Presence of Different Candida Species at Denture Wearers With Type 2 Diabetes and Clinically Healthy Oral Mucosa-Pilot Study

Download Article

Sanja Matić Petrović1, Milena Barać1, Jovana Kuzmanović Pfićer1, Milena Radunović1, Aleksandra Jotić2, Ana Pucar1

1School of Dental Medicine, University of Belgrade, Belgrade, Serbia
2Faculty of Medicine University of Belgrade, Belgrade, Serbia

Summary

Background/Aim: The aim of this study was to examine prevalence of different Candida spp. at diabetics and nondiabetics wearing dentures without clinical signs of Denture Stomatitis (DS) and to study if some local and systematic factors are confounders for harboring Candida at these subjects. Material and Methods: Total of 60 subjects wearing partial or complete upper acrylic denture having at least half of palatal mucosa covered by denture were selected and stratified into three experimental groups: systematically health subjects; patients with diagnosed Type 2 Diabetes (T2D) and good glycoregulation; and T2D subjects with poorly regulated blood sugar level. Cotton swab samples were obtained from each patient from hard palate mucosa and denture surface. Swab cultures were made on Sabouraud dextrose agar and ChromAgar Media for distinciton of various Candida spp. Density growth was also measured. Results: Frequency of Candida spp. findings were similar between groups. At healthy subjects, only C.albicans was detected. At diabetics, C.albicans was the most common isolated species, followed by C.glabrata and C.tropicalis. Negative finding of yeasts on palatal mucosa, but positive on denture surface were detected at all groups, with the highest frequency (33.4%) at diabetics with poor glycoregulation. Denture surface was heavier colonized than hard palate mucosa. Duration of diabetes in years were only independent predictors for harboring Candida spp. at denture surface (Exp B=1.186, CI=1.047-1.344, p=0.007). Conclusions: Prosthesis of denture wearers without DS may serve as reservoir of Candida spp. Presence of more pathogenic and resistant non-albicans species are related to diabetics, even without clinical signs of DS.

Keywords: Stomatitis; Denture; Candida albicans; Diabetes Mellitus Type 2; Denture; Complete; Denture; Partial; Removable

Reference

1. Budtz-Jørgensen E, Mojon P, Banon-Clément JM, Baehni P. Oral candidosis in long-term hospital care: comparison of edentulous and dentate subjects. Oral Dis, 1996;2:285-290.Google Scholar

 

2. Jainkittivong A, Aneksuk V, Langlais RP. Oral mucosal conditions in elderly dental patients. Oral Dis, 2002;8:218-223.Google Scholar

 

3. Chopde N, Jawale B, Pharande B, Chaudhari L, Hiremath V, Redasani R. Microbial colonization and their relation with potential cofactors in patients with denture stomatitis. J Contemp Dent Pract, 2012;13:456-459.Google Scholar

 

4. Guggenheimer J, Moore PA, Rossie K, Myers D, Mongelluzzo MB, Block HM et al. Insulin-dependent diabetes mellitus and oral soft tissue pathologies. II. Prevalence and characteristics of Candida and candidal lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2000;89:570-576.Google Scholar

 

5. Shulman JD, Rivera-Hidalgo F, Beach MM. Risk factors associated with denture stomatitis in the United States. J Oral Pathol Med, 2005;34:340-346.CrossrefGoogle Scholar

 

6. Figueiral MH, Azul A, Pinto E, Fonseca PA, Branco FM, Scully C. Denture-related stomatitis: identification of aetiological and predisposing factors – a large cohort. J Oral Rehabil, 2007;34:448-455.Web of ScienceCrossrefGoogle Scholar

 

7. Soysa NS, Samaranayake LP, Ellepola ANB. Diabetes mellitus as a contributory factor in oral candidosis. Diabet Med, 2006;23:455-459.CrossrefGoogle Scholar

 

8. Darwazeh A, Lamey PJ, Samaranayake L, MacFarlane T, Fisher B, Macrury S. et al. The relationship between colonisation, secretor status and in-vitro adhesion of Candida albicans to buccal epithelial cells from diabetics. J Med Microbiol, 1990;33:43-49.Google Scholar

 

9. Collis J, Stafford G. A survey of denture hygiene in patients attending Cardiff Dental Hospital. Eur J Prosthodont Restor Dent, 1994;3:67-71.Google Scholar

 

10. Barbeau J, Séguin J, Goulet JP, de Koninck L, Avon SL, Lalonde B et al. Reassessing the presence of Candida albicans in denture-related stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2003;95:51-59.Google Scholar

 

11. Marinoski J, Bokor-Bratic M, Cankovic M. Is denture stomatitis always related with candida infection? A case control study. Med Glas (Zenica), 2014;11:379-384.Google Scholar

 

12. Dar-Odeh NS, Shehabi AA. Oral Candidosis in patients with removable dentures. Mycoses, 2003;46:187-191.CrossrefGoogle Scholar

 

13. Olsen I. Denture stomatitis occurrence and distribution of fungi. Acta Odontol Scand, 1974;32:329-333.CrossrefGoogle Scholar

 

14. Rocha Gusmão JM, Ferreira dos Santos SS, Piero Neisser M, Cardoso Jorge AO, Ivan Faria M. Correlation between factors associated with the removable partial dentures use and Candida spp. in saliva. Gerodontol, 2011;28:283-288.Google Scholar

 

15. Costa F, Manaia C, Figueiral M, Pinto E. Genotypic analysis of Candida albicans isolates obtained from removable prosthesis wearers. Lett Appl Microbiol, 2008;46:445-449.Web of ScienceCrossrefGoogle Scholar

 

16. Burford-Mason A, Weber J, Willoughby J. Oral carriage of Candida albicans, ABO blood group and secretor status in healthy subjects. J Med Vet Mycol, 1988;26:49-56.Google Scholar

 

17. Kramer I, Pindborg JJ, Bezroukov V, Infirri J. Guide to epidemiology and diagnosis of oral mucosal diseases and conditions. World Health Organization. Community Dent Oral Epidemiol, 1980;8:1-26.Google Scholar

 

18. Ellis D, Davis S, Alexiou H, Handke R, Bartley R. Descriptions of medical fungi. Nexus Print Solutions, Adelaide, South Australia, Australia, 2007.Google Scholar

 

19. Marinho SA, Teixeira AB, Santos OS, Cazanova RF, Ferreira CAS, Cherubini K. et al. Identification of Candida spp. by phenotypic tests and PCR. Braz J Microbiol, 2010;41:286-294.CrossrefWeb of ScienceGoogle Scholar

 

20. Scully C. Oral and Maxillofacial Medicine: the basis of diagnosis and treatment. Second Edition ed: Elsevier Health Sciences; 2008, pp 393.Google Scholar

 

21. Kulak Y, Arikan A, Kazazoglu E. Existence of Candida albicans and microorganisms in denture stomatitis patients. J Oral Rehabil, 1997;24:788-790.CrossrefGoogle Scholar

 

22. Budtz-Jørgensen E. Ecology of Candida-associated denture stomatitis. Microb Ecol Health Dis, 2000;12:170-185.Google Scholar

 

23. Lamfon H, Porter SR, McCullough M, Pratten J. Formation of Candida albicans biofilms on non-shedding oral surfaces. Eur J Oral Sci, 2003;111:465-471.Google Scholar

 

24. Bartels H. Local and systemic factors in oral moniliasis. New York J Dent, 1965;35:283.Google Scholar

 

25. Sardi JCO, Almeida AMF, Mendes Giannini MJS. New antimicrobial therapies used against fungi present in subgingival sites-a brief review. Arch Oral Biol, 2011;56:951-959.CrossrefGoogle Scholar

 

26. Savage A, Eaton KA, Moles DR, Needleman I. A systematic review of definitions of periodontitis and methods that have been used to identify this disease. J Clin Periodont, 2009;36:458-467.Web of ScienceGoogle Scholar

 

27. Barros LM, Boriollo MFG, Alves ACBA, Klein MI, Gonçalves RB, Höfling JF. Genetic diversity and exoenzyme activities of Candida albicans and Candida dubliniensis isolated from the oral cavity of Brazilian periodontal patients. Arch Oral Biol, 2008;53:1172-1178.Web of ScienceGoogle Scholar

 

28. Epstein JB, Truelove EL, Izutzu KT. Oral Candidiasis: Pathogenesis and Host Defense. Rev Infect Dis, 1984;6:96-106.CrossrefGoogle Scholar

 

29. Yang Y-L. Virulence factors of Candida species. J Microbiol Immunol Infect, 2003;36:223-228.Google Scholar

 

30. 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.CrossrefGoogle Scholar

 

31. Pires F, Santos E, Bonan P, De Almeida O, Lopes M. Denture stomatitis and salivary Candida in Brazilian edentulous patients. J Oral Rehabil, 2002;29:1115-1119.CrossrefGoogle Scholar

 

32. Pereira CA, Toledo BC, Santos CT, Pereira Costa ACB, Back-Brito GN, Kaminagakura E et al. Opportunistic microorganisms in individuals with lesions of denture stomatitis. Diagn Microbiol Infect Dis, 2013;76:419-424.CrossrefGoogle Scholar

 

33. Rabelo GD, Noborikawa E, Siqueira CS, da Silveira FRX, Lotufo MA. Detection of single and mixed colonization of Candida species in patients with denture stomatitis. Braz J Oral Sci, 2011;10:184-188.Google Scholar

 

34. Sinnott JT, Cullison JP, Sweeney MP. Candida (Torulopsis) glabrata. Infect Control, 1987;8:334-336.Google Scholar

 

35. Zomorodian K, Haghighi NN, Rajaee N, Pakshir K, Tarazooie B, Vojdani M. et al. Assessment of Candida species colonization and denture-related stomatitis in complete denture wearers. Med Mycol, 2011;49:208-211.Web of ScienceGoogle Scholar

 

36. González GM, Elizondo M, Ayala J. Trends in species distribution and susceptibility of bloodstream isolates of Candida collected in Monterrey, Mexico, to seven antifungal agents: results of a 3-year (2004 to 2007) surveillance study. J Clin Microbiol, 2008;46:2902-2905.Web of ScienceGoogle Scholar

 

37. Colombo AL, Guimarães T, Silva LR, de Almeida Monfardini LP, Cunha AKB, Rady P. et al. Prospective observational study of candidemia in Sao Paulo, Brazil: incidence rate, epidemiology, and predictors of mortality. Infect Control Hosp Epidemiol, 2007;28:570-576.Google Scholar

 

38. Zomorodian K, Kavoosi F, Pishdad GR, Mehriar P, Ebrahimi H, Bandegani A. et al. Prevalence of oral Candida colonization in patients with diabetes mellitus. J Med Mycol, 2016;26:103-110.Web of ScienceCrossrefGoogle Scholar

 

39. Hitchcock C, Pye G, Troke P, Johnson E, Warnock D. Fluconazole resistance in Candida glabrata. Antimicro Agents Chemother, 1993;37:1962-1965.Google Scholar

 

40. O’Donnell LE, Robertson D, Nile CJ, Cross LJ, Riggio M, Sherriff A. et al. The Oral Microbiome of Denture Wearers Is Influenced by Levels of Natural Dentition. Plos One, 2015;10:e0137717.Google Scholar

 

41. Colombo A, Perfect J, DiNubile M, Bartizal K, Motyl M, Hicks P. 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.CrossrefGoogle Scholar

 

42. Bokor-Bratic M, Cankovic M, Dragnic N. Unstimulated whole salivary flow rate and anxiolytics intake are independently associated with oral Candida infection in patients with oral lichen planus. Eur J Oral Sci, 2013;121:427-433.Web of ScienceGoogle Scholar

 

43. Otašević S, Barac A, Pekmezovic M, Tasic S, Ignjatović A, Momčilović S. et al. The prevalence of Candida onychomycosis in Southeastern Serbia from 2011 to 2015. Mycoses, 2016;59:167-172.Web of ScienceGoogle Scholar

 

44. Freitas JB, Gomez RS, De Abreu MHNG, Ferreira E Ferreira E. Relationship between the use of full dentures and mucosal alterations among elderly Brazilians. J Oral Rehabil, 2008;35:370-374.CrossrefWeb of ScienceGoogle Scholar

 

45. Yang YL, Ho YA, Cheng HH, Ho M, Lo HJ. Susceptibilities of Candida species to amphotericin B and fluconazole: the emergence of fluconazole resistance in Candida tropicalis. Infect Control Hosp Epidemiol, 2004;25:60-64.Google Scholar

 

46. Hill LV, Tan MH, Pereira LH, Embil JA. Association of oral candidiasis with diabetic control. J Clin Pathol, 1989;42:502-505.CrossrefGoogle Scholar

Citation Information: Balkan Journal of Dental Medicine, Volume 22, Issue 1, Pages 15–21, ISSN (Online) 2335-0245,DOI: https://doi.org/10.2478/bjdm-2018-0003.

COMMENTS