ประสิทธิผลการรักษาโรคปากอักเสบเหตุฟันเทียมด้วยแสงโฟโตไดนามิกเทียบกับ การใช้ยาต้านเชื้อรา: การทบทวนอย่างเป็นระบบ และการวิเคราะห์อภิมาน

Panadda Tongwichian; Rassami Kessuwanrak

Authors

Panadda Tongwichian Institute of Dentistry
Rassami Kessuwanrak Institute of Dentistry

Keywords:

Photodynamic therapy, Antifungal medications, Denture stomatitis, Candida

Abstract

Background: Denture stomatitis is a common condition among denture wearers, characterized by erythematous inﬂammation of the oral mucosa in areas in contact with the denture. Treatment is based on the underlying cause and often includes antifungal agents. However, this approach has limitations such as prolonged treatment duration, high recurrence rates, and potential allergic reactions. These challenges have led to the development of alternative therapies, with photodynamic therapy being proposed as a potential treatment option in several studies. Objective: To gather scientific evidence studying the effectiveness of photodynamic therapy in reducing Candida fungal counts in the treatment of denture stomatitis compared to antifungal medications. Methods: Research studies were searched from PubMed, Cochrane, and Google Scholar databases along with manual searching. Only articles in English or Thai published from January 2009 to January 2024 were included. Studies were conducted following PICO guidelines. Results: A total of six studies were included and analyzed in two aspects. First, photodynamic therapy showed lower effectiveness in reducing fungal counts compared to antifungal medications; however, the difference was not statistically significant (SMD = 0.015, 95%CI: –0.352, 0.383, p = .935). Second, the combined treatment demonstrated significantly greater effectiveness in reducing fungal counts than antifungal medication alone (SMD = –1.173, 95%CI: –1.990, -0.356, p = .005). Conclusion: This meta-analysis concludes that photodynamic therapy may serve as an alternative treatment for denture stomatitis. While it is less effective than antifungal medications when used alone, the difference is not statistically significant. Notably, when combined with antifungal medications, photodynamic therapy demonstrates significantly enhanced efficacy in reducing Candida fungal counts.

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