Denture stomatitis is an oral mucosal condition that affects denture wearers. It is reported to occur in between 35-50% of denture wearers and is more common in the elderly. Denture stomatitis has a multifactorial aetiology and commonly associated with Candida spp and is characterised by inflammation and chronic erythema and oedema of the oral mucous membrane with the use of removable acrylic dentures. Good denture hygiene is important for prevention and treatment involves more stringent hygiene strategies, topical and systemic antifungals and possible rebasing or replacement of the dentures. Microwave cleaning has been suggested as an effective method of cleaning prostheses as an adjunct of alternative to antifungals.
The aim of this review was to evaluate the effectiveness of removable complete denture disinfection using microwaves for the treatment of denture stomatitis.
Methods
Searches were conducted in the Cochrane Library, PubMed/Medline, LILACS, Scopus, Web of Science and SiGLE databases. Clinical trials comparing the effectiveness of microwave denture disinfection and topical antifungal therapy for the treatment of denture stomatitis in patients wearing complete non-metallic removable dentures were considered. Two reviewers independently selected studies and extracted data with study quality being assessed using the Cochrane domain-based tool. A random effect meta-analysis was conducted, and the certainty of the evidence assessed using the GRADE approach.
Results
- 3 RCTs involving a total of 160 patients were included.
- 2 studies were at unclear risk of bias and 1 study at high risk.
- Treatment protocols in the 3 studies varied from 14-30 days with a follow up period of 90 days.
- All the studies reported significant reductions in Candida counts and the frequency of denture stomatitis of groups subjected to microwave disinfection of dentures and topical antifungal therapy with nystatin.
- Meta-analysis (2 studies) only identified significative differences between treatments for Candida quantification in the palate, at 90 days follow-up SMD = 0.47 (95%CI; 0.02-0.91).
Conclusions
The authors concluded: –
Microwave disinfection of complete dentures can be considered as efficient as antifungal therapy for the treatment of denture stomatitis. However, further well-designed studies are necessary to confirm such evidence.
Comments
This review of microwave disinfection of dentures was published at almost the same time as another review of the same topic by another group of researchers da Costa et al. Interestingly both groups had published their protocols on the PROSPERO database. As one of the aims of the PROSPERO database is to reduce duplication of effort it has not proved successful in this case or in many other cases. This review by Santos Sousa et al has searched an extensive range of databases and selected 3 RCTs compared with the 5 included in the da Costa et al review. Both reviews indicate that they followed the PRISMA guidelines and included the same two studies in their meta-analyses, with da Costa et al concluding;
Microwave disinfection showed comparable results with those of conventional therapies for treating candida-associated denture stomatitis (CADS).
Consequently, the findings of the reviews are similar however their findings should be viewed cautiously given both the small number and size of the included studies. In addition, the protocols for the use of microwaves varies so additional high quality well reported studies are needed to confirm the effectiveness and appropriate protocols for the use of microwaves in disinfecting dentures for the prevention and treatment of CADS.
Links
Primary Paper
Santos Sousa TM, Rodrigues de Farias O, Dantas Batista AU, Souto de Medeiros E, Santiago BM, Cavalcanti YW. Effectiveness of denture microwave disinfection for treatment of denture stomatitis: A systematic review and meta-analysis. Int J Dent Hyg. 2020 Oct 6. doi: 10.1111/idh.12477. Epub ahead of print. PMID: 33022878.
Other references
da Costa RMB, Poluha RL, De la Torre Canales G, Junior JFS, Conti PCR, Neppelenbroek KH, Porto VC. The effectiveness of microwave disinfection in treating Candida-associated denture stomatitis: a systematic review and metaanalysis. Clin Oral Investig. 2020 Nov;24(11):3821-3832. doi: 10.1007/s00784-020-03599-5. Epub 2020 Sep 24. PMID: 32974776.
Dental Elf – 20th Nov 2017
Dental Elf – 10th May 2017
Denture stomatitis: some evidence for nystatin and disinfecting agents
