Distribution Profile of Candida Species Involved in Angular Cheilitis Lesions Before and After Denture Replacement

Background: Angular cheilitis known as anoral candidiasis manifestation is deep fissures with ulcerated appearance, which affects angles of the mouth. Decreasing the vertical dimension (VD) of face in the elderly denture users is one of the predisposing factors for heavy colonization of Candida spp. in the cheek angles resulting angular cheilitis. Correcting vertical dimension by a new denture replacement can decrease Candida spp. colonization to prevent or improve the angular cheilitis lesions.

Objectives: The current study aimed to determine the distribution profile of Candida species isolated from cheek angles of patients with old denture before and after replacing with new ones.

Materials and Methods: Twenty eight complete denture users with decreased ridge, and outwear complete dentures, who referred for denture replacement, were randomly selected and their lip angles were cultured before and 3 months after using new dentures. Frequency and the species of isolated Candida spp. colonies before denture replacement and 3 months after using new dentures and correction of their vertical dimension were compared using Mann-Whitney statistical tests by SPSS software.

Results: All samples were colonized before denture replacement, though 3 months after using new dentures, only few cultures were positive. A significant statistical difference was observed between Candida colonization before and 3 months after denture replacement (P = 0.0001). Candida albicans, C. tropicalis, C. krusei, C. parapssilosis and C. glabrata were isolated from lesions.

Conclusions: The results of the current study suggest that long term use of dentures can cause a wide range of Candida species colonization, resulting angular cheilitis. There was a need for an oral manifestation management-based strategy focusing on clinical and preventative treatment. Angular cheilitis can be prevented by changing and replacing a new denture to modify the face vertical dimension, and improve the angular cheilitis lesions.