IADR Abstract Archives
Nystatin: Conventional Suspension Versus Drug Delivery for Denture Stomatitis Treatment
Objectives: This preliminary investigation compared the conventional topical antifungal therapy (nystatin oral suspension) with a sustained drug-delivery based on minimal inhibitory drug concentration (MIC) of nystatin for Candida albicans biofilm in patients with denture stomatitis.
Methods: Patients were randomly divided into two treatment groups during 14 days: Control (n=8): nystatin oral suspension (100,000 IU) 3x/day or NYS (n=8): maxillary complete denture (MCD) relined with Trusoft modified by nystatin at MCI (0.032 g per g of material powder). Mycological quantitative cultures and cytological smears were obtained from the MCD and palates of all patients before and after treatment and 15, 30, and 60 days after its suspension (follow-up). For clinical assessment, palatal photographs were obtained of all patients at each visit. Data were analyzed by chi-square, two-way ANOVA and Tukey tests (α=0.05).
Results: Palate smears of the NYS group exhibited absence of pathogenic form of Candida spp. at the end of treatment and follow-up while those of control group showed presence of pseudohyphae and hyphae in 67,5% of patients at 14 days, increasing to 87,5% at follow-up (P>0.05). Compared to the control group, denture smears of the NYS group demonstrated significantly less mycelial forms at 14 days (P<0.05), and this result was maintained during the follow-up. At end of treatment and follow-up, a substantial improvement in inflammation severity was observed for patients of NYS-group (P<0.05), while none of those in control showed any significant improvement throughout the clinical trial (P>0.05).
Conclusions: Compared to conventional therapy with nystatin suspension, relining dentures with temporary resilient material modified by nystatin may be a promising alternative denture stomatitis treatment since it reduced the Candida mycelial forms on palates and dentures as well clinical inflammation severity. At follow-up, this drug delivery system also prevented candida re-infection and palatal inflammation recurrence in comparison to the nystatin suspension.
Methods: Patients were randomly divided into two treatment groups during 14 days: Control (n=8): nystatin oral suspension (100,000 IU) 3x/day or NYS (n=8): maxillary complete denture (MCD) relined with Trusoft modified by nystatin at MCI (0.032 g per g of material powder). Mycological quantitative cultures and cytological smears were obtained from the MCD and palates of all patients before and after treatment and 15, 30, and 60 days after its suspension (follow-up). For clinical assessment, palatal photographs were obtained of all patients at each visit. Data were analyzed by chi-square, two-way ANOVA and Tukey tests (α=0.05).
Results: Palate smears of the NYS group exhibited absence of pathogenic form of Candida spp. at the end of treatment and follow-up while those of control group showed presence of pseudohyphae and hyphae in 67,5% of patients at 14 days, increasing to 87,5% at follow-up (P>0.05). Compared to the control group, denture smears of the NYS group demonstrated significantly less mycelial forms at 14 days (P<0.05), and this result was maintained during the follow-up. At end of treatment and follow-up, a substantial improvement in inflammation severity was observed for patients of NYS-group (P<0.05), while none of those in control showed any significant improvement throughout the clinical trial (P>0.05).
Conclusions: Compared to conventional therapy with nystatin suspension, relining dentures with temporary resilient material modified by nystatin may be a promising alternative denture stomatitis treatment since it reduced the Candida mycelial forms on palates and dentures as well clinical inflammation severity. At follow-up, this drug delivery system also prevented candida re-infection and palatal inflammation recurrence in comparison to the nystatin suspension.