial, the clinical and mycological efficacy of Photodynamic Therapy (PDT) was compared with that of topical antifungal therapy for the treatment of denture stomatitis (DS) and the prevalence of Candida species was identified. Patients were randomly assigned to one of two groups (n = 20 each); in the nystatin (NYT) group patients received topical treatment with nystatin (100,000 IU) four times daily for 15 days and in the PDT group the denture and palate of patients were sprayed with 500 mg/L of Photogem(®), and after 30 min of incubation, were illuminated by light emitting-diode light at 455 nm (37.5 and 122 J/cm(2), respectively) three times a week for 15 days. Mycological cultures taken from dentures and palates and standard photographs of the palates were taken at baseline (day 0), at the end of the treatment (day 15) and at the follow-up time intervals (days 30, 60 and 90). Colonies were quantified (CFU/mL) and identified by biochemical tests. Data were analysed by Fisher's exact test, analysis of variance and Tukey tests and κ test (α = 0.05). Both treatments significantly reduced the CFU/mL at the end of the treatments and on day 30 of the follow-up period (p <0.05). The NYT and PDT groups showed clinical success rates of 53% and 45%, respectively. Candida albicans was the most prevalent species identified. PDT was as effective as topical nystatin in the treatment of DS.

Topics: Adult; Aged; Aged, 80 and over; Antifungal Agents; Candida; Candidiasis, Oral; Colony Count, Microbial; Female; Humans; Male; Middle Aged; Nystatin; Photochemotherapy; Photosensitizing Agents; Risk Factors; Stomatitis, Denture; Treatment Outcome

The aim of this study was to compare the effectiveness of denture microwave disinfection and antifungal therapy on treatment of denture stomatitis.. Sixty denture wearers with denture stomatitis (3 groups; n = 20 each), were treated with nystatin or denture microwave disinfection (1 or 3 times/wk) for 14 days. Mycologic samples from palates and dentures were quantified and identified with the use of Chromagar, and clinical photographs of palates were taken. Microbiologic and clinical data were analyzed with the use of a series of statistical tests (α = .05).. Both treatments similarly reduced clinical signs of denture stomatitis and growth on palates and dentures at days 14 and 30 (P > .05). At sequential appointments, the predominant species (P < .01) isolated was C. albicans (range 98%-53%), followed by C. glabrata (range 22%-12%) and C. tropicalis (range 25%-7%).. Microwave disinfection, at once per week for 2 treatments, was as effective as topical antifungal therapy for treating denture stomatitis.

Topics: Adult; Aged; Analysis of Variance; Antifungal Agents; Chi-Square Distribution; Denture, Complete; Disinfection; Female; Humans; Male; Microwaves; Middle Aged; Mycoses; Nystatin; Oral Hygiene; Smoking; Stomatitis, Denture; Treatment Outcome; Xerostomia

The aim of this study was to identify in vitro and in vivo activity of Melaleuca alternifolia oil mixed with different tissue conditioners on the Candida albicans strain.. Microbiological tests were used to isolate Candida albicans from patients with denture stomatitis. The in vitro antifungal activity of Melaleuca alternifolia against Candida albicans was determined when it was applied directly and when it was mixed with tissue conditioners (Fitt, Lynal, Coe-Comfort). The responses of 27 denture stomatitis patients treated with Melaleuca alternifolia mixed with Coe-Comfort (n = 9), Nystatin mixed with Coe-Comfort (n = 9), and Coe-Comfort (Control Group, n = 9), were evaluated over a period of 12 days.. In the in vitro study, Coe-Comfort or Fitt conditioners mixed with 1 mL, 20% (vol/vol) of Melaleuca alternifolia oil exhibited a total inhibition of Candida albicans. Patients treated with M. alternifolia mixed with Coe-Comfort showed a significant decrease in palatal inflammation compared with those treated with Coe Comfort (P = .001). In addition, a significant inhibition of C. albicans growth was observed with M. alternifolia mixed with Coe-Comfort compared with only Coe-Comfort (P = .000004).. M. alternifolia oil mixed with Coe-Comfort tissue conditioner is effective in treating denture stomatitis.

Topics: Acrylic Resins; Aged; Antifungal Agents; Candida albicans; Candidiasis, Oral; Colony Count, Microbial; Denture, Complete; Drug Combinations; Female; Humans; Male; Melaleuca; Middle Aged; Nystatin; Phthalic Acids; Phytotherapy; Stomatitis, Denture; Tea Tree Oil; Tissue Conditioning, Dental

Nystatin has been formulated in the form of a flavored pastille (troche) as an alternative to the oral suspension. This parallel, double-blind, randomized, placebo-controlled study evaluated the acceptance and effectiveness of the nystatin pastille at two different dosages. Twenty-four subjects were selected on the basis of clinical signs of denture stomatitis and culture isolation of Candida spp. Each subject was randomly assigned to one of three treatment groups (A, 200,000 units; B, 400,000 units; and C, placebo). At entry, 7 days, 14 days, and at 10 days after cessation of treatment, the clinical condition was evaluated and Gram stain smears and imprint cultures were made and analyzed. The flavored pastille was well accepted by the subjects and both dosages were shown to be effective in significantly reducing or eliminating the Candida organism during active therapy. Data from the 10-day follow-up, however, demonstrated reinfection with the organism. Thus to resolve the condition, effective therapy must include treatment of the etiologic factors of denture stomatitis along with antimicrobial therapy.

Topics: Candidiasis, Oral; Clinical Trials as Topic; Double-Blind Method; Humans; Nystatin; Random Allocation; Stomatitis; Stomatitis, Denture; Tablets

This prospective study evaluated the significance of microbial analysis and antimicrobial treatment for the cure of angular cheilitis. Furthermore, various etiologic factors were investigated for their relative effect on the healing process. The study included 1) an open trial with 50 patients infected by Candida albicans and/or Staphylococcus aureus, and 2) an intraindividual comparison of eight patients with bilateral lesions infected by Candida albicans as the only detected pathogen. After a base-line examination the patients received ointments containing nystatin and/or fusidic acid, on the basis of the outcome of an initial microbial analysis. The patients were evaluated clinically, photographed, and examined for microorganisms at different time intervals. Ninety-six per cent of the patients who participated in the open trial had no sign of infection after 42 days of treatment. Lesions in the double-blind study, treated with nystatin, were healed after 28 days, whereas lesions that received placebo persisted throughout the treatment period. Increasing age, dry skin, and extended skinfolds at the corner of the mouth were factors closely related to the length of the healing process.

Topics: Adult; Aged; Aged, 80 and over; Candida albicans; Cheilitis; Double-Blind Method; Fusidic Acid; Humans; Middle Aged; Nystatin; Placebos; Prospective Studies; Staphylococcus aureus; Stomatitis, Denture; Wound Healing

Topics: Aged; Clinical Trials as Topic; Dental Plaque; Denture Rebasing; Denture, Complete; Female; Humans; Nystatin; Oral Hygiene; Stomatitis; Stomatitis, Denture

A double-blind trial of nystatin, amphotericin B, and a placebo was carried out in fifty-two cases of denture-related candidiasis and/or angular cheilitis. The drugs effected a significant clinical cure, but recurrence of the signs was common after withdrawal of the drugs. Concurrent bacteriologic examination showed few cures and continued presence of Candida albicans during the trial. A specimen from a red palate was examined histologically.

Topics: Amphotericin B; Blood Vessels; Candida albicans; Candidiasis, Oral; Cheilitis; Denture, Complete, Upper; Epithelium; Humans; Nystatin; Palate; Placebos; Stomatitis; Stomatitis, Denture

To investigate antifungal and mechanical properties after the impregnation of Dimethyl Amino-ethyl Hexa-decyl Di-methacrylate (DMAHDM) alone or in combination with Nystatin in polymethylmethacrylate.. The control group was fabricated by mixing powder and liquid of PMMA at the ratio of 2.5:1 g/mL. The DMAHDM was added to PMMA liquid and were mixed with PMMA powder. The Nystatin (500,000 International Units (IU)) was mixed with PMMA powder, whereby the composite powder was mixed with the DMAHDM-based liquid. The prepared specimens were tested for fungal adhesion testing (at days 1 and 30), impact strength and flexural strength. Oneway ANOVA post-hoc Tukey's test were used for statistical analysis.. Statistical analysis for the adhesion assay revealed that the antifungal activities of unaged and aged specimens in experimental groups were statistically significant as compared to control group A. The groups containing DMAHDM with Nystatin have shown statistically reduced flexural strength. The impact strength test revealed that groups containing 20% DMAHDM alone and DMAHDM with Nystatin showed statistically reduced impact strength compared to the control group.. Antifungal activities of experimental PMMA resin was increased. The addition of DMAHDM alone in PMMA resin has no deleterious effects on impact and flexural strength, however, at higher concentration values were reduced.

Topics: Acrylic Resins; Antifungal Agents; Candidiasis, Oral; Humans; Methacrylates; Nystatin; Polymethyl Methacrylate; Powders; Stomatitis, Denture; Surface Properties

Nystatin (Nys) is a fungicidal drug commonly prescribed for candidiasis disease in several administration routes. However, Nys is a class IV drug, according to the Biopharmaceutical Classification System, that possesses limited bioavailability and is used for local activity.. This study developed and characterized nystatin:β-cyclodextrin (Nys:βCD) inclusion complexes and evaluated their activity against. Complexes were characterized by physicochemical techniques and drug dissolution profiles. The susceptibility of. Nys was better complexed in a 1:1 molar ratio by freeze-drying and spray-drying methods. The inclusion complexes show bi-exponential release, an initial burst release followed by a sustained manner, presenting higher dissolution efficiency than raw Nys. The 1:1 freeze-drying Nys:βCD complex presents antifungal activity against all evaluated. This work represents a significant contribution to treating a wide variety of diseases caused by the

Topics: Antifungal Agents; Candida; Candida albicans; Candida parapsilosis; Microbial Sensitivity Tests; Nystatin; Stomatitis, Denture

Topics: Antifungal Agents; Biofilms; Candida albicans; Denture Liners; Equisetum; Humans; Nystatin; Pomegranate; Stomatitis, Denture

This study assessed the effects of chitosan (CS) on microcosm biofilms derived from saliva of patients with Candida-associated denture stomatitis.. Five removable denture wearers with denture stomatitis were included in the study. The minimum inhibitory concentration (MIC) of CS against clinical isolates of Candida albicans was determined according to the broth microdilution method. Pooled saliva from the donors was used as an inoculum for the formation of biofilms, which were developed during 72 h on acrylic surfaces in the Amsterdam Active Attachment model. The biofilms were then treated with different concentrations of CS, and the antibiofilm effects were evaluated through the quantification of colony-forming units (CFUs), total biomass (TB), metabolic activity (MA), lactic acid production (LAP), and cell viability (by confocal laser scanning microscopy). Chlorhexidine, miconazole, and nystatin were tested as positive controls, while the negative control (NC) was the untreated biofilm. Data were analyzed by 1-way ANOVA and Fischer LSD's post hoc test (α=0.05).. MIC values of CS ranged from 500 to 800 µg/mL. For CFUs, 2500 µg/mL CS was the most effective treatment in reducing total anaerobes, mutans streptococci, and Lactobacillus spp., significantly differing from the controls. For C. albicans CFUs, CS and positive controls did not differ from each other but led to significant reductions compared to NC. Regarding TB, MA, LAP, and cell viability, 2500 µg/mL CS promoted the greatest reductions compared to NC.. CS has similar or superior effects to conventional active principles on important parameters of oral candidiasis microcosm biofilms.. The antibiofilm effects of CS show that this compound has great potential to improve the clinical condition of denture stomatitis patients, and formulations containing this natural polymer could be useful for controlling oral candidiasis.

Topics: Acrylic Resins; Antifungal Agents; Biofilms; Candida albicans; Candidiasis, Oral; Chitosan; Chlorhexidine; Humans; Lactic Acid; Miconazole; Nystatin; Stomatitis, Denture

To evaluate the surface morphology and in vitro leachability of temporary soft linings modified by the incorporation of antifungals in minimum inhibitory concentrations (MIC) for Candida albicans biofilm.. Specimens of soft lining materials Softone and Trusoft were made without (control) or with the addition of nystatin (Ny), miconazole (Mc), ketoconazole (Ke), chlorhexidine diacetate (Chx), or itraconazole (It) at their MIC for C. albicans biofilm. The surface analyses were performed using Confocal laser scanning microscopy after 24 h, 7 days, or 14 days of immersion in distilled water at 37ºC. In vitro leachability of Chx or Ny from the modified materials was also measured using Ultraviolet visible spectroscopy for up to 14 days of immersion in distilled water at 37ºC. Data (μg/mL) were submitted to ANOVA 1-factor/Bonferroni (α=0.05).. Softone had a more irregular surface than Trusoft. Morphological changes were noted in both materials with increasing immersion time, particularly, in those containing drugs. Groups containing Chx and It presented extremely porous and irregular surfaces. Both materials had biexponential release kinetics. Softone leached a higher concentration of the antifungals than Trusoft (p=0.004), and chlorhexidine was released at a higher concentration than nystatin (p<0.001).. The surface of the soft lining materials changed more significantly with the addition of Chx or It. Softone released a higher concentration of drugs than Trusoft did, guiding the future treatment of denture stomatitis.

Topics: Antifungal Agents; Candida albicans; Denture Liners; Humans; Ketoconazole; Materials Testing; Nystatin; Stomatitis, Denture; Surface Properties

The study evaluated the effect of antimicrobial photodynamic therapy (aPDT) and nystatin (NYS) in the expression of genes (ACT1, ALS1, CAP1, CAT1, EFG1, HWP1, LIP3, PLB1, SAP1, and SOD1) involved in the virulence of Candida albicans strains recovered from patients with denture stomatitis (DS). These strains were isolated from the patients before (initial) and after treatment (final), and 45 days after the treatments (follow-up). For gene expression analyses, RNA was isolated from the clinical strains, followed by cDNA synthesis and qPCR using specific primers for each target gene. The samples that present integrity were pooled to increase the RNA yield. In the end, four patients treated with aPDT and five patients treated with NYS had the clinical isolates of C. albicans submitted to gene expression evaluation. The data demonstrated a statistical difference in the expression of PLB1 and ACT1 for the different therapies (aPDT versus NYS). Also, there was a statistical difference in the expression of CAT1, SOD1, and LIP3 at the time intervals assessed (initial, final, and follow-up). In contrast, no statistical difference was found in the expression of ALS1, HWP1, EFG1, CAP1, CAT1, SOD1, LIP3, and SAP1 between the therapies, while no significant difference was detected at the time intervals evaluated for ALS1, HWP1, EFG1, CAP1, and SAP1. Therefore, the topical treatments for DS with aPDT or NYS did not effect the expression of most C. albicans virulence genes evaluated.

Topics: Candida albicans; Gene Expression; Humans; Nystatin; Photochemotherapy; Photosensitizing Agents; Stomatitis, Denture

Microorganisms of the genus Candida have been recovered from complete dentures made of acrylic resin, with high numbers of colony forming units and species diversity, which can act as infectious agents causing chronic atrophic candidiasis (denture stomatitis).. The objective of this paper is present a treatment protocol for chronic atrophic candidiasis (denture stomatitis).. The work describes three cases of totally edentulous patients presenting palate stomatitis who were submitted for treatment associating denture rebasing with chemically-activated acrylic resin, night immersion in 2.5% sodium hypochlorite and use of topical antifungals for two weeks.. In all cases, remission of the inflammatory process occurred.. The proposed treatment protocol proved to be to be effective.

Topics: Acrylic Resins; Administration, Topical; Antifungal Agents; Clinical Protocols; Dental Disinfectants; Dental Materials; Denture Rebasing; Denture, Complete; Female; Follow-Up Studies; Humans; Male; Methylmethacrylates; Middle Aged; Mouthwashes; Nystatin; Sodium Hypochlorite; Stomatitis, Denture

Candida albicans is an opportunistic agent that colonizes the oral mucosa.. To determine the attitude of Spanish dentists toward the oral treatment of candidiasis.. Between May and November 2006, a questionnaire was circulated to a random selection of 1134 dentists obtained from the General Dental Council's main list. The survey consisted of a block of socio-demographic items followed by another block related to the diagnosis and treatment of oral candidiasis. Replies to the questionnaire were received from 840 (74%) dentists.. 50.4% of respondents were men, and 48.1% were female with a mean age of 38 and 12.2 years of professional experience. Miconazole was the most popular choice of antifungal agent prescribed (59.3%), followed by nystatin (57.7%) for topical use. Systemic antifungal agents were used by 30.20% of dentists, with a strong association between their use and the number of years in practice, gender and professional qualifications (P < 0.005).. Most Spanish dentists make clinical diagnosis and treat oral infections by C. albicans themselves with topical drugs (miconazole and nystatin) as a first choice. Systemic treatments are more commonly chosen by male dentists with long professional experience, especially by stomatologists.

Topics: Administration, Topical; Adult; Antifungal Agents; Attitude of Health Personnel; Candidiasis, Oral; Clotrimazole; Dentists; Female; General Practice, Dental; Humans; Ketoconazole; Male; Miconazole; Nystatin; Oral Medicine; Private Practice; Professional Practice; Public Health Dentistry; Sex Factors; Spain; Stomatitis, Denture; Surveys and Questionnaires; Time Factors

Although in vitro studies on the release of antifungal agents from tissue conditioners have been done, no in vivo research on the topic could be found. The purpose of this study was to determine the in vivo effect of an antifungal agent released from a tissue conditioner on the salivary yeast count. Forty edentulous patients with denture stomatitis caused by Candida albicans were divided in two groups. Group 1 (control) was treated with a tissue conditioner only. Group 2 was treated with a tissue conditioner incorporating 500,000 U nystatin. Oral rinses were performed by both groups before treatment and every second day during treatment for a period of 14 days. Total yeast counts of the oral rinses were performed and the averages and standard deviations for both groups calculated and logarithm-transformed data of the counts over time were statistically analysed using the Wilcoxon signed-rank test. The average oral rinse yeast count of the control group decreased up to day 4. Thereafter, the count increased till the end of the test period. At day 14, the oral rinse yeast level was higher than the pre-treatment level. The average yeast count of the test group decreased up to day 7. Thereafter, the count increased but remained significantly lower (P=0.01) than the control group and did not return to its pre-treatment level. A nystatin-containing short-term denture liner significantly decreases the salivary yeast count of patients with denture stomatitis compared with a liner without nystatin.

Topics: Adult; Aged; Antifungal Agents; Candidiasis, Oral; Denture Liners; Female; Humans; Male; Middle Aged; Nystatin; Pilot Projects; Saliva; Stomatitis, Denture; Tissue Conditioning, Dental

Topics: Anti-Infective Agents, Local; Antifungal Agents; Candida albicans; Candidiasis, Oral; Chlorhexidine; Drug Antagonism; Humans; Nystatin; Stomatitis, Denture

Denture biofilms represent a protective reservoir for oral microbes. The study of the biology of Candida in these biofilms requires a reliable model. A reproducible model of C. albicans denture biofilm was developed and used to determine the susceptibility of two clinically relevant C. albicans isolates against 4 antifungals. C. albicans, growing as a biofilm, exhibited resistance to amphotericin B, nystatin, chlorhexidine, and fluconazole, with 50% reduction in metabolic activity (50% RMA) at concentrations of 8, 16, 128, and > 64 microg/mL, respectively. In contrast, planktonically cultured C. albicans were susceptible (50% RMA for the same antifungals was obtained at 0.25, 1.0, 4.0, and 0.5 microg/mL, respectively). In conclusion, results obtained by means of our biofilm model show that biofilm-associated C. albicans cells, compared with cells grown in planktonic form, are resistant to antifungals used to treat denture stomatitis.

Topics: Acrylic Resins; Amphotericin B; Anti-Infective Agents, Local; Antifungal Agents; Biofilms; Candida albicans; Candidiasis, Oral; Chlorhexidine; Colony Count, Microbial; Denture Bases; Dose-Response Relationship, Drug; Drug Resistance, Microbial; Fluconazole; Galactose; Glucose; Humans; Indicators and Reagents; Nystatin; Polymethyl Methacrylate; Saliva; Statistics as Topic; Stomatitis, Denture; Sucrose; Tetrazolium Salts; Time Factors

Strain differentiation of 66 clinical isolates of Candida albicans obtained from healthy dentate and complete denture wearers was performed. Resistogram method based on differences in the resistance of C. albicans isolates to sodium selenite, boric acid, cetrimide, sodium periodate and silver nitrate was used for strain differentiation. Of the 32 potential strains that can be distinguished, 14 different resistogram strains of C. albicans were found among the 66 isolates tested. Strain-C--was the most predominant (24.3% of total isolates), while strain A-CDE was the least predominant (1.5%). The results showed no particular association of certain strains with Candida infections in complete denture wearers. Sensitivity to antifungal agents showed that isolates from different strains were most sensitive to amphotericin B and nystatin and least sensitive to miconazole.

Topics: Amphotericin B; Antifungal Agents; Boric Acids; Candida albicans; Candidiasis, Oral; Cetrimonium; Cetrimonium Compounds; Denture, Complete; Drug Resistance, Microbial; Humans; Miconazole; Microbial Sensitivity Tests; Nystatin; Periodic Acid; Silver Nitrate; Sodium Selenite; Stomatitis, Denture

Chronic atrophic candidiasis is prevalent in up to 72% of institutionalized geriatric populations and is causally associated with Candida albicans. Topical antifungal treatments are difficult to implement in some geriatric patients due to cognitive impairment, reduced motor dexterity and memory loss.. This in vitro study incorporated antifungal agents into tissue conditioners to investigate the effectiveness of this method of drug delivery.. Combinations of nystatin, fluconazole, itraconazole and Coe Soft, Viscogel, Fitt were tested at 1, 3, 5, 7, 9 and 11 wt/wt%, with and without sterilized saliva. 6 mm diameter cores were punched in Sabouraud plates pre-grown with standardized C. albicans. Antifungal agents plus tissue conditioner mixtures were injected into each core. Inhibition diameters were measured for 14 days.. Cores with only tissue conditioners acted as negative control and showed no significant inhibition activity (ANOVA, p > 0.05). Peak activity was between 65 to 89 hours; followed by a plateau. Itraconazole had greater fungicidal activity than fluconazole; while nystatin was found to have the least fungicidal activity (ANOVA, p < 0.05). The most effective concentration for nearly all combinations was 5% wt/wt (ANOVA, p < 0.05). Specimens with saliva showed greater antifungal activity than those without (t-test, p < 0.001). Itraconazole altered the physical properties of Viscogel hence this combination is not recommended for clinical use.. The treatment of chronic atrophic candidiasis by incorporation of antifungal drugs into tissue conditioners is efficacious. 5% wt/wt itraconazole mixed with Coe Soft or Fitt is recommended for clinical study where compliance of patient or care giver cannot be relied upon. Peak antifungal activity at 3 days suggests that mixtures prepared for clinical study may be replaced soon after this time for maximum effectiveness.

Topics: Acrylic Resins; Aged; Analysis of Variance; Antifungal Agents; Candida albicans; Candidiasis, Oral; Dental Care for Aged; Denture Liners; Drug Combinations; Drug Delivery Systems; Fluconazole; Humans; Itraconazole; Methylmethacrylates; Microbial Sensitivity Tests; Nystatin; Phthalic Acids; Statistics, Nonparametric; Stomatitis, Denture; Tissue Conditioning, Dental

Candidal adherence to denture acrylic surfaces is implicated as the first step in the pathogenesis of Candida-associated denture stomatitis, the most prevalent form of oral candidosis in the West. This condition is treated by topically administered antifungal agents, mainly belonging to the polyenes and azoles. As the intraoral concentrations of antifungals fluctuate considerably due to the dynamics of the oral environment, the effect of short exposure to sublethal concentrations of antifungals on the adhesion of Candida albicans to denture acrylic surfaces was investigated. Seven oral C. albicans isolates were exposed to four-eight times minimum inhibitory concentrations (MIC) of five antifungal drugs, nystatin, amphotericin B, 5-fluorocytosine, ketoconazole and fluconazole, for 1 h. After removing the drug (by repeated washing) the adhesion of these isolates to acrylic strips was assessed by an in vitro adhesion assay. Exposure to antifungal agents significantly reduced the adherence of all seven C. albicans isolates to denture acrylic. The mean percentage reductions of adhesion after limited exposure to nystatin, amphotericin B, 5-fluorocytosine, ketoconazole and fluconazole were 86.48, 90.85, 66.72, 65.88 and 47.42%, respectively. These findings indicate that subtherapeutic doses of antifungals may modulate oral candidal colonization. Further, these results may have an important bearing on dosage regimens currently employed in treating oral candidosis.

Topics: Adhesiveness; Administration, Topical; Amphotericin B; Analysis of Variance; Antifungal Agents; Candida albicans; Candidiasis, Oral; Denture Bases; Drug Administration Schedule; Fluconazole; Flucytosine; Humans; Image Processing, Computer-Assisted; Ketoconazole; Mouth; Nystatin; Polymethyl Methacrylate; Stomatitis, Denture; Surface Properties; Time Factors

Denture-induced stomatitis with concurrent candidal infection is the most commonly encountered intraoral abnormality among individuals who wear dentures. The institutionalized elderly demonstrate increased susceptibility and could benefit from its management with a fungicidal denture liner. As an integral part of the prosthesis, the efficacy of the fungicidal liner would be independent of patient compliance and/or nursing involvement and would provide a predictable therapeutic modality. In this study a "slant agar assay" was developed to evaluate the in vitro antimycotic activity of Visco-gel and Lynal liners impregnated with various concentrations of nystatin over a 14-day period in nonaqueous and aqueous environments. The results were as follows: preparations incorporating higher concentrations of nystatin resulted in greater inhibition of Candida albicans growth; Visco-gel liner-nystatin preparations exhibited a greater fungicidal activity than equivalent Lynal preparations; loss of potency by all of the reline-nystatin preparations consisted of an initial rapid loss between days 0 and 2, followed by a plateau during which the preparations gradually continued to lose inhibitory activity; and 1 million units of nystatin were necessary to maintain an adequate level of antifungal activity in an aqueous environment, where the liners demonstrated decreasing antifungal activity proportional to the duration of exposure to water.

Topics: Candida albicans; Denture Liners; Humans; Microbial Sensitivity Tests; Multivariate Analysis; Nystatin; Stomatitis, Denture; Water

This study aimed at evaluating the incorporation of two antimicrobial drugs (nystatin and polynoxylin) as regards: the effect of the liner on the activity of the drug, determination of the least effective concentration of each drug and its duration of action, as well as assessment of the effect of the drug on the mechanical properties and the chemical composition of the liner. Results showed that nystatin added to denture liners in three different concentrations by weight (3%, 5%, 10%) acted effectively against Candida albicans, and that there was a direct relationship between concentration of Nystatin and its duration of action. The inhibitory effect of nystatin (10%) lasted for at least 32 weeks (end of study period). Furthermore, this concentration did not affect the strength properties of the liner. On the other hand, polynoxylin inhibited a number of strains of bacteria and Candida only in high concentrations (40-60%), and these concentrations adversely affected the strength properties of the liner.

Topics: Acrylic Resins; Anti-Bacterial Agents; Anti-Infective Agents; Antifungal Agents; Candida albicans; Denture Liners; Dose-Response Relationship, Drug; Humans; Materials Testing; Mechanics; Microbial Sensitivity Tests; Nystatin; Polymers; Staphylococcus aureus; Stomatitis, Denture; Streptococcus; Urea

Antibody-dependent cellular cytotoxicity (ADCC) and lymphocyte-induced angiogenesis (LIA) of mononuclear leucocytes (MNC) isolated from the peripheral blood of patients with denture stomatitis mycotic were examined. The obtained results have shown a decrease in ADCC in patients with mycotic infection of oral cavity. Similarly, the ability to induce angiogenesis by MNC isolated from these patients was decreased in comparison with angiogenesis induced by control MNC. After the anti-mycotic treatment, an increase in ADCC and LIA was noted.

Topics: Animals; Candidiasis, Oral; Cytotoxicity Tests, Immunologic; Humans; Immunity, Cellular; Leukocytes, Mononuclear; Mice; Mice, Inbred BALB C; Middle Aged; Neovascularization, Pathologic; Nystatin; Polyenes; Stomatitis; Stomatitis, Denture

Infection of the oral mucous membrane is frequent in patients with removable prostheses, either totally of partially, and particularly when the prostheses is palatal. The principal etiological factor causing the infection is accepted to be "Candidas" aided by the presence of plaque bacteria (in patients with poor oral hygiene care), and a poor fit of the prostheses to the soft tissues. Treatment of the infection must proceed in the following order: a) use of effective medication against oral fungus such as Nystatin or Ketoconazole. b) Meticulous oral hygiene care in the mucous membrane as well as in the prostheses, but using the prostheses as little as possible during the treatment period. c) A total cure of the infection (denture stomatitis) before proceeding to the next phase of the treatment. d) Determination of the adjustment and occlusion of the prostheses in order to determine those areas of the prostheses which need to be refilled because of maladjustment of the prostheses to the soft tissues of the patient.

Topics: Candidiasis, Oral; Chlorhexidine; Denture, Complete; Humans; Ketoconazole; Nystatin; Oral Hygiene; Stomatitis; Stomatitis, Denture

Topics: Adult; Aged; Candida albicans; Candidiasis, Oral; Chlorhexidine; Denture, Complete; Disinfection; Female; Humans; Male; Middle Aged; Mouth; Mouthwashes; Nystatin; Stomatitis; Stomatitis, Denture

Topics: Adult; Aged; Atrophy; Candida albicans; Candidiasis, Oral; Cheilitis; Chronic Disease; Denture, Complete, Upper; Drug Resistance, Microbial; Female; Humans; Male; Middle Aged; Nystatin; Stomatitis; Stomatitis, Denture; Tablets

Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Mouth; Natamycin; Nystatin; Stomatitis; Stomatitis, Denture; Time Factors

Topics: Candidiasis, Oral; Chlorhexidine; Dental Plaque; Denture, Complete; Humans; Nystatin; Stomatitis; Stomatitis, Denture

The effect of nystatin treatment on denture stomatitis subclassified as generalized simple inflammation and inflammatory papillary hyperplasia has been studied. Twenty-four patients were carefully instructed to apply a thin layer of nystatin dusting powder on the fitting surface of the maxillary denture three times a day for 14 d. Different parameters were studied on three occasions; at the beginning of experiment and after 14 and 28 d. An untreated group of 24 patients with the same types of denture stomatitis served as control. The effect of treatment was evaluated by changes in the clinical erythema, the yeast colonization obtained by mycologic sampling on the palatal mucosa and on the denture base, and changes in the histologic picture of the mucosa obtained by biopsy. Subepithelial inflammation, leukocyte penetration, edema and thickness of the epithelium were histologic parameters. After 14 d of treatment the experimental group compared with the control group showed a statistically significant decrease in palatal erythema and in the amount of yeast colonies. No significant changes were found microscopically. Twenty-eight days after start, i.e. 14 d after withdrawal of the nystatin, there still was a statistically significant improvement of the palatal erythema in the experimental group compared with the controls. However, no patient was totally cured. There were no significant changes in the number of yeast colonies and the histologic parameters.

Topics: Aged; Denture, Complete; Female; Humans; Male; Middle Aged; Nystatin; Palate; Stomatitis; Stomatitis, Denture; Yeasts

The therapy of denture sore mouth which is induced by Candida albicans must take its bearings about the general and local disposition factors. The crucial points of stomatological treatment are pointed to. The problems related to local antimycotic therapy in the oral cavity are discussed. A new antimycotic dosage form, the nystatin-gelatin foil, for local application in denture wearers in presented. Its dosage and its use are described.

Topics: Administration, Topical; Bandages; Candidiasis, Oral; Gelatin; Humans; Nystatin; Stomatitis; Stomatitis, Denture

The authors describe the formula and the manufacture of nystatin-gelatin foils that are a new dosage form for local application in case of denture sore mouth induced by Candida albicans. It is pointed to the requirements that a pharmaceutically used gelatin should meet. Furthermore, the authors discuss biopharmaceutical aspects of the nystatin-gelatin foil.

Topics: Candidiasis, Oral; Citrates; Drug Compounding; Gelatin; Humans; Nystatin; Stomatitis; Stomatitis, Denture

Seventy-four patients wearing full upper and lower dentures were examined in the study; 37 exhibited varying degrees of denture sore mouth (DSM) while the remaining 37 patients acted as controls. Denture trauma was more common in the DSM group. Candida was grown from 73 per cent of patients with DSM but only from 22 per cent of controls. Control patients had better denture hygiene than DSM patients. One year later 22 of the original DSM patients wearing newly made dentures were re-examined. Nine out of 22 still exhibited varying degrees of DSM. In the 9 cases persisting, a nystatin-chlorhexidine treatment plan was prescribed, resulting in resolution of 7 further cases. The cases that failed resolve were wearing unstable traumatogenic new dentures.

Topics: Aged; Candida; Candidiasis, Oral; Chlorhexidine; Dental Occlusion, Traumatic; Denture Retention; Denture, Complete, Upper; Female; Follow-Up Studies; Humans; Male; Middle Aged; Nystatin; Oral Hygiene; Stomatitis; Stomatitis, Denture

Topics: Adult; Aged; Candidiasis, Oral; Denture, Complete; Female; Humans; Middle Aged; Mouth Diseases; Mycoses; Nystatin; Stomatitis, Denture

Topics: Candida albicans; Candidiasis, Oral; Nystatin; Stomatitis, Denture

Topics: Antibodies; Bacteria; Dentures; Epithelial Cells; Epithelium; Fungi; Humans; Microscopy, Electron, Scanning; Mouth; Nystatin; Palate; Penicillins; Pressure; Stomatitis; Stomatitis, Denture; Streptococcus; Streptococcus pneumoniae

Topics: Candida; Candidiasis, Oral; Denture Liners; Humans; Nystatin; Stomatitis; Stomatitis, Denture

Topics: Amphotericin B; Biopsy; Candida albicans; Candidiasis, Oral; Cheilitis; Diabetes Complications; Endocrine System Diseases; Fluorescent Antibody Technique; Humans; Immunity, Cellular; Immunologic Deficiency Syndromes; Leukoplakia, Oral; Metabolic Diseases; Nutrition Disorders; Nystatin; Sjogren's Syndrome; Stomatitis, Denture