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Evaluation of different treatment methods against denture stomatitis: a randomized clinical study

Published:April 07, 2014DOI:https://doi.org/10.1016/j.oooo.2014.03.017

      Objective

      The aim of this clinical study was to determine the efficacy of Uncaria tomentosa (cat's claw) against denture stomatitis (DS).

      Study Design

      Fifty patients with DS were randomly assigned into 3 groups to receive 2% miconazole, placebo, or 2% U tomentosa gel. DS level was recorded immediately, after 1 week of treatment, and 1 week after treatment. The clinical effectiveness of each treatment was measured using Newton's criteria. Mycologic samples from palatal mucosa and prosthesis were obtained to determinate colony forming units per milliliter (CFU/mL) and fungal identification at each evaluation period.

      Results

      Candida species were identified with HiCrome Candida and API 20C AUX biochemical test. DS severity decreased in all groups (P < .05). A significant reduction in number of CFU/mL after 1 week (P < .05) was observed for all groups and remained after 14 days (P > .05). C albicans was the most prevalent microorganism before treatment, followed by C tropicalis, C glabrata, and C krusei, regardless of the group and time evaluated. U tomentosa gel had the same effect as 2% miconazole gel.

      Conclusions

      U tomentosa gel is an effective topical adjuvant treatment for denture stomatitis.
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      References

        • Rex J.H.
        • Rinaldi M.G.
        • Pfaller M.A.
        Resistance of Candida species to fluconazole.
        Antimicrob Agents Chemother. 1995; 39: 1-8
        • Rabiei M.
        • Kasemnezhad E.
        • Masoudi rad H.
        • Shakiba M.
        • Pourkay H.
        Prevalence of oral and dental disorders in institutionalized elderly people in Rasht, Iran.
        Gerodontology. 2010; 27: 174-177
        • Jorge Jr., J.
        • Almeida O.P.
        • Bozzo L.
        • Scully C.
        • Graner E.
        Oral mucosal health and disease in institutionalized elderly in Brazil.
        Community Dent Oral Epidemiol. 1991; 19: 173-175
        • Altarawneh S.
        • Bencharit S.
        • Mendoza L.
        • et al.
        Clinical and histological findings of denture stomatitis as related to intraoral colonization patterns of Candida albicans, salivary flow, and dry mouth.
        J Prosthodont. 2013; 22: 13-22
        • Amanlou M.
        • Beitollahi J.M.
        • Abdollahzadeh S.
        • Tohidast-Ekrad Z.
        Miconazole gel compared with Zataria multiflora Boiss gel in the treatment of denture stomatitis.
        Phytother Res. 2006; 20: 966-969
        • Redding S.
        • Bhatt B.
        • Rawls R.
        • Siegel G.
        • Scott K.
        • Lopez-Ribot J.
        Inhibition of Candida albicans biofilm formation on denture material.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 107: 669-672
        • Aldana L.
        • Marker V.A.
        • Kolstad R.
        • Iacopino A.M.
        Effects of Candida treatment regimens on the physical properties of denture resins.
        Int J Prosthodont. 1994; 7: 473-478
        • Casaroto A.R.
        • Lara V.S.
        Phytomedicines for Candida-associated denture stomatitis.
        Fitoterapia. 2010; 81: 323-328
        • Valerio Jr., L.G.
        • Gonzales G.F.
        Toxicological aspects of the South American herbs cat's claw (Uncaria tomentosa) and maca (Lepidium meyenii): a critical synopsis.
        Toxicol Rev. 2005; 24: 11-35
        • Mammone T.
        • Akesson C.
        • Gan D.
        • Giampapa V.
        • Pero R.W.
        A water soluble extract from Uncaria tomentosa (cat's claw) is a potent enhancer of DNA repair in primary organ cultures of human skin.
        Phytother Res. 2006; 20: 178-183
        • Keplinger K.
        • Laus G.
        • Wurm M.
        • Dierich M.P.
        • Teppner H.
        Uncaria tomentosa (Willd.) DC.—ethnomedicinal use and new pharmacological, toxicological and botanical results.
        J Ethnopharmacol. 1999; 64: 23-34
        • Lemaire I.
        • Assinewe V.
        • Cano P.
        • Awang D.V.
        • Arnason J.T.
        Stimulation of interleukin-1 and -6 production in alveolar macrophages by the neotropical liana, Uncaria tomentosa (uña de gato).
        J Ethnopharmacol. 1999; 64: 109-115
        • Sandoval M.
        • Okuhama N.N.
        • Zhang X.J.
        • et al.
        Anti-inflammatory and antioxidant activities of cat's claw (Uncaria tomentosa and Uncaria guianensis) are independent of their alkaloid content.
        Phytomedicine. 2002; 9: 325-337
        • Santos Araújo Mdo C.
        • Farias I.L.
        • Gutierres J.
        • et al.
        Uncaria tomentosa—adjuvant treatment for breast cancer: clinical trial.
        Evid Based Complement Alternat Med. 2012; 2012 ([published online June 28, 2012]): 676984
        http://dx.doi.org/10.1155/2012/676984
        • Herrera D.R.
        • Tay L.Y.
        • Rezende E.C.
        • Kozlowski Jr., V.A.
        • Santos E.B.
        In vitro antimicrobial activity of phytotherapic Uncaria tomentosa against endodontic pathogens.
        J Oral Sci. 2010; 52: 473-476
        • Ribeiro A.F.
        • de Oliveira Rezende R.L.
        • Cabral L.M.
        • de Sousa V.P.
        Poly ε-caprolactone nanoparticles loaded with Uncaria tomentosa extract: preparation, characterization, and optimization using the Box-Behnken design.
        Int J Nanomedicine. 2013; 8: 431-442
        • Heitzman M.E.
        • Neto C.C.
        • Winiarz E.
        • Vaisberg A.J.
        • Hammond G.B.
        Ethnobotany, phytochemistry and pharmacology of Uncaria (Rubiaceae).
        Phytochemistry. 2005; 66: 5-29
        • Ccahuana-Vasquez R.A.
        • Santos S.S.
        • Koga-Ito C.Y.
        • Jorge A.O.
        Antimicrobial activity of Uncaria tomentosa against oral human pathogens.
        Braz Oral Res. 2007; 21: 46-50
        • Uludamar A.
        • Ozkan Y.K.
        • Kadir T.
        • Ceyhan I.
        In vivo efficacy of alkaline peroxide tablets and mouthwashes on Candida albicans in patients with denture stomatitis.
        J Appl Oral Sci. 2010; 18: 291-296
        • Newton A.V.
        Denture sore mouth: a possible aetiology.
        Br Dent J. 1962; 112: 357-360
        • Sanitá P.V.
        • Machado A.L.
        • Pavarina A.C.
        • Massucato E.M.S.
        • Colombo A.L.
        • Vergani C.E.
        Denture microwave disinfection versus nystatin in treating well-controlled type 2 diabetics with denture stomatitis: a randomized clinical trial.
        Int J Prosthod. 2012; 25: 232-244
        • Neppelenbroek K.H.
        • Pavarina A.C.
        • Palomari Spolidorio D.M.
        • Sgavioli Massucato E.M.
        • Spolidorio L.C.
        • Vergani C.E.
        Effectiveness of microwave disinfection of complete dentures on the treatment of Candida-related denture stomatitis.
        J Oral Rehabil. 2008; 35: 836-846
        • Könsberg R.
        • Axéll T.
        Treatment of Candida-infected denture stomatitis with a miconazole lacquer.
        Oral Surg Oral Med Oral Pathol. 1994; 78: 306-311
        • Barnabé W.
        • de Mendonça Neto T.
        • Pimenta F.C.
        • Pegoraro L.F.
        • Scolaro J.M.
        Efficacy of sodium hypochlorite and coconut soap used as disinfecting agents in the reduction of denture stomatitis, Streptococcus mutans, and Candida albicans.
        J Oral Rehabil. 2004; 31: 453-459
        • Ramage G.
        • Zalewska A.
        • Cameron D.A.
        • et al.
        A comparative in vitro study of two denture cleaning techniques as an effective strategy for inhibiting Candida albicans biofilms on denture surfaces and reducing inflammation.
        J Prosthodont. 2012; 21: 516-522
        • Kanli A.
        • Demirel F.
        • Sezgin Y.
        Oral candidosis, denture cleanliness and hygiene habits in an elderly population.
        Aging Clin Exp Res. 2005; 17: 502-507
        • Kulak-Ozkan Y.
        • Kazazoglu E.
        • Arikan A.
        Oral hygiene habits, denture cleanliness, presence of yeasts and stomatitis in elderly people.
        J Oral Rehabil. 2002; 29: 300-304
        • Paiva L.C.A.
        • Ribeiro R.A.
        • Pereira J.V.
        Avaliação clínica e laboratorial do gel da Uncaria tomentosa (unha de gato) sobre candidose oral.
        Brazilian Journal of Pharmacognosy. 2009; 19 ([in Portuguese]): 423-428
        • Wagner H.
        • Kreutzkamp B.
        • Jurcic K.
        Die Alkaloide von Uncaria tomentosa und ihre Phagozytose-steigernde Wirkung.
        Planta Med. 1985; 51 ([in German]): 419-423
        • Wurm M.
        • Kacani L.
        • Laus G.
        • Keplinger K.
        • Dierich M.P.
        Pentacyclic oxindole alkaloids from Uncaria tomentosa induce human endothelial cells to release a lymphocyte-proliferation-regulating factor.
        Planta Med. 1998; 64: 701-704
        • De Amici D.
        • Klersy C.
        • Ramajoli F.
        • Brustia L.
        • Politi P.
        Impact of the Hawthorne effect in a longitudinal clinical study: the case of anesthesia.
        Control Clin Trials. 2000; 21: 103-114
        • Van den Bossche H.
        • Willemsens G.
        • Cools W.
        • Marichal P.
        • Lauwers W.
        Hypothesis on the molecular basis of the antifungal activity of N-substituted imidazoles and triazoles.
        Biochem Soc Trans. 1983; 11: 665-667
        • Vandenbosch D.
        • Braeckmans K.
        • Nelis H.J.
        • Coenye T.
        Fungicidal activity of miconazole against Candida spp. biofilms.
        J Antimicrob Chemother. 2010; 65: 694-700
        • Kobayashi D.
        • Kondo K.
        • Uehara N.
        • et al.
        Endogenous reactive oxygen species is an important mediator of miconazole antifungal effect.
        Antimicrob Agents Chemother. 2002; 46: 3113-3117
        • Campanha N.H.
        • Neppelenbroek K.H.
        • Spolidorio D.M.
        • Spolidorio L.C.
        • Pavarina A.C.
        Phenotypic methods and commercial systems for the discrimination between C. albicans and C. dubliniensis.
        Oral Dis. 2005; 11: 392-398
        • Sanitá P.V.
        • Pavarina A.C.
        • Giampaolo E.T.
        • et al.
        Candida spp. prevalence in well controlled type 2 diabetic patients with denture stomatitis.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011; 111: 726-733
        • Dağistan S.
        • Aktas A.E.
        • Caglayan F.
        • Ayyildiz A.
        • Bilge M.
        Differential diagnosis of denture-induced stomatitis, Candida, and their variations in patients using complete denture: a clinical and mycological study.
        Mycoses. 2009; 52: 266-271
        • Dorko E.
        • Jenca A.
        • Pilipcinec E.
        • Danko J.
        • Svický E.
        • Tkáciková L.
        Candida-associated denture stomatitis.
        Folia Microbiol (Praha). 2001; 46: 443-446
        • Cross L.J.
        • Williams D.W.
        • Sweeney C.P.
        • Jackson M.S.
        • Lewis M.A.
        • Bagg J.
        Evaluation of the recurrence of denture stomatitis and Candida colonization in a small group of patients who received itraconazole.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 97: 351-358
        • Colombo A.L.
        • Perfect J.
        • DiNubile M.
        • et al.
        Global distribution and outcomes for Candida species causing invasive candidiasis: results from an international randomized double-blind study of caspofungin versus amphotericin B for the treatment of invasive candidiasis.
        Eur J Clin Microbiol Infect Dis. 2003; 22: 470-474
        • Pfaller M.A.
        • Moet G.J.
        • Messer S.A.
        • Jones R.N.
        • Castanheira M.
        Geographic variations in species distribution and echinocandin and azole antifungal resistance rates among Candida bloodstream infection isolates: report from the SENTRY Antimicrobial Surveillance Program (2008 to 2009).
        J Clin Microbiol. 2011; 49: 396-399
        • Panackal A.A.
        • Gribskov J.L.
        • Staab J.F.
        • Kirby K.A.
        • Rinaldi M.
        • Marr K.A.
        Clinical significance of azole antifungal drug cross-resistance in Candida glabrata.
        J Clin Microbiol. 2006; 44: 1740-1743
        • Lyon J.P.
        • Resende M.A.
        Evaluation of adhesion to buccal epithelial cells in Candida species obtained from denture wearers after exposure to fluconazole.
        Mycoses. 2007; 50: 21-24
        • Ramage G.
        • Tomsett K.
        • Wickes B.L.
        • López-Ribot J.L.
        • Redding S.W.
        Denture stomatitis: a role for Candida biofilms.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 98: 53-59