Abstract Background: Denture wearers are at high risk for oral candidiasis, presenting significant oral health challenges. Effective antifungal therapies are crucial to manage this condition and improve patient outcomes. Aims and Objectives: This systematic review aimed to evaluate the safety and effectiveness of antifungal therapies for treating oral candidiasis in denture wearers, focusing on both traditional and emerging treatment options. Materials and Methods: A comprehensive literature search was conducted using PubMed, CINAHL, Cochrane Library, Medline, and Web of Science databases. Twenty-four studies involving 1746 patients were included. Randomized controlled trials were assessed for bias risk using Robvis 2.0, while nonrandomized studies were evaluated with the ROBINS-I tool. Results: Nystatin demonstrated significant superiority over photodynamic therapy (PDT) in reducing palatal Candida ( P = 0.006) and comparable efficacy for denture surface decontamination ( P = 0.57). Fluconazole achieved a 77.8% short-term improvement rate but was associated with high recurrence rates post-treatment. PDT showed Candida reduction outcomes similar to nystatin, with reductions ranging from 0.68 to 0.77 log10 for PDT versus 0.57–1.43 log10 for nystatin. Chlorhexidine exhibited significant antifungal activity ( P < 0.0001), while miconazole and propolis achieved clinical cure rates of 70%. Conclusion: Traditional antifungals like nystatin and fluconazole offer reliable short-term effectiveness for oral candidiasis in denture wearers but are limited by high recurrence risks. Emerging therapies, such as PDT, show comparable efficacy and are promising alternatives. Future research should prioritize strategies to prevent recurrence and enhance long-term outcomes.
Muhammad A. Almoyad (Tue,) studied this question.