Miconazole lacquer in the treatment of denture stomatitis: clinical and microbiological findings in Chinese patients.

Abstract

OBJECTIVE: To investigate the efficacy of a miconazole lacquer in producing mycological and clinical cure of Candida-associated denture stomatitis in a Chinese cohort and to study the microbiology of the conditions. DESIGN: A cross-sectional study of the clinical and microbiological features of the condition and its response to treatment with the lacquer. SUBJECTS AND METHOD: Twenty-one Chinese adults with palatal erythema; 15 denture wearers matched for age and sex as controls for microbiology. Clinical examination, impression for culture, photograph of palate to monitor response to treatment, and lacquer application on upper denture base on days 0, 7 and 14. Impression and photograph repeated on day 21; impression cultures quantified by image analysis. Palatal impression in controls; dummy impression as control for impression culture procedures. MAIN OUTCOME MEASURES: Severity of lesion, incidence and type of microorganism at presentation and during treatment; qualitative and quantitative assessment of yeast growth; the latter by statistical analysis of pixel units of yeast colonies; correlation of clinical and mycological cure. RESULTS: Out of the 21 lesions (16 Newton's stage I and 5 stage II), 57% had yeasts at presentation, 10% coliforms and 33% no significant growth. Clinical cure in 3 weeks in 71%, mycological cure in 75% in 7 days; clinical and mycological cure coincided only in 43%. Polymicrobial growth of yeasts and coliforms throughout the course in some. CONCLUSIONS: Miconazole lacquer was a viable treatment option for Candida-associated denture stomatitis in this adult, Chinese cohort; microbiology comprised yeasts, mainly C. albicans and coliforms, especially Klebsiella and Enterobacter species; the pathogenic role of the latter is questionable.