The prevalence of denture stomatitis as well as the frequency of isolation of Candida species and their density on the palatal mucosa have been compared in 70 acrylic denture-wearers suffering from non-insulin-dependent diabetes mellitus (NIDDM) versus 58 acrylic denture-wearers with normal glucose metabolism. The adherence of C. albicans to palatal epithelial cells in vitro was also assessed in both groups. The patients with NIDDM had a significantly higher prevalence of denture stomatitis compared with the controls. The frequency of Candida colonization was increased in diabetics, but not significantly. According to the imprint culture technique, the density of Candida species was significantly higher in patients with NIDDM compared with the controls. The adherence of C. albicans to palatal epithelial cells from patients with NIDDM showed a significant increase compared with that observed in cells collected from the controls. This study supports the view that NIDDM predisposes to Candida-associated denture stomatitis.

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IntroductionRecurrent aphthous stomatitis (RAS) is a common chronic inflammatory oral mucosa disease with an unknown cause. However, dysregulation of the immune response seems to play an important role in this disease.AimTo evaluate the vitamin D status in RAS patients and its effects on RAS severity, given the likely immunomodulatory function of vitamin D in the human organism.Material and methodsSixty-six patients with RAS and 66 controls were examined. Immunomodulatory or immunosuppressive treatment and other ulcerative oral diseases were used as exclusion criteria. The severity of RAS was assessed according to the clinical classification of the disease, the number of lesions per flare-up and the length of intervals between the attacks. The serum vitamin D level was established in each participant.ResultsThe mean serum vitamin D (25(OH)D) levels were found to be 16.81 ng/ml in the study group and 19.22 ng/ml in the control group, with no statistically significant difference between the two groups. In the study group, 5 (7.6%) participants were diagnosed with the “normal” vitamin D levels, while 16 (24.2%) had “insufficient” levels and 45 (68.2%) had “deficient” levels. The corresponding distribution in the control group was 8 (12.1%), 18 (27.3%) and 40 (60.6%), respectively. There was no statistical significance in the difference of vitamin D deficits between the study and the control groups. No correlation was detected between the severity of RAS and the serum vitamin D level.ConclusionsVitamin D does not seem to be a trigger factor for RAS occurrence and does not appear to influence the severity of the disease in the studied group.

Candida-associated denture stomatitis has a high rate of recurrence. Candida biofilms formed on denture acrylic are more resistant to antifungals than planktonic yeasts. Histatins, a family of basic peptides secreted by the major salivary glands in humans, especially histatin 5, possess significant antifungal properties. We examined antifungal activities of histatin 5 against planktonic or biofilm Candida albicans and Candida glabrata. Candida biofilms were developed on poly(methyl methacrylate) discs and treated with histatin 5 (0.01-100 microM) or fluconazole (1-200 microM). The metabolic activity of the biofilms was measured by the XTT reduction assay. The fungicidal activity of histatin 5 against planktonic Candida was tested by microdilution plate assay. Biofilm and planktonic C. albicans GDH18, UTR-14 and 6122/06 were highly susceptible to histatin 5, with 50% RMA (concentration of the agent causing 50% reduction in the metabolic activity; biofilm) of 4.6 +/- 2.2, 6.9 +/- 3.7 and 1.7 +/- 1.5 microM, and IC(50) (planktonic cells) of 3.0 +/- 0.5, 2.6 +/- 0.1 and 4.8 +/- 0.5, respectively. Biofilms of C. glabrata GDH1407 and 6115/06 were less susceptible to histatin 5, with 50% RMA of 31.2 +/- 4.8 and 62.5 +/- 0.7 microM, respectively. Planktonic C. glabrata was insensitive to histatin 5 (IC(50) > 100 microM). Biofilm-associated Candida was highly resistant to fluconazole in the range 1-200 microM; e.g. at 100 microM only approximately 20% inhibition was observed for C. albicans, and approximately 30% inhibition for C. glabrata. These results indicate that histatin 5 exhibits antifungal activity against biofilms of C. albicans and C. glabrata developed on denture acrylic. C. glabrata is significantly less sensitive to histatin 5 than C. albicans.