- Email: [email protected]
Denture stomatitis and ABO blood types
SECTION
EDITOR
Louie J. Boucher
IDenture
stomatitis
and ABO blood types
Hiroki Nikawa, DD!3, PhD,* Hiroo Kotani, Shinsuke Sadamori, DDS, PhD,C and Taizo Hiroshima
Univl rsity. School of Dentistry,
Hiroshima,
DDS, PhD,b Hamada, DDS,
PhDd
,lapan
To determine the interrelation between ABO blood types of denture wearers, denture plaque accumulation, and denture stomatitis, 442 denture wearers were studi(ed using a simplified culture method, which is convenient to use in the dental office. The degree of plaque accumulation and the occurrence of denture stomatitis varied depending on the blood type of the patients. Especially in blood group 0 compared with other types, both denture plaque accumulation and denture stomatitis were found to be higher or more severe. These results suggest that the ABO blood group is one of the etiologic factors of denture stomatitis and that denture wearers of’ blood group 0 are more susceptible to denture stomatitis. (J PROSTHET DENT 1991;66:391-4.)
T
he interrelation between ABO blood groups and infection has been extensivel:i studied,le6 but the results are not consistent. Kinane et a1.3 reported that women of blood groups B and AB are more susceptible to urinary tract infection, whereas Deresinski et a1.l have shown that blood group B is significantly associated with disseminated fungal infection. Other investigators, however, reported that blood type 0 and/or nonsecretion of antigen are risk factors for Candida al&cans infection or its oral carriage.4W” One of the reasons for these discrepancies might be the difference in mechanisms of adherence of these organiarns2~“~ 5 Many studies have s11own that Candida albicans adherence is mediated by specific interaction with several N-acetyl D-glucossugar moielties, such as D-mannose, amine, and L-fucose,“-” some of which are immunodominant sugars of blood type. However, the relationship bletween blood groups of denture wearers and their susceptibility to denture stomatitis In clinical dentistry has not bseen previously evaluated. Accordingly, in this study, interrelations between ABO blood groups and both denture plaque accumulation ancl the occurrence of denture stomatitis were clinically investigated using a simplified meth0d.l”
MATERIAL
AND
METHODS
Four hundred forty-two derture wearers, who visited a dentist’s office from 1.985 to 1990, were investigated. Basic data of this population are summarized in Table I. No sig-
OABAB
Fig. 1. Populations of degree of denture plaque accumulation (a) and denture stomatitis !b) in blood groups of denture wearers.
nificant differences in the sex incidence were observed. Both denture plaque accumulation and denture stomatitis were studied using a simplified test culture for detection of Candida genus (Stomastat, Sankin Industry Co., Ltd., Osaka, Japan). l2 Briefly, swabs collected from the tissue surface of the maxillary denture and the corresponding denture-bearing palatal mucosa were incubated in the cultures for 24 hours at 37“ C. These cultures were then submitted to a calorimetric judgment according to the following scale as the manufacturer indicated: - = red (less than 102 Candida cells/ml) + = orange (about 7x10” Candida cells/m11 ++ = yellow (more than 7x10” C’andido cells/ml)
The grades of denture stomatitis were determined in detail from clinical findings by means of the following scale:
-aliesearch bl’art-time C12ecturer, dProfessor
Associate, Department of Prosthetic Dentistry. Lecturer, Department of Prosthetic Dentistry. Departm’snt of Prosthetic Dentistry. and Chairman, Depart nent of Prosthetic Dentistry.
1’0/1/24229 TIHE
OABAB
JOURNAL
OF PROSTHETIC
DENTISTRY
- = no symptoms t = slight inflammation and Candida ~basically equivalent to Newton’s ++ = ie\:ere inflammation and C’un&do 1basically equivalent to Newton’s
were detected type I) were detected type II1 391
NIKAWA
Table
ET AL
Blood groups and age and sex of denture wearers
I.
ABO blood group
Age W (M/F)
Sex ratio
Table
II.
0
A
B
AB
58-83 35175
58-89 471136
61-80 33164
64-79 16/36
Blood groups and denture plaque accumulation ABO blood group
Degree of denture plaque accumulation
0
A
B
AB
Total
+ ++ Total
24 36 50 110
62 76 45 183
31 37 29 97
18 21 13 52
135 170 137 442
Chi square 15.678 (degrees of freedom 6; p C 0.05).
Table
III.
Blood groups and occurrence of denture stomatitis ABO blood group
Degree of denture stomatitis
0
A
B
AB
Total
+ ++ Total
29 39 42 110
75 62 46 183
40 37 20 97
23 20 9 52
167 158 117 442
Chi square 14.342 (degrees of freedom
Table
IV.
6; p < 0.05).
Results of ANOVA on denture plaque
Denture
plaque A e T
S, Sum of squares; f, frequency;
Table
V.
V, variance;
S
f
V
F
P
1135.9 26.4 1162.3
11 12 23
103.3 2.2
46.9
F, F test; A, Atabrine;
e, epizootic;
Results of multiple range test on denture
plaque Degree of denture
J51oou type O-A O-B 0-AB A-B A-AB B-AB
392
+
++
p < 0.01 p < 0.01 p < 0.01
p < 0.01 p < 0.01 p < 0.01
p < 0.01 p < 0.01 p < 0.01
-
The numerical data obtained were subjected to chi square test, a one-way analysis of variance (ANOVA), and a multiple range test at the 5 ‘2%or 1% level.
RESULTS
plaque
-
-
T, tropical.
-
Both in the degree of denture plaque accumulation and in the occurrence of denture stomatitis, significant differences were observed among blood groups A, B, 0, and AB (p < 0.05; Tables II and III). Furthermore, Fig. 1 shows the tendency for blood group 0 to be a risk factor for plaque accumulation and the occurrence of denture stomatitis. Therefore whether the denture wearers in blood group 0 have a high risk or not
SEPTEMBER
1991
VOLUME
66
NUMBER
3
DIENTURE
Table
STOMATITIS
VI.
AXD
ABO
BLOOD
TYPES
Results of ANOVA on denture stomatitis
Denture stomatitis
S
ii
1856.7
,’
88.4
‘1 -_-Abbreviations aq in Table 1J.
1945.1
f
v
P
P
II 12 23
168.8 7.1
22.5
was examined using more sensitive statistical analysis. It was revealed that both the amount of denture plaque and the occurrence of denture stomatitis are significantly higher in blood group 0 than in those subjects having other blood types (p < 0.05; Tables IV and V). Furthermore, the population with both marked plaque accumulation (++) and palatal iinflammation ( ++:I was significantly higher in blood group 0 than in those of other blood types (p < 0.05; Tables VI and VII). DISCUSSION Since one of ma.jor etiologic factors of denture stomatitis is considered to ble denture plaque accumulation or cand:idal colonization on the denture surface,13-lg Candida adherence to inert surfaces or host cell surfaces is now recognized as an important initial step in the successful colonization and development of pathogenesis.20,21 Reports have shown that Candida adherence to the host surface is mediated mainly by specific adherence,7-11,20*21 and several kinds of hexoses and hexosamines are identified as the receptor for Candiidu ulbicuns, some of which are immunodlominant sugars of blood types. Furthermore, these glycocompounds in body fluids such assaliva have been reported to enhance or inhibit the adherence of Cundidu to the host cell surfaces in viva and in vitro.4r 5,21 Although the adherence of Candidu to bare acrylic resin surfaces or to solid surfaces is considered to be mediated mainly by nonspecific interac tion,22-26serum or salivary proteins adsorbed to inert surf.acesaffect the adherence of Cundidu,27-2g and it is suggested these proteins adsorbed p:rovide specific recept,or sites.30Since in vivo adherence of Cundidu to denture surfaces might also be affected by body fluids containing immunodominant glycocompounds of some blood types, investigations to detect the type of blood group that is more susceptible to denture stomatitis were initiated. To study these points, a simplified culture method was, used that is sensitive to detect Cundidu regardless of‘ any microbial contamination and is suitable to use in the dental c)ffice.*2 It was found that both the degree of denture plaque accumulation and the occurrence of denture stomatitis varied depending upon the blood types of denture wearers. Further examinations have revealed that the population of both plaque accumulation and the occurrence of denture
THE
JOURNAL.
OF PROSTHETIC
IXNTISTRY
--..-II_
Table
VII.
Results of multiple range test on denture
stomatitis Degree
of denture
Blood type
stomatitis
+
++
O-A
p < 0.05
p < 0.05
O-B
p < 0.01 p < 0.01
p < 0.01 p < 0.01
0-AB A-B A-AB B-AB
--
stomatitis were greater in blood group 0 than in those with other blood group types. In addition, the population of denture wearers with marked denture plaque or with severe palatal inflammation was higher in blood group 0 than in those of other blood groups. This finding is consistent with the conclusion of Burford-mason et al.,” who investigated the interrelation between ABO blood types or the secretor state and Candidu association with soft tissues. These results suggest that in complete denture wearers, blood group 0 is a comparative risk factor for both denture plaque accumulation and denture stomatitis. Although many etiologic factors, such as microbial, allergic, nutrient, and systemic factorsls, I43Ia,31,X2are involved in denture plaque accumulation and the occurrence of denture stomatitis, our results may provide some information about the etiology of denture stomatitis. CLINICAL
IMPLICATIONS
Many etiologic factors, such as sex distribution, habits, nutrient factors, and systemic factors have been reported to be associated with denture stomatitis. In this study we investigated whether the ABO blood type of patients affects denture plaque accumulation and denture stomatitis. The results show that patients from blood group 0 are more susceptible to denture plaque accumulation or denture stomatitis. CONCLUSIONS The hypothesis that certain blood groups were a risk factor for both denture plaque accumulation and denture
393
NIKAWA
stomatitis was investigated in a group of 442 denture wearers using a simplified method, and the following results were obtained. 1. There were significant differences in the degree of denture plaque accumulation among blood groups A, B, 0, and AB (p < 0.05). 2. Significant differences were observed in the degree of denture stomatitis among blood groups A, B, 0, and AB (p < 0.05). 3. Both the amount of denture plaque and the occurrence of denture stomatitis are significantly higher in blood group 0 than in those in other types (p < 0.05). 4. The populations with both plaque accumulation (++) and palatal inflammation (++) were significantly higher in blood group 0 than in those with other blood types (p < 0.05). REFERENCES 1. Deresinski SC, Pappagianis D, Stevens DA. Association of ABO blood group and outcome of coccidal infection. Sabouraudia 1979;17:261-4. 2. Hogg SD, Embery G. Blood-group-reactive glycoprotein from human saliva interacts with lipoteichoic acid on the surface of Streptococcus sanguis cells. Arch Oral Biol 1982;27:261-8. 3. Kinane DF, Blackwell CC, Brettle RP, Weir DM, Winstanley FP, Elton RA. ABO blood group, secretor state, and susceptibility to recurrent urinary tract infection in women. Br Med J 1982;285:7-9. 4. Blackwell CC. Jdnsdpdttir K, Hanson M, et al. Non-secretion of ABO antigens predisposing to infection by Neisseria meningitidis and Streptococcus pneunoniae. Lancet 1986;2:284-5. 5. Blackwell CC, Thorn SM, Weir DM, Kinane DF, Johnstone FD. Hostparasite interactions underlying non-secretion of blood group antigens and susceptibility to infections by Candida albicans. In: Lark DL, ed. Protein-carbohydrate interactions in biological systems. London: Academic Press Inc, 1986231-3. 6. Burford-mason AP, Weber JCP, Willoughby JMT. Oral carriage of Candida albicans, ABO blood group and secretor status in healthy subjects. J Med Vet Mycol 1988;26:49-56. 7. Sobel JD, Myers D, Kaye D, Levinson ME. Adherence of Candida albicans to human vaginal and buccal epithelial cells. J Infect Dis 1981;143:76-82. 8. Sandin RF, Rogers AL, Patterson RJ, Beneke ES. Evidence for mannose-mediated adherence of Candida albicans to human buccal cells in vitro. Infect Immun 1982;35:79-85. 9. Segal E, Lehrer N, Ofek I. Adherence of Candida albicans to human vaginal epithelial cells: inhibition by amino sugars. Exp Cell Biol 1982;50:13-7. 10. Critchley IA, Douglas LJ. Role of glycoside as epithelial cell receptors for Candida albicam. J Gen Microbial 1987;133:637-43. 11. Douglas LJ. Adhesion of Candida species to epithelial surfaces. CRC Crit Rev Microbial 1987;15:27-43. 12. Hamada T, Yuhda S, Shigeto N, Tamamoto M, Nahara Y, Sadamori S. A simplified culture for the diagnosis of denture stomatitis. Hiroshima J Med Sci 1987:36:289-94.
394
ET AL
13. Davenport JC. The oral distribution of Candida in denture stomatitis. Br Dent J 1970;129:151-6. 14. Budts-J#rgensen E. The significance of Candida albicans in denture stomatitis. Stand J Dent Res 1974;82:151-90. 15. Olsen I. Denture stomatitis. Occurrence and distribution of fungi. Acta Odontol Stand 1974;32:329-33. 16. Arendorf TM, Walker DM. Oral candidal populations in health and disease. Br Dent J 1979;147:267-72. 17. Bergendal T, Holmberg K, Nord C-E. Yeast colonization in oral cavity and feces in patients with denture stomatitis. Acta Odontol Stand 1979;37:37-45. 18. Davenport JC, Hamada T. Denture stomatitis-a literature review with case reports. Hiroshima J Med Sci 1979;28:209-20. 19. Fouche MH, Slabbert JCG, Coogan MM. Candidal antibodies in patients undergoing treatment for denture stomatitis. J PROSTHET DENT 1987;57:587-91.
20. Rotrosen D, Calderone RA, Edwards JE Jr. Adherence of Candida species to host tissues and plastic surfaces. Rev Infect Dis 1986;8:73-85. 21. Kennedy MJ. Adhesion and association mechanisms of Candida albicans. Curr Top Med Mycol 1988;2:73-169. 22. Klotz SA, Drutz DJ, Zajic JE. Factors governing adherence of Candida species to plastic surfaces. Infect Immun 1985;50:97-101. 23. Minagi S, Miyake Y, Inagaki K, Tsuru H, Suginaka H. Hydrophobic interaction in Candida albicans and Candida tropicalis adherence to various denture base resin materials. Infect Immun 1985;47:11-4. 24. Miyake Y, Fujita Y, Minagi S, Suginaka H. Surface hydrophobicity and adherence of Candida to acrylic surfaces. Microbios 1986;46:7-14. 25. Odds FC. Pathogenesis of candidosis. In: Odds FC, ed. Candida and candidosis. 2nd ed. London: Buttler & Tanner Ltd, 1988252-78. 26. Nikawa H, Sadamori S, Hamada T, Okuda K. Non-specific adherence of Candida species to surface-modified glass. J Med Vet Mycol 1989;27:269-71. 27. Samaranayake LP, McCourtie J, MacFarlane TW. Factors affecting the in-vitro adherence of Candida albicans to acrylic surfaces. Arch Oral Biol 1980;25:611-5. 28. McCourtie J, MacFarlane TW, Samaranayake LP. A comparison of the effects of chlorhexidine gluconate, amphotericin B and nystatin on the adherence of Candida species to denture acrylic. J Antimicrob Chemother 1986;17:575-83. 29. McCourtie J, MacFarlane TW, Samaranayake, LP. Effect of saliva and serum on the adherence of Candida species to chlorhexidine-treated denture acrylic. J Med Microbial 1986;21:209-13. 30. Jones GW, Isaacson RE. Proteinaceous bacterial adhesions and their receptors. CRC Crit Rev Microbial 1983;10:229-60. 31. Olsen I, Birkeland JM. Initiation and aggravation of denture stomatitis by sucrose rinses. Stand J Dent Res 1976;84:94-7. 32. Samaranayake LP. Nutritional factors and oral candidosis. J Oral Path01 1986;15:61-5. Reprint requests to: DR. HIROKI NIKAWA SCHOOL OF DENTISTRY HIROSHIMA UNIVERSITY 1-2-3 KASUMI, MINAMI-KU HIROSHIMA 734 JAPAN
SEPTEMBER
1991
VOLUME
06
NUMBER
3
EDITOR
Louie J. Boucher
IDenture
stomatitis
and ABO blood types
Hiroki Nikawa, DD!3, PhD,* Hiroo Kotani, Shinsuke Sadamori, DDS, PhD,C and Taizo Hiroshima
Univl rsity. School of Dentistry,
Hiroshima,
DDS, PhD,b Hamada, DDS,
PhDd
,lapan
To determine the interrelation between ABO blood types of denture wearers, denture plaque accumulation, and denture stomatitis, 442 denture wearers were studi(ed using a simplified culture method, which is convenient to use in the dental office. The degree of plaque accumulation and the occurrence of denture stomatitis varied depending on the blood type of the patients. Especially in blood group 0 compared with other types, both denture plaque accumulation and denture stomatitis were found to be higher or more severe. These results suggest that the ABO blood group is one of the etiologic factors of denture stomatitis and that denture wearers of’ blood group 0 are more susceptible to denture stomatitis. (J PROSTHET DENT 1991;66:391-4.)
T
he interrelation between ABO blood groups and infection has been extensivel:i studied,le6 but the results are not consistent. Kinane et a1.3 reported that women of blood groups B and AB are more susceptible to urinary tract infection, whereas Deresinski et a1.l have shown that blood group B is significantly associated with disseminated fungal infection. Other investigators, however, reported that blood type 0 and/or nonsecretion of antigen are risk factors for Candida al&cans infection or its oral carriage.4W” One of the reasons for these discrepancies might be the difference in mechanisms of adherence of these organiarns2~“~ 5 Many studies have s11own that Candida albicans adherence is mediated by specific interaction with several N-acetyl D-glucossugar moielties, such as D-mannose, amine, and L-fucose,“-” some of which are immunodominant sugars of blood type. However, the relationship bletween blood groups of denture wearers and their susceptibility to denture stomatitis In clinical dentistry has not bseen previously evaluated. Accordingly, in this study, interrelations between ABO blood groups and both denture plaque accumulation ancl the occurrence of denture stomatitis were clinically investigated using a simplified meth0d.l”
MATERIAL
AND
METHODS
Four hundred forty-two derture wearers, who visited a dentist’s office from 1.985 to 1990, were investigated. Basic data of this population are summarized in Table I. No sig-
OABAB
Fig. 1. Populations of degree of denture plaque accumulation (a) and denture stomatitis !b) in blood groups of denture wearers.
nificant differences in the sex incidence were observed. Both denture plaque accumulation and denture stomatitis were studied using a simplified test culture for detection of Candida genus (Stomastat, Sankin Industry Co., Ltd., Osaka, Japan). l2 Briefly, swabs collected from the tissue surface of the maxillary denture and the corresponding denture-bearing palatal mucosa were incubated in the cultures for 24 hours at 37“ C. These cultures were then submitted to a calorimetric judgment according to the following scale as the manufacturer indicated: - = red (less than 102 Candida cells/ml) + = orange (about 7x10” Candida cells/m11 ++ = yellow (more than 7x10” C’andido cells/ml)
The grades of denture stomatitis were determined in detail from clinical findings by means of the following scale:
-aliesearch bl’art-time C12ecturer, dProfessor
Associate, Department of Prosthetic Dentistry. Lecturer, Department of Prosthetic Dentistry. Departm’snt of Prosthetic Dentistry. and Chairman, Depart nent of Prosthetic Dentistry.
1’0/1/24229 TIHE
OABAB
JOURNAL
OF PROSTHETIC
DENTISTRY
- = no symptoms t = slight inflammation and Candida ~basically equivalent to Newton’s ++ = ie\:ere inflammation and C’un&do 1basically equivalent to Newton’s
were detected type I) were detected type II1 391
NIKAWA
Table
ET AL
Blood groups and age and sex of denture wearers
I.
ABO blood group
Age W (M/F)
Sex ratio
Table
II.
0
A
B
AB
58-83 35175
58-89 471136
61-80 33164
64-79 16/36
Blood groups and denture plaque accumulation ABO blood group
Degree of denture plaque accumulation
0
A
B
AB
Total
+ ++ Total
24 36 50 110
62 76 45 183
31 37 29 97
18 21 13 52
135 170 137 442
Chi square 15.678 (degrees of freedom 6; p C 0.05).
Table
III.
Blood groups and occurrence of denture stomatitis ABO blood group
Degree of denture stomatitis
0
A
B
AB
Total
+ ++ Total
29 39 42 110
75 62 46 183
40 37 20 97
23 20 9 52
167 158 117 442
Chi square 14.342 (degrees of freedom
Table
IV.
6; p < 0.05).
Results of ANOVA on denture plaque
Denture
plaque A e T
S, Sum of squares; f, frequency;
Table
V.
V, variance;
S
f
V
F
P
1135.9 26.4 1162.3
11 12 23
103.3 2.2
46.9
F, F test; A, Atabrine;
e, epizootic;
Results of multiple range test on denture
plaque Degree of denture
J51oou type O-A O-B 0-AB A-B A-AB B-AB
392
+
++
p < 0.01 p < 0.01 p < 0.01
p < 0.01 p < 0.01 p < 0.01
p < 0.01 p < 0.01 p < 0.01
-
The numerical data obtained were subjected to chi square test, a one-way analysis of variance (ANOVA), and a multiple range test at the 5 ‘2%or 1% level.
RESULTS
plaque
-
-
T, tropical.
-
Both in the degree of denture plaque accumulation and in the occurrence of denture stomatitis, significant differences were observed among blood groups A, B, 0, and AB (p < 0.05; Tables II and III). Furthermore, Fig. 1 shows the tendency for blood group 0 to be a risk factor for plaque accumulation and the occurrence of denture stomatitis. Therefore whether the denture wearers in blood group 0 have a high risk or not
SEPTEMBER
1991
VOLUME
66
NUMBER
3
DIENTURE
Table
STOMATITIS
VI.
AXD
ABO
BLOOD
TYPES
Results of ANOVA on denture stomatitis
Denture stomatitis
S
ii
1856.7
,’
88.4
‘1 -_-Abbreviations aq in Table 1J.
1945.1
f
v
P
P
II 12 23
168.8 7.1
22.5
was examined using more sensitive statistical analysis. It was revealed that both the amount of denture plaque and the occurrence of denture stomatitis are significantly higher in blood group 0 than in those subjects having other blood types (p < 0.05; Tables IV and V). Furthermore, the population with both marked plaque accumulation (++) and palatal iinflammation ( ++:I was significantly higher in blood group 0 than in those of other blood types (p < 0.05; Tables VI and VII). DISCUSSION Since one of ma.jor etiologic factors of denture stomatitis is considered to ble denture plaque accumulation or cand:idal colonization on the denture surface,13-lg Candida adherence to inert surfaces or host cell surfaces is now recognized as an important initial step in the successful colonization and development of pathogenesis.20,21 Reports have shown that Candida adherence to the host surface is mediated mainly by specific adherence,7-11,20*21 and several kinds of hexoses and hexosamines are identified as the receptor for Candiidu ulbicuns, some of which are immunodlominant sugars of blood types. Furthermore, these glycocompounds in body fluids such assaliva have been reported to enhance or inhibit the adherence of Cundidu to the host cell surfaces in viva and in vitro.4r 5,21 Although the adherence of Candidu to bare acrylic resin surfaces or to solid surfaces is considered to be mediated mainly by nonspecific interac tion,22-26serum or salivary proteins adsorbed to inert surf.acesaffect the adherence of Cundidu,27-2g and it is suggested these proteins adsorbed p:rovide specific recept,or sites.30Since in vivo adherence of Cundidu to denture surfaces might also be affected by body fluids containing immunodominant glycocompounds of some blood types, investigations to detect the type of blood group that is more susceptible to denture stomatitis were initiated. To study these points, a simplified culture method was, used that is sensitive to detect Cundidu regardless of‘ any microbial contamination and is suitable to use in the dental c)ffice.*2 It was found that both the degree of denture plaque accumulation and the occurrence of denture stomatitis varied depending upon the blood types of denture wearers. Further examinations have revealed that the population of both plaque accumulation and the occurrence of denture
THE
JOURNAL.
OF PROSTHETIC
IXNTISTRY
--..-II_
Table
VII.
Results of multiple range test on denture
stomatitis Degree
of denture
Blood type
stomatitis
+
++
O-A
p < 0.05
p < 0.05
O-B
p < 0.01 p < 0.01
p < 0.01 p < 0.01
0-AB A-B A-AB B-AB
--
stomatitis were greater in blood group 0 than in those with other blood group types. In addition, the population of denture wearers with marked denture plaque or with severe palatal inflammation was higher in blood group 0 than in those of other blood groups. This finding is consistent with the conclusion of Burford-mason et al.,” who investigated the interrelation between ABO blood types or the secretor state and Candidu association with soft tissues. These results suggest that in complete denture wearers, blood group 0 is a comparative risk factor for both denture plaque accumulation and denture stomatitis. Although many etiologic factors, such as microbial, allergic, nutrient, and systemic factorsls, I43Ia,31,X2are involved in denture plaque accumulation and the occurrence of denture stomatitis, our results may provide some information about the etiology of denture stomatitis. CLINICAL
IMPLICATIONS
Many etiologic factors, such as sex distribution, habits, nutrient factors, and systemic factors have been reported to be associated with denture stomatitis. In this study we investigated whether the ABO blood type of patients affects denture plaque accumulation and denture stomatitis. The results show that patients from blood group 0 are more susceptible to denture plaque accumulation or denture stomatitis. CONCLUSIONS The hypothesis that certain blood groups were a risk factor for both denture plaque accumulation and denture
393
NIKAWA
stomatitis was investigated in a group of 442 denture wearers using a simplified method, and the following results were obtained. 1. There were significant differences in the degree of denture plaque accumulation among blood groups A, B, 0, and AB (p < 0.05). 2. Significant differences were observed in the degree of denture stomatitis among blood groups A, B, 0, and AB (p < 0.05). 3. Both the amount of denture plaque and the occurrence of denture stomatitis are significantly higher in blood group 0 than in those in other types (p < 0.05). 4. The populations with both plaque accumulation (++) and palatal inflammation (++) were significantly higher in blood group 0 than in those with other blood types (p < 0.05). REFERENCES 1. Deresinski SC, Pappagianis D, Stevens DA. Association of ABO blood group and outcome of coccidal infection. Sabouraudia 1979;17:261-4. 2. Hogg SD, Embery G. Blood-group-reactive glycoprotein from human saliva interacts with lipoteichoic acid on the surface of Streptococcus sanguis cells. Arch Oral Biol 1982;27:261-8. 3. Kinane DF, Blackwell CC, Brettle RP, Weir DM, Winstanley FP, Elton RA. ABO blood group, secretor state, and susceptibility to recurrent urinary tract infection in women. Br Med J 1982;285:7-9. 4. Blackwell CC. Jdnsdpdttir K, Hanson M, et al. Non-secretion of ABO antigens predisposing to infection by Neisseria meningitidis and Streptococcus pneunoniae. Lancet 1986;2:284-5. 5. Blackwell CC, Thorn SM, Weir DM, Kinane DF, Johnstone FD. Hostparasite interactions underlying non-secretion of blood group antigens and susceptibility to infections by Candida albicans. In: Lark DL, ed. Protein-carbohydrate interactions in biological systems. London: Academic Press Inc, 1986231-3. 6. Burford-mason AP, Weber JCP, Willoughby JMT. Oral carriage of Candida albicans, ABO blood group and secretor status in healthy subjects. J Med Vet Mycol 1988;26:49-56. 7. Sobel JD, Myers D, Kaye D, Levinson ME. Adherence of Candida albicans to human vaginal and buccal epithelial cells. J Infect Dis 1981;143:76-82. 8. Sandin RF, Rogers AL, Patterson RJ, Beneke ES. Evidence for mannose-mediated adherence of Candida albicans to human buccal cells in vitro. Infect Immun 1982;35:79-85. 9. Segal E, Lehrer N, Ofek I. Adherence of Candida albicans to human vaginal epithelial cells: inhibition by amino sugars. Exp Cell Biol 1982;50:13-7. 10. Critchley IA, Douglas LJ. Role of glycoside as epithelial cell receptors for Candida albicam. J Gen Microbial 1987;133:637-43. 11. Douglas LJ. Adhesion of Candida species to epithelial surfaces. CRC Crit Rev Microbial 1987;15:27-43. 12. Hamada T, Yuhda S, Shigeto N, Tamamoto M, Nahara Y, Sadamori S. A simplified culture for the diagnosis of denture stomatitis. Hiroshima J Med Sci 1987:36:289-94.
394
ET AL
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20. Rotrosen D, Calderone RA, Edwards JE Jr. Adherence of Candida species to host tissues and plastic surfaces. Rev Infect Dis 1986;8:73-85. 21. Kennedy MJ. Adhesion and association mechanisms of Candida albicans. Curr Top Med Mycol 1988;2:73-169. 22. Klotz SA, Drutz DJ, Zajic JE. Factors governing adherence of Candida species to plastic surfaces. Infect Immun 1985;50:97-101. 23. Minagi S, Miyake Y, Inagaki K, Tsuru H, Suginaka H. Hydrophobic interaction in Candida albicans and Candida tropicalis adherence to various denture base resin materials. Infect Immun 1985;47:11-4. 24. Miyake Y, Fujita Y, Minagi S, Suginaka H. Surface hydrophobicity and adherence of Candida to acrylic surfaces. Microbios 1986;46:7-14. 25. Odds FC. Pathogenesis of candidosis. In: Odds FC, ed. Candida and candidosis. 2nd ed. London: Buttler & Tanner Ltd, 1988252-78. 26. Nikawa H, Sadamori S, Hamada T, Okuda K. Non-specific adherence of Candida species to surface-modified glass. J Med Vet Mycol 1989;27:269-71. 27. Samaranayake LP, McCourtie J, MacFarlane TW. Factors affecting the in-vitro adherence of Candida albicans to acrylic surfaces. Arch Oral Biol 1980;25:611-5. 28. McCourtie J, MacFarlane TW, Samaranayake LP. A comparison of the effects of chlorhexidine gluconate, amphotericin B and nystatin on the adherence of Candida species to denture acrylic. J Antimicrob Chemother 1986;17:575-83. 29. McCourtie J, MacFarlane TW, Samaranayake, LP. Effect of saliva and serum on the adherence of Candida species to chlorhexidine-treated denture acrylic. J Med Microbial 1986;21:209-13. 30. Jones GW, Isaacson RE. Proteinaceous bacterial adhesions and their receptors. CRC Crit Rev Microbial 1983;10:229-60. 31. Olsen I, Birkeland JM. Initiation and aggravation of denture stomatitis by sucrose rinses. Stand J Dent Res 1976;84:94-7. 32. Samaranayake LP. Nutritional factors and oral candidosis. J Oral Path01 1986;15:61-5. Reprint requests to: DR. HIROKI NIKAWA SCHOOL OF DENTISTRY HIROSHIMA UNIVERSITY 1-2-3 KASUMI, MINAMI-KU HIROSHIMA 734 JAPAN
SEPTEMBER
1991
VOLUME
06
NUMBER
3