Efficacy of photodynamic therapy versus local nystatin in the treatment of denture stomatitis: A randomized clinical study
Efficacy of photodynamic therapy versus local nystatin in the treatment of denture stomatitis: A randomized clinical study
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DOI：
10.1016/j.pdpdt.2019.08.028
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发表时间：
2019-12-01
影响因子：
3.3
通讯作者：
Vohra, Fahim
中科院分区：
文献类型：
--
作者：
Alrabiah, Mohammed;Alsahhaf, Abdulaziz;Vohra, Fahim
目的：本随机临床研究的目的是比较光动力灭活（PDI）和制霉菌素（NST）对假牙口炎（DS）患者念珠菌种类的影响。方法：36例患者随机分为两组；PDI 18分，NST 18分。采用GaA1As二极管激光器进行辐照，波长、传输方式、激光输出和能量密度分别标准化为660 nm、连续模式、100 mW功率和28 J/cm2。PDI每周应用两次，在四周的疗程中间隔至少48小时。局部制霉菌素口服混悬液100,000 IU，每日4次，连用15天。采用微生物培养技术证实了念珠菌的存在。在基线、治疗结束（第15天）和随访（第30天和第60天）时测量腭和义齿表面的念珠菌菌落计数，量化为菌落形成单位(CFU)/mL，并确定两组治疗中念珠菌的流行情况。结果：两组患者的总CFU/mL值均高于上颚患者。在研究的所有时间段内，NST组和PDI组获得的CFU/mL值没有显着差异。对于假牙和腭，与基线（第0天）相比，NST组和PDI组在第15天观察到平均CFU/mL值显着降低。可以看出，治疗对NST组患者腭部的效应量较大（1.79），对PDI组患者腭部的效应量中等（0.63）。另一方面，两组对义齿的效应量都非常大（NST组= 3.01；PDI组= 1.58）。在整个研究期间，患者的假牙和腭上最常见的菌种是白色念珠菌，其次是热带念珠菌和光滑念珠菌。结论：在所有念珠菌中，白色念珠菌的感染率最高。此外，PDI与制霉菌素治疗DS同样有效。
Aim: The aim of the present randomized clinical study was to compare the efficacies of photodynamic inactivation (PDI) to nystatin (NST) in terms of prevalence of Candida species in cases with denture stomatitis (DS).Methods: Thirty-six patients were randomly divided into two groups; 18 in PDI and 18 in NST. Irradiation was carried out by using the GaA1As diode laser with wavelength, mode of transmission, laser output and energy density were standardized at 660 nm, continuous mode, 100 mW power and 28 J/cm2 respectively. The PDI was applied twice a week, with an interval of at least 48 h among the sessions during four weeks. Topical nystatin oral suspension 100,000 IU was used four times daily for 15 days. The existence of Candida spp. was confirmed by employing the microbiological culture technique. Candida colony counts from the palates and dentures surfaces, quantified as colony forming unit (CFU)/mL, measured at baseline, at the end of treatments (day 15), and at follow-up (days 30 and 60) and the prevalence of Candida spp. were identified in the two groups of treatments.Results: The overall CFU/mL values were higher in the dentures of the patients of both the groups than those from the palates. During all time periods of the study, the CFU/mL values obtained from both NST and PDI groups showed no significant differences. For dentures and palates, a significant reduction in mean CFU/mL values was observed on day 15 compared with baseline (day 0) in both NST and PDI groups. It can be seen that the effect size of treatments was large for the palates of patients in the NST group (1.79) and moderate for the palates of patients in the PDI group (0.63). On the other hand, the effect size was very large for the dentures for both groups (NST group = 3.01; PDI group = 1.58). C. albicans was the most common species on both dentures and palates of patients throughout the study period followed by C. tropicalis and C. glabrata.Conclusion: Out of all the Candida spp., C. albicans showed the highest prevalence among all species. In addition, PDI was equally effective as nystatin for the treatment of DS.