The effectiveness of microwave disinfection in treating Candida-associated denture stomatitis: a systematic review and m
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REVIEW
The effectiveness of microwave disinfection in treating Candida-associated denture stomatitis: a systematic review and metaanalysis Rodrigo Moreira Bringel da Costa 1 & Rodrigo Lorenzi Poluha 1 & Giancarlo De la Torre Canales 1 & Joel Ferreira Santiago Junior 2 & Paulo Cesar Rodrigues Conti 1 & Karin Hermana Neppelenbroek 1 & Vinicius Carvalho Porto 1 Received: 17 July 2020 / Accepted: 16 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective To evaluate the effectiveness of microwave disinfection in treating Candida-associated denture stomatitis (CADS). Materials and methods The PubMed/MEDLINE, Embase, and Scopus databases were searched for reports on randomized clinical trials (RCTs) published in English until May 2020 (PROSPERO CRD42020192062) that evaluated the treatment of CADS by using microwave disinfection. The main outcomes were the improvement of clinical signs and/or the decrease in the residual yeast present on the dentures and palatal mucosa. The mean differences, standard deviations, risk ratio, and 95% confidence interval were calculated by using the random-effects model. Heterogeneity was assessed by using Cochran’s Q test and I2 values. The level of significance was set at α = 0.05. Results Five RCTs with 245 participants were included. The descriptive investigations demonstrated that microwave disinfection was as effective (p > 0.05) as 0.2% chlorhexidine, 0.02% sodium hypochlorite, and topical nystatin (100.000 IU/mL), and was superior to topical miconazole in treating CADS. The metaanalysis did not show a statistical difference between microwave disinfection and nystatin (100.000 IU/mL) treatment in terms of mycological counts, cure, and recurrence rates (p > 0.05). Conclusion Microwave disinfection showed comparable results with those of conventional therapies for treating CADS. In addition, treatment with 650 W for 3 min once a week for 14 days had better cost-effect results, indicating both the prevention and treatment of CADS. Clinical relevance Our findings provide evidence regarding the treatment of CADS using microwave disinfection, and also indicating the best cost-effective option for this treatment modality. Keywords Denture stomatitis . Treatment . Microwaves . Randomized controlled trial . Systematic review . Metaanalysis
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00784-020-03599-5) contains supplementary material, which is available to authorized users. * Rodrigo Moreira Bringel da Costa [email protected] 1
Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla, 9-75, Bauru, SP 17012-901, Brazil
2
Department of Health Sciences, School of Dentistry, Centro Universitário Sagrado Coração – UNISAGRADO, Irmã Arminda St., 10-50, Bauru, SP 17011-160, Brazil
Candida-associated denture stomatitis (CADS) is an opportunistic fungal infection that affects approximately 15–70% of complete removable
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