萎縮性慢性カンジダ症患者における義歯のバイオフィルム除去と口蓋病変の治癒を目的とした2種類の洗浄ペーストの比較検討

Comparison of two cleansing pastes for the removal of biofilm from dentures and palatal lesions in patients with atrophic chronic candidiasis.

抄録

萎縮性慢性カンジダ症患者を対象に，義歯洗浄専用の実験用歯磨剤と通常の歯磨剤の2種類の口腔衛生用品について，義歯バイオフィルムの除去と口蓋病変の治癒の観点からその有効性を比較検討した．また，バイオフィルムの有無と粘膜紅斑の相関性を検討した．24名の総義歯装着者（45～80歳）を実験用ペーストと標準歯磨剤（Sorriso-Kolynos，ブラジル）の2群に分けた．両群とも軟質歯ブラシを使用した．上顎義歯の内面を1%フルオレセインナトリウムで染色し，0，15，30，60日目に45マス角で写真撮影を行った．スライドをスキャンし，関心領域（総義歯面積とバイオフィルム面積）を測定した（Image Toolソフトウェア）．紅斑の程度は，Prosthesis Tissue Indexに基づきスライドで評価した．初診時（0日，15日）と最終診察時（30日，60日）のバイオフィルム面積（ANOVA/Tukey），0日～60日の平均紅斑値（Kruskal-Wallis）は両群で有意に減少した．Mann-Whitney検定により，バイオフィルムの程度はペースト間で有意差（1%）を示したが，紅斑スコアには差が認められなかった．バイオフィルムと紅斑の相関値は0.3801（実験用ペースト）と0.3678（標準歯磨き粉）であった。以上のことから，実験品は義歯プラークバイオフィルムの除去に有効であると判断した．

The efficacy of 2 oral hygiene products, an experimental toothpaste specific for complete denture cleansing and a regular standard toothpaste, was compared in terms of denture biofilm removal and cure of palatal lesions in patients with atrophic chronic candidiasis. The degree of correlation between presence of biofilm and mucosa erythema was also evaluated. Twenty-four complete denture wearers (45-80 years old) were divided into 2 groups: experimental paste and standard toothpaste (Sorriso-Kolynos, Brazil). Both groups received soft toothbrushes. The internal surfaces of upper dentures were stained using 1% sodium fluorescein and photographed at a 45 masculine angle at 0, 15, 30 and 60 days. The slides were scanned and the areas of interest (denture total area and biofilm area) were measured (Image Tool software). The degree of erythema was evaluated on slides according to the Prosthesis Tissue Index. There was a significant reduction (1%) in the degree of biofilm (ANOVA/Tukey) between the two initial visits (0 and 15 days) and the two final visits (30 and 60 days), and in the average erythema scores (Kruskal-Wallis) between 0 and 60 days, in both groups. The Mann-Whitney test showed a significant difference (1%) between pastes in terms of biofilm degree, but no difference was found for the erythema score. Correlation values between biofilm and erythema degree were 0.3801 (experimental paste) and (0.3678 (standard toothpaste). We may therefore conclude that the experimental product was efficient for the removal of denture plaque biofilm.