title: The effect of complete dentures with a metal palate on candida species growth in HIV-infected patients.
abstract: OBJECTIVE
  This in vivo investigation compared the oral candidal population between heat-cured acrylic resin and nickel-chromium-beryllium alloy in maxillary complete dentures in HIV-infected patients.
  
  
  METHODS
  Split-palate maxillary complete dentures were fabricated for 19 HIV-infected patients: one-half of the palate was made in acrylic resin and the other half in nickel-chromium-beryllium. Patients were divided into low or high CD4+ lymphocyte count groups. Dentures were worn for 5 months. Palatal mucosa was clinically evaluated at baseline, 1, 3, and 5 months after denture insertion. Specimens were collected at 1, 3, and 5 months using a modified imprint culture method. Speciation of Candida was performed using a chromogenic culture medium. Two-sample t-test was employed to determine effects and significant interactions between the control and test groups and the low and high CD4+ lymphocyte groups. A chi(2) test analyzed and compared the results of the clinical evaluation (p < 0.05).
  
  
  RESULTS
  Significant differences were observed in the colony counts between both materials during the third (p= 0.046) and fifth months (p= 0.039). The low CD4+ group demonstrated significant differences during the third (p= 0.03) and fifth months (p= 0.05). There were no significant differences between the species of Candida that colonized either material with the exception of Candida dubliniensis (p < 0.001) and "Others" (p < 0.001) during the first and fifth months. There were no significant differences on the clinical appearance of the palatal mucosa between both materials (p= 1.00).
  
  
  CONCLUSIONS
  The metal base proved to be effective in decreasing the fungal growth typically present in complete dentures. Although overt clinical manifestations were not present, colony counts of Candida species were high in the acrylic resin denture bases of these patients. This investigation demonstrated that metal base complete dentures provide an important alternative dental service for edentulous HIV-positive and other patients who are particularly prone to higher incidences of fungal infections.
authors.affiliation: Department of Prosthodontics, University of Texas - Dental Branch, Houston, TX 77030, USA. leticia.f.perezous@uth.tmc.edu
authors.forename: Leticia F
authors.initials: LF
authors.lastname: Perezous
authors.forename: Gene C
authors.initials: GC
authors.lastname: Stevenson
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Flaitz
authors.forename: Millicent E
authors.initials: ME
authors.lastname: Goldschmidt
authors.forename: Robert L
authors.initials: RL
authors.lastname: Engelmeier
authors.forename: C Mark
authors.initials: CM
authors.lastname: Nichols
mesh_terms: D000180:Acrylic Resins; D000328:Adult; D000368:Aged; D001608:Beryllium; D018791:CD4 Lymphocyte Count; D002175:Candida / Q000254:growth & development*; D002180:Candidiasis, Oral / Q000150:complications / Q000517:prevention & control; D002448:Cell Adhesion; D002858:Chromium Alloys; D015169:Colony Count, Microbial; D003819:Denture Bases / Q000382:microbiology*; D003779:Denture Design; D003827:Denture, Complete, Upper / Q000382:microbiology*; D005260:Female; D015658:HIV Infections / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D009532:Nickel; D010865:Pilot Projects
chemical_list: D000180:Acrylic Resins; D002858:Chromium Alloys; D009532:Nickel; D001608:Beryllium