Natural products for the treatment of denture stomatitis: A systematic review

Statement of problem. Evidence for the efficacy and safety of natural products for the treatment of denture stomatitis is lacking. Purpose. The purpose of this systematic review was to answer the question "Are topical natural substances effective and safe compared with conventional antifungals in the treatment of denture stomatitis?" Material and methods. A structured search in 11 databases, including non-peer-reviewed, was undertaken. Two authors independently selected the studies, extracted the data, assessed the study quality, and graded the evidence, with disagreement resolved with a third reviewer. Data were evaluated descriptively by following Synthesis Without Meta-analysis (SWiM) reporting items. This study was registered at the International Prospective Register of Systematic Reviews (PROSPERO), number CRD42020216213. Results. After the removal of duplicates, 1925 records remained, and after a 2-phase reading of abstracts and full texts, 17 studies were included. Propolis, green tea, ginger, Zataria multiflora, chitosan, garlic, Artemisia, Schinus terebinthifolius Raddi, Uncaria tomentosa, Punica granatum, and Ricinus communis appeared to have similar efficacy and safety when compared with nystatin or miconazole. Most of the studies presented a high risk of bias. Conclusions. Certainty in the body of evidence that natural products might be appropriately used in the treatment of denture stomatitis is low. Well-designed randomized controlled trials are still needed to evaluate the topic better because there is high heterogeneity among the studies. (J Prosthet Dent 2023;129:413-24)