Comparative Antifungal Efficacy of Curcumin Plus Nystatin Versus Nystatin Monotherapy for Treatment of Denture Stomatitis: A Clinical Trial
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Abstract
Objectives: This study compared the antifungal efficacy of curcumin plus nystatin versus nystatin monotherapy for treatment of denture stomatitis.
Materials and Methods: This single-blind clinical trial evaluated 32 patients with types II and III denture stomatitis. Microbial samples were collected from the patients’ palate to count the Candida albicans (C. albicans) colonies. Erythema of the palate was quantified by measuring the surface area of the erythematous sites. The patients were randomly assigned to two groups (n=16). The control group received nystatin suspension while the test group received a curcumin mouthwash plus nystatin suspension. The number of C. albicans colony forming units (CFUs) and the surface area of the erythematous sites were calculated again after 14 days. Data were analyzed using t-test and Wilcoxon signed-rank test (alpha=0.05).
Results: Both groups experienced a significant reduction in C. albicans colony count after the intervention (P<0.001). There was no significant difference in reduction of colony count between the two groups (P=0.341). Both groups experienced a significant reduction in the size of erythema (P=0.001 for the nystatin and P<0.001 for the nystatin plus curcumin). The two groups were not significantly different regarding the size of erythema at baseline (P=0.956) or after the intervention (P=0.491).
Conclusion: Addition of curcumin to nystatin suspension did not add any significant advantage with regard to reduction of C. albicans colony count or erythema of the palate, and both interventions were equally effective.
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4. P, Kouadio AA, Bandiaky ON, Le Guehennec L, La Cochetière M-F. Host’s immunity and Candida species and associated with denture stomatitis: A narrative review. Microorganisms. 2022 Jul; 10(7):1437.
5. Gauch LM, Pedrosa SS, Silveira-Gomes F, Esteves RA, Marques-da-Silva SH. Isolation of Candida spp. from denture-related stomatitis in Pará, Brazil. Braz J Microbial. 2018 Jan;49(1):148-51.
6. Pinelli LAP, Montandon AAB, Corbi SCT, Moraes TA, Fais LMG. Ricinus communis treatment of denture stomatitis in institutionalised elderly. J Oral Rehabil. 2013 May;40(5):375-80.
7. Lyu X, Zhao C, Yan ZM, Hua H. Efficacy of nystatin for the treatment of oral candidiasis: a systematic review and meta-analysis. Drug Des Devel Ther. 2016 Mar;10:1161-71.
8. Jamalpour P, Lesan S, Ghodarzi M. Investigate the antifungal effect of three type of honey on Candida albicans, an in vitro study. J Res Dent Sci 2021 Jan;18:99-108.
9. Lesan S, Haji Fattahi F, Rahbar M, Mohammadi S. The effect of probiotic yoghurt on the frequency of salivary Candida. J Res Dentomaxillofac Sci 2017 Jul;2(2):1-7.
10. Bhat N, Mitra R, Reddy J, Oza S, Vinayak M. Evaluation of the efficacy of chlorhexidine and an herbal mouthwash on dental plaque: an invitro comparative study. Int J Pharm Bio Sci. 2013;4:625–32.
11. Joe B, Lokesh B. Dietary n-3 fatty acids, curcumin and capsaicin lower the release of lysosomal enzymes and eicosanoids in rat peritoneal macrophages. Mol Cell Biochem. 2000 Jan;203(1):153-61.
12. Lantz RC, Chen GJ, Sarihan M, Solyom AM, Jolad SD, Timmermann BN. The effect of extracts from ginger rhizome on inflammatory mediator production. Phytomedicine. 2007 Feb;14(2-3):123-8.
13. Anand P, Kunnumakkara AB, Newman RA, Aggarwal BB. Bioavailability of curcumin: Problems and promises. Mol Pharm 2007 Dec;4(6):807-18.
14. Mustafa MW, Ungphaiboon S, Phadoongsombut N, Pangsomboon K, Chelae S, Mahattanadul S. Effectiveness of an alcohol-free chitosan–curcuminoid mouthwash compared with chlorhexidine mouthwash in denture stomatitis treatment: a randomized trial. J Altern Complement Med. 2019 May;25(5):552-8.
15. Babaii N, Zamaninejad S. Inhibitory effect of curcumin on Candida-albicans compared with nystatin: an in-vitro study. J Dent Mater Tech. 2016 Dec;5(4):196-201.
16. Garcia-Gomes AS, Curvelo JA, Soares RA, Ferreira-Pereira A. Curcumin acts synergistically with fluconazole to sensitize a clinical isolate of Candida albicans showing a MDR phenotype. Med Mycol. 2012 Jan;50(1):26-32.
17. Alalwan H, Rajendran R, Lappin DF, Combet E, Shahzad M, Robertson D, et al. The anti-adhesive effect of curcumin on Candida albicans biofilms on denture materials. Front Microbiol. 2017 Apr;8:659.
18. Maheshwari RK, Singh AK, Gaddipati J, Srimal RC. Multiple biological activities of curcumin: a short review. Life Sci. 2006 Mar;78(18):2081-7.
19. Golpour H, Ranji N, Sharami SH. Investigation of antifungal effect of nanoparticle-encapsulated curcumin on CDR1 gene expression in fluconazole-resistant isolates of Candida albicans. J Microb World. 2017;10(3):222-30.
20. Amanlou M, Beitollahi JM, Abdollahzadeh S, Tohidast‐Ekrad Z. Miconazole gel compared with Zataria multiflora Boiss. gel in the treatment of denture stomatitis. Phytother Res. 2006 Nov;20(11):966-9.
21. Sahlan M, Ardiellaputri AP, Hermasnyah H, Wijanarko A, Darwita RR. Anti oral biofilm mouthwash nanoemulsion containing extract propolis and curcumin. In AIP Conference Proceedings 2018 Nov 7 (Vol. 2024, No. 1, p. 020059). AIP Publishing LLC.
22. Tanaka S, Yoshida M, Murakami Y, Ogiwara T, Shoji M, Kobayashi S, et al. The relationship of Prevotella intermedia, Prevotella nigrescens and Prevotella melaninogenica in the supragingival plaque of children, caries and oral malodor. J Clin Pediatr Dent. 2008 Apr;32(3):195-200.
23. E, da Silva RM, Leite CE, Campos MM, Figueiredo MA, Salum FG, et al. Stability and efficacy of combined nystatin and chlorhexidine against suspensions and biofilms of candida albicans. Arch Oral Biol. 2018 May;89:70-6.
24. Alazzawi H, Ahmed JN. Assessment of oral sample collection technique for the isolation of Candida albicans from patients having denture stomatitis. Int J Sci Res. 2017 Apr;6(4):1100-3.
25. Sharma M, Manoharlal R, Negi AS, Prasad R. Synergistic anticandidal activity of pure polyphenol curcumin I in combination with azoles and polyenes generates reactive oxygen species leading to apoptosis. FEMS yeast Res. 2010 Aug;10(5):570-8.
26. Mugilan R, Jayaswal R, Sowmya R, Vincent SS, Vaishali K, Prasad K. Effect of curcumin on healing of extraction sockets in type II diabetic patients-A pilot study. J Evol Med Dent Sci. 2020 Mar;9(13):1045-50.
27. Raman P, Pitty R, Krithika CL, Anand SN, Subramani GP. Topical curcumin and triamcinolone acetonide in recurrent minor aphthous ulcers: A pilot trial. J Contemp Dent Pract. 2020 Aug;21(8):885-90.
28. Malekzadeh M, Kia SJ, Mashaei L, Moosavi MS. Oral nano‐curcumin on gingival inflammation in patients with gingivitis and mild periodontitis. Clin Exp Dent Res. 2021 Feb;7(1):78-84.
29. Gonoudi E, Rezai M, Farrokhnia T, Goudarzi M, Sima A. Comparison of antifungal efficacy of Zataria multiflora and nystatin for treatment of denture stomatitis: A randomized clinical trial. J Dent (Shiraz) 2021 Mar;22(1):60-6.
30. Dos Santos AG, Marquês JT, Carreira AC, Castro IR, Viana AS, Mingeot-Leclercq MP, et al. The molecular mechanism of nystatin action is dependent on membrane biophysical properties and lipid composition. Phys Chem Chem Phys. 2017 Nov;19(44):30078-88.
2. de Souza RF, Khiyani MF, Chaves CAL, Feine J, Barbeau J, Fuentes R, et al. Improving practice guidelines for the treatment of denture-related erythematous stomatitis: a study protocol for a randomized controlled trial. Trials. 2017 May;18(1):1-8.
3. Badaró MM, Bueno FL, Arnez RM, Oliveira VC, Macedo AP, Souza RF, et al. The effect of three disinfection protocols on candida spp., denture stomatitis, and biofilm: A parallel group Randomized Controlled Trial. J Prosthet Dent. 2020 Dec;124(6):690-8.
4. P, Kouadio AA, Bandiaky ON, Le Guehennec L, La Cochetière M-F. Host’s immunity and Candida species and associated with denture stomatitis: A narrative review. Microorganisms. 2022 Jul; 10(7):1437.
5. Gauch LM, Pedrosa SS, Silveira-Gomes F, Esteves RA, Marques-da-Silva SH. Isolation of Candida spp. from denture-related stomatitis in Pará, Brazil. Braz J Microbial. 2018 Jan;49(1):148-51.
6. Pinelli LAP, Montandon AAB, Corbi SCT, Moraes TA, Fais LMG. Ricinus communis treatment of denture stomatitis in institutionalised elderly. J Oral Rehabil. 2013 May;40(5):375-80.
7. Lyu X, Zhao C, Yan ZM, Hua H. Efficacy of nystatin for the treatment of oral candidiasis: a systematic review and meta-analysis. Drug Des Devel Ther. 2016 Mar;10:1161-71.
8. Jamalpour P, Lesan S, Ghodarzi M. Investigate the antifungal effect of three type of honey on Candida albicans, an in vitro study. J Res Dent Sci 2021 Jan;18:99-108.
9. Lesan S, Haji Fattahi F, Rahbar M, Mohammadi S. The effect of probiotic yoghurt on the frequency of salivary Candida. J Res Dentomaxillofac Sci 2017 Jul;2(2):1-7.
10. Bhat N, Mitra R, Reddy J, Oza S, Vinayak M. Evaluation of the efficacy of chlorhexidine and an herbal mouthwash on dental plaque: an invitro comparative study. Int J Pharm Bio Sci. 2013;4:625–32.
11. Joe B, Lokesh B. Dietary n-3 fatty acids, curcumin and capsaicin lower the release of lysosomal enzymes and eicosanoids in rat peritoneal macrophages. Mol Cell Biochem. 2000 Jan;203(1):153-61.
12. Lantz RC, Chen GJ, Sarihan M, Solyom AM, Jolad SD, Timmermann BN. The effect of extracts from ginger rhizome on inflammatory mediator production. Phytomedicine. 2007 Feb;14(2-3):123-8.
13. Anand P, Kunnumakkara AB, Newman RA, Aggarwal BB. Bioavailability of curcumin: Problems and promises. Mol Pharm 2007 Dec;4(6):807-18.
14. Mustafa MW, Ungphaiboon S, Phadoongsombut N, Pangsomboon K, Chelae S, Mahattanadul S. Effectiveness of an alcohol-free chitosan–curcuminoid mouthwash compared with chlorhexidine mouthwash in denture stomatitis treatment: a randomized trial. J Altern Complement Med. 2019 May;25(5):552-8.
15. Babaii N, Zamaninejad S. Inhibitory effect of curcumin on Candida-albicans compared with nystatin: an in-vitro study. J Dent Mater Tech. 2016 Dec;5(4):196-201.
16. Garcia-Gomes AS, Curvelo JA, Soares RA, Ferreira-Pereira A. Curcumin acts synergistically with fluconazole to sensitize a clinical isolate of Candida albicans showing a MDR phenotype. Med Mycol. 2012 Jan;50(1):26-32.
17. Alalwan H, Rajendran R, Lappin DF, Combet E, Shahzad M, Robertson D, et al. The anti-adhesive effect of curcumin on Candida albicans biofilms on denture materials. Front Microbiol. 2017 Apr;8:659.
18. Maheshwari RK, Singh AK, Gaddipati J, Srimal RC. Multiple biological activities of curcumin: a short review. Life Sci. 2006 Mar;78(18):2081-7.
19. Golpour H, Ranji N, Sharami SH. Investigation of antifungal effect of nanoparticle-encapsulated curcumin on CDR1 gene expression in fluconazole-resistant isolates of Candida albicans. J Microb World. 2017;10(3):222-30.
20. Amanlou M, Beitollahi JM, Abdollahzadeh S, Tohidast‐Ekrad Z. Miconazole gel compared with Zataria multiflora Boiss. gel in the treatment of denture stomatitis. Phytother Res. 2006 Nov;20(11):966-9.
21. Sahlan M, Ardiellaputri AP, Hermasnyah H, Wijanarko A, Darwita RR. Anti oral biofilm mouthwash nanoemulsion containing extract propolis and curcumin. In AIP Conference Proceedings 2018 Nov 7 (Vol. 2024, No. 1, p. 020059). AIP Publishing LLC.
22. Tanaka S, Yoshida M, Murakami Y, Ogiwara T, Shoji M, Kobayashi S, et al. The relationship of Prevotella intermedia, Prevotella nigrescens and Prevotella melaninogenica in the supragingival plaque of children, caries and oral malodor. J Clin Pediatr Dent. 2008 Apr;32(3):195-200.
23. E, da Silva RM, Leite CE, Campos MM, Figueiredo MA, Salum FG, et al. Stability and efficacy of combined nystatin and chlorhexidine against suspensions and biofilms of candida albicans. Arch Oral Biol. 2018 May;89:70-6.
24. Alazzawi H, Ahmed JN. Assessment of oral sample collection technique for the isolation of Candida albicans from patients having denture stomatitis. Int J Sci Res. 2017 Apr;6(4):1100-3.
25. Sharma M, Manoharlal R, Negi AS, Prasad R. Synergistic anticandidal activity of pure polyphenol curcumin I in combination with azoles and polyenes generates reactive oxygen species leading to apoptosis. FEMS yeast Res. 2010 Aug;10(5):570-8.
26. Mugilan R, Jayaswal R, Sowmya R, Vincent SS, Vaishali K, Prasad K. Effect of curcumin on healing of extraction sockets in type II diabetic patients-A pilot study. J Evol Med Dent Sci. 2020 Mar;9(13):1045-50.
27. Raman P, Pitty R, Krithika CL, Anand SN, Subramani GP. Topical curcumin and triamcinolone acetonide in recurrent minor aphthous ulcers: A pilot trial. J Contemp Dent Pract. 2020 Aug;21(8):885-90.
28. Malekzadeh M, Kia SJ, Mashaei L, Moosavi MS. Oral nano‐curcumin on gingival inflammation in patients with gingivitis and mild periodontitis. Clin Exp Dent Res. 2021 Feb;7(1):78-84.
29. Gonoudi E, Rezai M, Farrokhnia T, Goudarzi M, Sima A. Comparison of antifungal efficacy of Zataria multiflora and nystatin for treatment of denture stomatitis: A randomized clinical trial. J Dent (Shiraz) 2021 Mar;22(1):60-6.
30. Dos Santos AG, Marquês JT, Carreira AC, Castro IR, Viana AS, Mingeot-Leclercq MP, et al. The molecular mechanism of nystatin action is dependent on membrane biophysical properties and lipid composition. Phys Chem Chem Phys. 2017 Nov;19(44):30078-88.
| Issue | Vol 22 (Continuously Published Article-Based) | |
| Section | Original Article | |
| DOI | https://doi.org/10.18502/fid.v22i8.17841 | |
| Keywords | ||
| Candida albicans Curcumin Erythema Nystatin Stomatitis Denture | ||
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How to Cite
1.
Meftahpour H, Leasan S, Jafariazar Z, Farrokhnia T. Comparative Antifungal Efficacy of Curcumin Plus Nystatin Versus Nystatin Monotherapy for Treatment of Denture Stomatitis: A Clinical Trial. Front Dent. 2025;22.
