Antifungal Efficacy of Ganoderma lucidum and Clotrimazole for Treatment of Denture Stomatitis: A Randomized Clinical Trial
antifungal effect of Ganoderma and clotrimazole
Abstract
Objectives: This study aimed to compare the antifungal efficacy of Ganoderma lucidum (G. lucidum) and clotrimazole for treatment of denture stomatitis (DS).
Materials and Methods: This double-blind randomized clinical trial was conducted on 50 patients with DS types I and II assigned to two groups (N=25). In the first group, G. lucidum extract was administered in the form of 5% gel while 1% clotrimazole gel was prescribed for the second group. Pain intensity according to the visual analog scale (VAS), and the percentage of DS recovery based on the Budtz-Jorgenson index were evaluated and recorded after 7 and 14 days. Data were analyzed using the Chi-square test, independent samples t-test, repeated measures ANOVA, and logistic regression (alpha=0.05).
Results: The percentage of complete recovery on day 7 in the G. lucidum group (28%) was higher than that in the clotrimazole group (16%) but not significantly (P=0.592). Not wearing dentures overnight significantly increased the odds of recovery by 6.56 times, while the odds of recovery decreased by 0.03 times in DS type II, as compared to DS type I (P= 0.009).Conclusion: No significant difference existed between the antifungal efficacy of G. lucidum and clotrimazole for clinical treatment of DS. Thus, Ganoderma may be regarded as an alternative treatment, especially in patients’ resistant to azoles. Nonetheless, further clinical studies are required to shed more light on this topic.
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2. Chopde N, Pharande A, Khade MN, Khadtare YR, Shah SS, Apratim A. In vitro antifungal activity of two tissue conditioners combined with nystatin, miconazole and fluconazole against Candida albicans. J Contemp Dent Pract. 2012 Sep;13(5):695-8.
3. Martin-Mazuelos E, Aller AI, Romero MJ, Rodriguez Armijo A, Gutierrez MJ, Bernal S, et al. Response to fluconazole and itraconazole of Candida spp. in denture stomatitis. Mycoses. 1997 Nov;40(7-8):283-9.
4. Jazayeri M, Radi S, Abdosamadi HR, Madani Pour A, Samie L. Comparison the inhibitory effects of essential oil of thymus eriocalyx and thymus kotschyanus with nystatin on candida albicans growth-in vitro study. J Mashad Dent Sch. 2016;40(2):133-42.
5. Bondaryk M, Kurzątkowski W, Staniszewska M. Antifungal agents commonly used in the superficial and mucosal candidiasis treatment: mode of action and resistance development. Postepy Dermatol Alergol. 2013 Oct;30(5):293-301.
6. Av N. Denture sore mouth. A possible etiology. Br Dent J. 1962,112:357-60.
7. Östlund SG. The effect of complete dentures on the gum tissues. Acta Odontol Scand. 1958 Jan;16(1):1-41.
8. Bakhshi M, Taheri JB, Shabestari SB, Tanik A, Pahlevan R. Comparison of therapeutic effect of aqueous extract of garlic and nystatin mouthwash in denture stomatitis. Gerodontology. 2012 Jun;29(2):e680-4.
9. 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. 2016,10:1161-71.
10. Crowley PD, Gallagher HC. Clotrimazole as a pharmaceutical: past, present and future. J Appl Microbiol. 2014 Sep;117(3):611-7.
11. Gad MM, Fouda SM. Current perspectives and the future of Candida albicans-associated denture stomatitis treatment. Dent Med Probl. 2020 Jan-Mar;57(1):95-102.
12. Gupta A, Kirar V, Keshri GK, Gola S, Yadav A, Negi PS, et al. Wound healing activity of an aqueous extract of the Lingzhi or Reishi medicinal mushroom Ganoderma lucidum (higher Basidiomycetes). Int J Med Mushrooms. 2014;16(4):345-54.
13. Cör D, Knez Ž, Knez Hrnčič M. Antitumour, antimicrobial, antioxidant and antiacetylcholinesterase effect of Ganoderma lucidum terpenoids and polysaccharides: A review. Molecules. 2018 Mar;23(3):649.
14. Sharma C, Bhardwaj N, Sharma A, Tuli HS, Batra P, Beniwal V, et al. Bioactive metabolites of Ganoderma lucidum: Factors, mechanism and broad spectrum therapeutic potential. J Herb Med. 2019 Sep;17:100268.
15. Wang H, Ng TB. Ganodermin, an antifungal protein from fruiting bodies of the medicinal mushroom Ganoderma lucidum. Peptides. 2006 Jan;27(1):27-30.
16. Ghorbani A, Sadrzadeh A, Habibi E, Dadgar K, Akbari J, Moosazadeh M, et al. Efficacy of Camellia sinensis extract against Candida species in patients with denture stomatitis. Curr Med Mycol. 2018 Sep;4(3):15.
17. Sholapurkar AA, Pai KM, Rao S. Comparison of efficacy of fluconazole mouthrinse and clotrimazole mouthpaint in the treatment of oral candidiasis. Aust Dent J. 2009 Dec;54(4):341-6.
18. Hulley SB, Cummings SR, Browner WS, Grady DG, Newman TB. Designing Clinical Research: Wolters Kluwer Health; 2013;p.349.
19. Zhou LW, Cao Y, Wu SH, Vlasák J, Li DW, Li MJ, et al. Global diversity of the Ganoderma lucidum complex (Ganodermataceae, Polyporales) inferred from morphology and multilocus phylogeny. Phytochemistry. 2015 Jun;114:7-15.
20. Ghalayani P, Emami H, Pakravan F, Nasr Isfahani M. Comparison of triamcinolone acetonide mucoadhesive film with licorice mucoadhesive film on radiotherapy-induced oral mucositis: A randomized double-blinded clinical trial. Asia Pac J Clin Oncol. 2017 Apr;13(2):e48-56.
21. Budtz-Jørgensen E, Kelstrup J, Poulsen S. Reduction of formation of denture plaque by a protease (Alcalase). Acta Odontol Scand. 1983 Jan;41(2):93-8.
22. Arikan A, Kulak Y, Kadir T. Comparison of different treatment methods for localized and generalized simple denture stomatitis. J Oral Rehabil. 1995 May;22(5):365-9.
23. Khadka S, Sherchand JB, Pokhrel BM, Parajuli K, Mishra SK, Sharma S, et al. Isolation, speciation and antifungal susceptibility testing of Candida isolates from various clinical specimens at a tertiary care hospital, Nepal. BMC research notes. 2017 Dec;10:1-5.
24. Pelletier R, Peter J, Antin C, Gonzalez C, Wood L, Walsh TJ. Emergence of resistance of Candida albicans to clotrimazole in human immunodeficiency virus-infected children: in vitro and clinical correlations. J Clin Microbiol. 2000 Apr;38(4):1563-8.
25. Nayak A, Nayak RN, Bhat K. Antifungal activity of a toothpaste containing Ganoderma lucidum against Candida albicans-an in vitro study. J Int Oral Health. 2010 Aug;2(2):51-7.
26. Alizadeh Z, Babaee N, Moghadamnia AA, Kazemi S, Sefidgar SAA, Mortazavi N. Comparison of the effect of 2% ginger mouthwash and nystatin mouthwash on denture stomatitis. Int J Adv Biotechnol Res. 2016 Apr;7:1152-7.
27. Sefidgar SAA, Moghadamnia AA, Akhavan TA, Sahebjami M, Heydari M, Motallebnejad M. Evaluation of the effect of Artemisia Sieberi mouthwash 1% on denture stomatitis (A preliminary study). Caspian J Intern Med 2010;1(2):47-9.
28. Pina GM, Lia EN, Berretta AA, Nascimento AP, Torres EC, Buszinski AF, et al. Efficacy of propolis on the denture stomatitis treatment in older adults: A multicentric randomized trial. Evid Based Complement Alternat Med. 2017;2017 (1):8971746.
29. Hannah VE, O'Donnell L, Robertson D, Ramage G. Denture stomatitis: Causes, cures and prevention. Prim Dent J. 2017 Dec;6(4):46-51.
30. Qiu W, Ren B, Dai H, Zhang L, Zhang Q, Zhou X, et al. Clotrimazole and econazole inhibit Streptococcus mutans biofilm and virulence in vitro. Arch Oral Biol 2017 Jan;73:113-20.
2. Chopde N, Pharande A, Khade MN, Khadtare YR, Shah SS, Apratim A. In vitro antifungal activity of two tissue conditioners combined with nystatin, miconazole and fluconazole against Candida albicans. J Contemp Dent Pract. 2012 Sep;13(5):695-8.
3. Martin-Mazuelos E, Aller AI, Romero MJ, Rodriguez Armijo A, Gutierrez MJ, Bernal S, et al. Response to fluconazole and itraconazole of Candida spp. in denture stomatitis. Mycoses. 1997 Nov;40(7-8):283-9.
4. Jazayeri M, Radi S, Abdosamadi HR, Madani Pour A, Samie L. Comparison the inhibitory effects of essential oil of thymus eriocalyx and thymus kotschyanus with nystatin on candida albicans growth-in vitro study. J Mashad Dent Sch. 2016;40(2):133-42.
5. Bondaryk M, Kurzątkowski W, Staniszewska M. Antifungal agents commonly used in the superficial and mucosal candidiasis treatment: mode of action and resistance development. Postepy Dermatol Alergol. 2013 Oct;30(5):293-301.
6. Av N. Denture sore mouth. A possible etiology. Br Dent J. 1962,112:357-60.
7. Östlund SG. The effect of complete dentures on the gum tissues. Acta Odontol Scand. 1958 Jan;16(1):1-41.
8. Bakhshi M, Taheri JB, Shabestari SB, Tanik A, Pahlevan R. Comparison of therapeutic effect of aqueous extract of garlic and nystatin mouthwash in denture stomatitis. Gerodontology. 2012 Jun;29(2):e680-4.
9. 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. 2016,10:1161-71.
10. Crowley PD, Gallagher HC. Clotrimazole as a pharmaceutical: past, present and future. J Appl Microbiol. 2014 Sep;117(3):611-7.
11. Gad MM, Fouda SM. Current perspectives and the future of Candida albicans-associated denture stomatitis treatment. Dent Med Probl. 2020 Jan-Mar;57(1):95-102.
12. Gupta A, Kirar V, Keshri GK, Gola S, Yadav A, Negi PS, et al. Wound healing activity of an aqueous extract of the Lingzhi or Reishi medicinal mushroom Ganoderma lucidum (higher Basidiomycetes). Int J Med Mushrooms. 2014;16(4):345-54.
13. Cör D, Knez Ž, Knez Hrnčič M. Antitumour, antimicrobial, antioxidant and antiacetylcholinesterase effect of Ganoderma lucidum terpenoids and polysaccharides: A review. Molecules. 2018 Mar;23(3):649.
14. Sharma C, Bhardwaj N, Sharma A, Tuli HS, Batra P, Beniwal V, et al. Bioactive metabolites of Ganoderma lucidum: Factors, mechanism and broad spectrum therapeutic potential. J Herb Med. 2019 Sep;17:100268.
15. Wang H, Ng TB. Ganodermin, an antifungal protein from fruiting bodies of the medicinal mushroom Ganoderma lucidum. Peptides. 2006 Jan;27(1):27-30.
16. Ghorbani A, Sadrzadeh A, Habibi E, Dadgar K, Akbari J, Moosazadeh M, et al. Efficacy of Camellia sinensis extract against Candida species in patients with denture stomatitis. Curr Med Mycol. 2018 Sep;4(3):15.
17. Sholapurkar AA, Pai KM, Rao S. Comparison of efficacy of fluconazole mouthrinse and clotrimazole mouthpaint in the treatment of oral candidiasis. Aust Dent J. 2009 Dec;54(4):341-6.
18. Hulley SB, Cummings SR, Browner WS, Grady DG, Newman TB. Designing Clinical Research: Wolters Kluwer Health; 2013;p.349.
19. Zhou LW, Cao Y, Wu SH, Vlasák J, Li DW, Li MJ, et al. Global diversity of the Ganoderma lucidum complex (Ganodermataceae, Polyporales) inferred from morphology and multilocus phylogeny. Phytochemistry. 2015 Jun;114:7-15.
20. Ghalayani P, Emami H, Pakravan F, Nasr Isfahani M. Comparison of triamcinolone acetonide mucoadhesive film with licorice mucoadhesive film on radiotherapy-induced oral mucositis: A randomized double-blinded clinical trial. Asia Pac J Clin Oncol. 2017 Apr;13(2):e48-56.
21. Budtz-Jørgensen E, Kelstrup J, Poulsen S. Reduction of formation of denture plaque by a protease (Alcalase). Acta Odontol Scand. 1983 Jan;41(2):93-8.
22. Arikan A, Kulak Y, Kadir T. Comparison of different treatment methods for localized and generalized simple denture stomatitis. J Oral Rehabil. 1995 May;22(5):365-9.
23. Khadka S, Sherchand JB, Pokhrel BM, Parajuli K, Mishra SK, Sharma S, et al. Isolation, speciation and antifungal susceptibility testing of Candida isolates from various clinical specimens at a tertiary care hospital, Nepal. BMC research notes. 2017 Dec;10:1-5.
24. Pelletier R, Peter J, Antin C, Gonzalez C, Wood L, Walsh TJ. Emergence of resistance of Candida albicans to clotrimazole in human immunodeficiency virus-infected children: in vitro and clinical correlations. J Clin Microbiol. 2000 Apr;38(4):1563-8.
25. Nayak A, Nayak RN, Bhat K. Antifungal activity of a toothpaste containing Ganoderma lucidum against Candida albicans-an in vitro study. J Int Oral Health. 2010 Aug;2(2):51-7.
26. Alizadeh Z, Babaee N, Moghadamnia AA, Kazemi S, Sefidgar SAA, Mortazavi N. Comparison of the effect of 2% ginger mouthwash and nystatin mouthwash on denture stomatitis. Int J Adv Biotechnol Res. 2016 Apr;7:1152-7.
27. Sefidgar SAA, Moghadamnia AA, Akhavan TA, Sahebjami M, Heydari M, Motallebnejad M. Evaluation of the effect of Artemisia Sieberi mouthwash 1% on denture stomatitis (A preliminary study). Caspian J Intern Med 2010;1(2):47-9.
28. Pina GM, Lia EN, Berretta AA, Nascimento AP, Torres EC, Buszinski AF, et al. Efficacy of propolis on the denture stomatitis treatment in older adults: A multicentric randomized trial. Evid Based Complement Alternat Med. 2017;2017 (1):8971746.
29. Hannah VE, O'Donnell L, Robertson D, Ramage G. Denture stomatitis: Causes, cures and prevention. Prim Dent J. 2017 Dec;6(4):46-51.
30. Qiu W, Ren B, Dai H, Zhang L, Zhang Q, Zhou X, et al. Clotrimazole and econazole inhibit Streptococcus mutans biofilm and virulence in vitro. Arch Oral Biol 2017 Jan;73:113-20.
| Issue | Vol 21 (Continuously Published Article-Based) | |
| Section | Original Article | |
| DOI | https://doi.org/10.18502/fid.v21i45.17178 | |
| Keywords | ||
| Reishi Clotrimazole Antifungal Agents | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Pakravan F, Yegdaneh A, Taymouri S, Rahimi S, Ghahremani N. Antifungal Efficacy of Ganoderma lucidum and Clotrimazole for Treatment of Denture Stomatitis: A Randomized Clinical Trial. Front Dent. 2024;21.
