Ahariz M, Loeb I, Courtois P
Service de stomatologie et chirurgie maxillofaciale, CHU Saint-Pierre, université libre de Bruxelles (ULB), 129, boulevard de Waterloo, 1000 Bruxelles, Belgique.
Rev Stomatol Chir Maxillofac. 2010 Apr;111(2):74-8. doi: 10.1016/j.stomax.2009.10.007. Epub 2010 Mar 27.
Yeasts belonging to the Candida genus usually colonize the human oral cavity. Immunocompromised patients or individuals with an imbalance of their oral microflora can develop yeast infections from this reservoir. However, saliva protects oral mucosa against candidosis; in turn, dry mouth is associated with increased yeast counts and candidosis risk. In vivo and in vitro studies have shown Candida incorporation into biofilms covering different biomaterials such as dentures: these biofilms may be an increased risk factor for invasive candidosis when the host immune system is compromised. Daily denture brushing is recommended to all wearers. Family or healthcare workers must take over this task when there is autonomy loss, especially in the elderly. In case of candidosis in denture wearers, decontamination of dentures is mandatory. Antimycotics (azoles, nystatin) must be kept for curative treatments of infected patients; they are less active against Candida biofilms on dentures and could lead to emergent resistance if applied daily to dentures against yeast colonization. There are several antiphlogistic solutions with antifungal properties. Nevertheless, literature data does not integrate all aspects of denture care: welfare of denture wearers, prevention of candidosis, biomaterial defects after decontamination processing, and taking into account possible Candida biofilm development. Daily brushing of dentures remains the key recommendation.
念珠菌属的酵母菌通常定殖于人类口腔。免疫功能低下的患者或口腔微生物群失衡的个体可能会从这个菌库中引发酵母菌感染。然而,唾液可保护口腔黏膜免受念珠菌病侵害;反之,口干与酵母菌数量增加及念珠菌病风险相关。体内和体外研究表明,念珠菌可嵌入覆盖不同生物材料(如假牙)的生物膜中:当宿主免疫系统受损时,这些生物膜可能是侵袭性念珠菌病的一个风险增加因素。建议所有假牙佩戴者每日刷洗假牙。当佩戴者失去自主能力时,尤其是老年人,家人或医护人员必须承担这项任务。假牙佩戴者发生念珠菌病时,必须对假牙进行消毒。抗真菌药(唑类、制霉菌素)必须留作治疗感染患者之用;它们对假牙上的念珠菌生物膜活性较低,如果每日用于假牙以防止酵母菌定殖,可能会导致出现耐药性。有几种具有抗真菌特性的消炎溶液。然而,文献数据并未涵盖假牙护理的所有方面:假牙佩戴者的健康、念珠菌病的预防、消毒处理后的生物材料缺陷,以及考虑到可能出现的念珠菌生物膜形成。每日刷洗假牙仍然是关键建议。