白色念珠菌在义齿软衬材料表面黏附的研究与进展

目的:综合分析白色念珠菌在义齿软衬材料表面黏附的影响因素及主要防治措施.资料来源:文献检索时限为1995/2009;检索的中文关键词包括:义齿,软衬材料,白色念珠菌,黏附;英文关键词包括:denture,soft liningmaterial,candida albicans,adherence.文献来源数据库:中国期刊全文数据库,网址http://ckrd.cnki.net;PubMed数据库,网址http://www.ncbi.nlm.nih.gov/PubMed.资料选择:纳入具有原创性的研究论文,其研究材料或方法具有代表性.排除重复性研究及与课题相关性较弱的文献.结局评价指标:白色念珠菌在义齿软衬材料表面黏附的各种影响因素以及防治白色念珠菌黏附的主要措施.结果:①不同化学组成的义齿软衬材料对白色念珠菌黏附有一定影响,丙烯酸酯类软衬材料在使用过程中有增塑剂和乙醇析出,容易导致材料逐渐变硬而失去功效,另外可能对人体造成危害.硅橡胶类材料生物相容性好,细胞毒性小,对微生物的毒性也小.但表面为多孔性,易于滋生真菌.含氟弹性体材料长期吸水率低于硅橡胶类,但是不易滋生真菌.②目前材料的表面粗糙度或表面自由能与念珠菌附着之间的相关性并不能确定.③白色念珠菌的生物膜形成还与唾液、底物环境和口腔共生菌丛有关.④目前预防控制义齿软衬材料表面白色念珠菌黏附的方法主要有:材料中添加抗真菌剂、选择与软衬材料匹配的义齿清洁剂、用义齿封闭剂处理软衬材料表面、抗真菌剂口服治疗、微波消毒.结论:目前白色念珠菌对软衬材料的黏附仍然是一个常见而严重的问题.通过改善软衬材料性能,减少微生物黏附,延长材料的使用寿命,从而控制义齿性口炎的发生.

Adherence of Candida albicans to the surface of soft lining materials

OBJECTIVE: To analyze the influencing factor of Candida albicans adhered to soft lining materials surface, and to find the main prevention and cure methods. DATA SOURCE: The relevant articles between 1995 and 2009 were retrieved from PubMed (http://www.ncbi.nlm.nih.gov/PubMed) and database of Chinese knowledge (CNKI www.cnki.net/index.htm) using key words of "denture, soft lining material, Candida albicans, and adherence", and restricting the language as English and Chinese by computer. DATA SELECTION: The original articles with representation in the materials or methods were included. Repetitiveness or unrelated papers were excluded. MAIN OUTCOME MEASURES: The influencing factor of Candida albicans adhered to soft lining materials surface, as well as the main prevention and cure methods. RESULTS: ①The materials of dentures had certain effect on Candida albicans adherence, in using, plasticizer and ethanol would separate from acrylics soft-lining materials, which could result in dentures failure. Silicon rubber soft-lining materials exhibited good biocompatibility with little cytotoxicity, but the porosity easy lead to fungi propagation. The water absorption of materials containing fluorine was lower than silicon rubber materials with lower fungi propagation. ②The correlation between surface roughness or surface free energy of materials and Monilia adherence was uncertain. ③The formation of Candida albicans film was associated with saliva, substrate circumstances and symbiotic bacteria strains.④The main methods for preventing Candida albicans adherence was as following: adding antifungal agent in soft lining materials; selecting matched denture cleansing agents; treating surface of soft lining materials; antifungal agent treatment or microwave sterilization. CONCLUSION: Presently, the adherence of Candida albicans to surface of soft lining materials is still a common but serious problem. The denture stomatitis can be controlled by improving the performance of soft lining materials, reducing the adherence of microorganism, and prolonging useful life of dentures.