FEATURES OF THE MANIFESTATION OF CANDIDIASIS OF THE ORAL MUCOSA IN PATIENTS WITH REMOVABLE DENTURES


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Abstract

Identification of factors influencing the occurrence of candidiasis of the oral mucosa in patients with removable dentures. Methods. The study involved patients with acrylic removable dentures aged 65–80 years. Clinical examination of patients, questioning, determination of the hygienic state of removable dentures and the index of oral hygiene were carried out. Identified nutritional features, assessing the quality of fit of prostheses. When signs of candidal stomatitis were detected, patients were sent for a cultural study to detect fungi of the genus Candida. Results. In 23.3% of cases, atrophic candidiasis of the oral mucosa, 4.6% angular cheilitis, 2.3% cheilitis, and 4.6% candidal glossitis were detected. In 6.9%, a decrease in bite height was recorded. Carriage of fungi of the genus Candida was determined in 18.6% of cases, and in 4.6% with a significant content of colonies in swabs (more than 104 CFU/ml), candidiasis was diagnosed. In 70% of cases, the hygiene of the oral cavity and prostheses was unsatisfactory. According to the survey data, diseases of the gastrointestinal tract were detected in 46.5% of cases, type 2 diabetes mellitus in 13.9%, and smoking in 11.6%. Conclusions. Prolonged wearing of removable dentures during the day, especially at night, has an adverse effect on the condition of the palatal mucosa as a result of mechanical pressure and biofilm fixation on the denture. The presence of a comorbid pathology that reduces immunity, as well as the deterioration of the manual skills of patients with age and the progressive weakening of visual acuity contribute to the development and exacerbation of oral candidiasis. 

Full Text

Relevance: Fungi of the genus Candida belong to the conditionally pathogenic flora, C. albicans most often causes diseases of the oral mucosa. This form of fungi creates a biofilm on the surface. The combination of favorable conditions for the growth of fungi (22-36 degrees) and a moderately moist slightly acidic environment (pH 5.8-6.5) allows the disease to develop [1]. Antigens of a protein nature contribute to the manifestation of an allergy of the body. Due to the ability of adhesion to mucosal cells and changes in the immune response (antigenic mimicry), the ability to form strains of resistant forms increases the risk of developing mucosal candidiasis [2].

The purpose of the study: to identify the factors influencing the occurrence of candidiasis of the oral mucosa in patients with removable dentures.

Materials and methods. The study involved 43 patients aged 65 to 80 years (12 men, 31 women) who used acrylic removable dentures of the upper jaw (17 full removable dentures, 2 partial removable dentures6). A clinical examination of patients was carried out, determination of the hygienic condition of the prosthesis according to the method of V.N. Trezubov et al. [3] and the oral hygiene index OHI-s (Green-Vermillion, 1964) (in the presence of preserved teeth) [4]. Patients filled out a questionnaire indicating the presence of somatic diseases, as well as a specially designed questionnaire to identify risk factors for oral candidiasis (the presence of discomfort when wearing a prosthesis, injuries to the oral mucosa, the amount of refined carbohydrates in food, bad habits). In the presence of signs of prosthetic stomatitis, patients were referred for a cultural study: flushes from the palate and from a removable prosthesis to detect colonies of the fungus genus Candida. The data were processed using the Statistica10.0 program (StatSoft, Russia).

Results. In 23.3% of cases (10 people), atrophic candidiasis of the oral mucosa was detected, in 2 people (4.6%) - angular cheilitis, in 1 person - cheilitis (2.3%), in 2 people(4.6%) – candidiasis glossitis. In 6.9% of cases (3 people), a decrease in the height of the bite was recorded. In 18.6% of cases (8 people), the carrier of fungi of the genus Candida albicans was determined (detection of micromycetes in the amount of 102 CFU/ml). In 4.6% of cases (2 people), more than CFU/ml was detected when seeding on the nutrient medium of flushing from the mucous membrane of the palate, which corresponds to the existing candidiasis. Oral hygiene in patients with atrophic candidiasis of the oral mucosa with complete absence of teeth on both jaws was satisfactory, in the presence of preserved teeth in 70% of cases, hygiene was unsatisfactory (7 people) and in 30% (3 people) satisfactory. According to the survey, the presence of diseases of the gastrointestinal tract was revealed in 46.5% of cases, type 2 diabetes in 13.9% of cases, smoking in 11.6% of cases.

Conclusions. Wearing removable dentures for a long time during the day, especially at night, has an adverse effect on the condition of the mucous membrane of the palate as a resultmechanical pressure and fixation of the biofilm on the prosthesis. The presence of comorbid pathology that reduces immunity, as well as the deterioration of patients' manual skills with age and the progressive weakening of visual acuity contribute to the development and exacerbation of oral candidiasis.

 
 
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About the authors

Yulia Fedorovna Semiglazova

Pavlov First St. Petersburg State Medical University

Email: jusemig@mail.ru
ORCID iD: 0000-0001-5898-088X
Russian Federation, 6-8, L. Tolstoy str., St. Petersburg, 197022, Russia

Vladimir Sultanovich Emgahov

Pavlov First St. Petersburg State Medical University

Author for correspondence.
Email: em2853@mail.ru
ORCID iD: 0009-0001-1743-6068
Russian Federation, 6-8, L. Tolstoy str., St. Petersburg, 197022, Russia

References

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  2. Давлеева Б.А. Современные аспекты патогенеза и лечения кандидоза полости рта // Вестник КазНМУ. – 2014. - №1. – С. 179-182. https://cyberleninka.ru/article/n/sovremennye-aspekty-patogeneza-i-lecheniya-kandidoza-polosti-rta.
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  4. Михайленко Т.Н. Клиническая оценка состояния гигиены полости рта у лиц со съемными конструкциями зубных протезов на основании интегрального индекса // Медицинский вестник Башкортостана. – 2014. – Т.9, №1. – С. 65-69. https://cyberleninka.ru/article/n/klinicheskaya-otsenka-sostoyaniya-gigieny-polosti-rta-u-lits-so-semnymi-konstruktsiyami-zubnyh-protezov-na-osnovanii-integralnogo.

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