Int J Evidence-Based Practice Dent Hygienist 2 (2016), No. 4 5. Dec. 2016
Background: This article critically appraises a systematic review that was conducted in 2014 to compare the efficacy of antifungal medications with that of alternative methods for the treatment of denture stomatitis.
Clinical question: Are alternative therapies for the treatment of denture stomatitis (eg, disinfection agents or antiseptic mouthwashes) as effective as antifungal medications?
Summary of methods: Four databases were searched for relevant studies without language restriction, and a manual search of the references of the included studies was conducted to include all randomized controlled studies (RCTs) that compared antifungal medications with alternative treatments. Studies with a treatment period of less than 7 days were excluded from this review, including quasi-randomized trials. Data extraction was conducted independently by two reviewers, and consensus was obtained by discussion in case of disagreement. A priori subgroup analysis was planned, and a random-effects model was used to conduct the analyses. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to compare results across studies.
Critical appraisal: This review met all requirements on the AMSTAR checklist. The overall quality of evidence was considered low, as most of the included RCTs had a high risk of bias. The results of this study should be interpreted with caution, and more well-designed studies should be conducted to produce more robust evidence.
Practical implications: Possible side effects of antifungal medication include gastrointestinal irritation and renal and liver toxicity. Disinfection methods could be used instead for the management of denture stomatitis, as they have an equivalent treatment efficacy.