Denture stomatitis: Treatment with antimicrobial drugs or antifungal gels? A systematic review of clinical trials

João Marcos Carvalho-Silva; Carol Silva Gaspar; Andréa Cândido Dos Reis; Ana Beatriz Vilela Teixeira

doi:10.1016/j.prosdent.2023.12.014

Denture stomatitis: Treatment with antimicrobial drugs or antifungal gels? A systematic review of clinical trials

J Prosthet Dent. 2024 Jan 8:S0022-3913(23)00829-6. doi: 10.1016/j.prosdent.2023.12.014. Online ahead of print.

Authors

João Marcos Carvalho-Silva¹, Carol Silva Gaspar², Andréa Cândido Dos Reis³, Ana Beatriz Vilela Teixeira⁴

Affiliations

¹ Undergraduate student, Department of Dental Materials and Prosthesis, Ribeirão Preto Dental School, University of São Paulo (USP), Ribeirão Preto, Brazil.
² Graduate student, Department of Dental Materials and Prosthesis, Ribeirão Preto Dental School, University of São Paulo (USP), Ribeirão Preto, Brazil.
³ Associate Professor, Department of Dental Materials and Prosthesis, Ribeirão Preto Dental School, University of São Paulo (USP), Ribeirão Preto, Brazil. Electronic address: andreare73@yahoo.com.br.
⁴ Postdoctoral student, Department of Dental Materials and Prosthesis, Ribeirão Preto Dental School, University of São Paulo (USP), Ribeirão Preto, Brazil.

PMID: 38195253
DOI: 10.1016/j.prosdent.2023.12.014

Abstract

Statement of problem: Gel formulations containing antimicrobials are a potential alternative for the development of new medicines for the treatment of denture stomatitis (DS). However, whether they are more effective than antifungal drugs is unclear.

Purpose: The purpose of this systematic review was to identify whether gels formulated with antimicrobial substances are more effective and biocompatible for the treatment of DS than antifungal drugs.

Material and methods: This systematic review was structured according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42022379510). Searches were performed in the PubMed, Lilacs, Web of Science, Scopus, Embase, and Google Scholar databases in November 2022. Randomized and nonrandomized clinical trials comparing the efficacy of experimental gels and conventional antifungals in the treatment of DS were included.

Results: Gels formulated with Zataria multiflora essential oil and clove and cinnamon extracts showed higher antimicrobial efficacy compared with miconazole and clotrimazole. Formulations containing Uncaria tomentosa, Punica granatum, and propolis extract showed similar efficacy to nystatin and miconazole. Two formulations containing P. granatum were less effective than nystatin and miconazole. Gels of Z. multiflora and miconazole induced adverse effects including burning, itching, nausea, and vomiting. The included studies did not evaluate the biocompatibility of the gels.

Conclusions: Gels formulated with natural antimicrobials such as Z. multiflora, U. tomentosa, P. granatum, propolis, and clove and cinnamon showed higher or similar antimicrobial efficacy to conventional antifungals in the treatment of DS. The biocompatibility of experimental gels based on natural agents should be evaluated.

Publication types

Review