Biomedical Engineering Reference
In-Depth Information
cells and grows within its cytoplasm (Belton and Eversole 1986). Induction
of epithelial cell proliferation following contact with
C. albicans
has also
been reported (Cawson 1973). The infl ammatory process in the stratum
corneum varies in density but does not reach the basement membrane.
It has been reported that most if not all non-homogeneous forms of
leukoplakia result from a candidal infection. Although higher nitrosation
potentials of
C. albicans
in non-homogeneous leukoplakia have been
observed, the involvement of
C. albicans
in the etiology or progression of
oral leukoplakia remains to be elucidated.
Denture Stomatitis
Denture stomatitis refers to an infl ammatory reaction of denture-bearing
mucosa that may affect up to two thirds of all patients wearing an upper
denture (Gendreau and Loewy 2011). Different types of denture-related
stomatitis have been identifi ed on the basis of their clinical presentation,
two of which are now considered to be
Candida
-associated lesions (Pereira-
Cenci et al. 2008). Type I corresponds to a localized infl ammatory reaction
characterized by either a hyperemic area of red pinpoints around minor
palatal salivary gland ducts or areas of circumscribed erythema. This type
has been associated with excessive pressure or trauma caused by ill-fi tting
dentures (Farah et al. 2010). Type II refers to diffuse changes from local
to large areas of palatal denture-bearing mucosa that redden and become
smooth (
Fig. 2d)
,
while type III, also called “papillary hyperplasia”,
corresponds to a granular or nodular infl ammatory reaction involving
the palatal mucosa. Clinically, each case exhibits the granular type of
denture stomatitis (infl ammatory papillary hyperplasia). As shown in
Figure 3f,
specimens of denture stomatitis reveal a chronic infl ammatory
reaction and papillary patterns showing broad and irregular connective
tissue papillae that support a focally hyperplastic and partly atrophic
surface epithelium. The upper layer of the epithelium displays a slight
desquamation, ledged cell borders and surface pitting and/or microridge
formation.
It is now well established that microbial plaque accumulation on the
fi tting surface of a removable denture (Coulthwaite and Verran 2007) is
a potential vector for the development of palatal infl ammation (Fig. 3).
In some cases, yeast growth is signifi cantly higher in
C. albicans
isolated
from a denture than it is in that isolated from the mucosa (Figs. d2 and d1,
respectively). Perhaps by colonizing the ecological niche of denture biofi lm,
C. albicans
shelters itself from local defense mechanisms. Over time and
under favorable conditions, the denture biofi lm's structure and make-up
enhances virulence by enabling the yeast to develop and eventually express
