Revista de Odontologia da UNESP
https://www.revodontolunesp.com.br/article/doi/10.1590/1807-2577.1027
Revista de Odontologia da UNESP
Original Article

Identificação das espécies de Candida em portadores de estomatite protética e avaliação da susceptibilidade ao miconazol e à terapia fotodinâmica

Identification of Candida species in patients with denture stomatitis and evaluation of susceptibility to miconazole and photodynamic therapy

Leite, Danielle Prado; Piva, Marta Rabello; Martins Filho, Paulo Ricardo S.

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Resumo

Introdução: Próteses mucossuportadas são consideradas facilitadoras, em potencial, da estomatite protética (EP), condição caracterizada pelo aspecto eritematoso, difuso ou pontilhado da mucosa palatina sob a base das próteses. A etiologia da doença é multifatorial, embora a infecção por Candida seja uma causa bastante comum. Objetivo: Relacionar a EP com a presença de Candida, identificar as espécies de Candida mais prevalentes, a partir do meio CHROMagar Candida®, e caracterizar o perfil de sensibilidade das colônias ao miconazol e à terapia fotodinâmica (TFD). Material e método: A amostra foi constituída por 45 usuários de prótese total, sendo 30 com diagnóstico clínico de EP e 15 sem a doença. Realizou-se raspagem com swab da mucosa palatina e das próteses, e as amostras foram semeadas em CHROMagar Candida®, para identificação de espécies de C. albicans, C. krusei e C. tropicalis. Após incubação e leitura das placas, as colônias foram reisoladas em Ágar Sabouraud, para caracterização da sensibilidade ao miconazol e à TFD. Resultado: Espécies de Candida estiveram presentes em 53,33% das amostras dos pacientes com EP e em 6,67% das amostras dos pacientes sem EP, considerando-se o total de amostras de mucosa (p=0,008) e próteses (p=0,001). As espécies mais prevalentes foram C. albicans (36,67% e 53,33%), seguida de C. tropicalis (13,33% e 16,67%) e C. krusei (13,33% e 6,67%), em mucosa e prótese, respectivamente. As amostras mostraram maior sensibilidade ao miconazol que à TFD (p<0,0001). Conclusão: Existiu uma associação entre a presença de Candida e EP, sendo C. albicans a espécie mais prevalente. Miconazol proveu melhores resultados na eliminação in vitro de colônias de Candida quando comparado à TFD.

Palavras-chave

Prótese dentária, estomatite, Candida.

Abstract

Introduction: Denture stomatitis (DS) is a common oral mucosal lesion in complete denture users. It is usually seen as limited to the area beneath an upper denture, characterized by focal or diffuse erythema of the denture-supporting tissues. The etiology of this lesion is multifactorial, although Candida infection is a common cause of disease. Objective: To relate the DS with the presence of Candida, to identify the most prevalent species of Candida using CHROMagar Candida® medium and to verify the susceptibility of the isolates to miconazole and photodynamic therapy (PDT). Material and method: The sample was constituted of 45 complete denture users, 30 patients with clinical DS and 15 without disease. Palatal mucosa and dentures were frictioned with sterilized swabs and sown in CHROMagar Candida® medium to identify species of C. albicans, C. tropicalis and C. krusei. After incubation and observation of the plaques, the yeasts were reisolated in Sabouraud Agar medium for verification of species susceptibility to miconazole and PDT. Result: Candida species were found in 53,33% of the patients with DS and in 6,67% of the patients without DS, considering all of the palatal mucosa (p=0,008) and denture (p=0,001). The most prevalent species were C. albicans (36,67% and 53,33%), followed by C. tropicalis (13,33% and 16,67%) and C. krusei (13,33 and 6,67%), on mucosal and denture, respectively. The samples were more sensitive to miconazole than PDT (p<0,0001). Conclusion: There was an association between the presence of Candida and DS, and C. albicans the most prevalent species. Miconazole provided better results in the elimination of in vitro colonies of Candida compared with PDT.

Keywords

Dental prosthesis, stomatitis, Candida.

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