Oral candidiasis is an opportunistic infection of the oral mucosa sustained by fungi of the genus Candida. Various Candida species, with a predominance of C. albicans, normally a saprophyte of the oral cavity, may become virulent and infect the oral mucosa with variegated clinical presentation, in case of imbalance of the oral microbiota, the presence of local predisposing factors and systemic conditions that weaken the immune system. Conventionally, oral candidiasis eradication is done with the help of antifungal drugs. However, the growing phenomena of drug resistance and the increase in infections sustained by non-albicans species being less responsive to common antifungals have orientied researches towards the experimentation of alternative therapies. The present review considered the most promising alternative therapeutic proposals. The use of plant derivatives with phytotherapy is a promising option, such as probiotics, to rebalance the oral microbiota in case of dysbiosis. Finally, antimicrobial photodynamic therapy (aPDT), with highly selective fungicidal activity and free of side effects, is also being studied as a powerful alternative to drug administration. All these therapies are alternatives or supportive to the conventional treatment of recurrent and non-drug-responsive forms of oral candidiasis. However, further studies are needed to define the most active compounds, the efficacy of the therapies compared with the conventional ones, and the planning of regulated and standardized protocols.

中文翻译：

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口腔念珠菌病和新的治疗策略：抗真菌药、植物疗法、益生菌和光动力疗法

口腔念珠菌病是由念珠菌属真菌引起的口腔粘膜机会性感染。各种念珠菌，以白色念珠菌为主，通常是口腔的腐生菌，可能会变得有毒并感染口腔粘膜，临床表现多样，如果口腔微生物群失衡，存在局部易感因素和全身性削弱免疫系统的情况。通常，口腔念珠菌病的根除是在抗真菌药物的帮助下完成的。然而，越来越多的耐药现象和非白色念珠菌物种对常见抗真菌药反应较弱的感染增加，使研究转向了替代疗法的实验。本综述考虑了最有希望的替代治疗方案。在植物疗法中使用植物衍生物是一个很有前途的选择，例如益生菌，可以在生态失调的情况下重新平衡口腔微生物群。最后，抗微生物光动力疗法 (aPDT) 具有高度选择性的杀真菌活性且无副作用，作为药物给药的有力替代方案也正在研究中。所有这些疗法都是对复发性和非药物反应性口腔念珠菌病的常规治疗的替代或支持。然而，需要进一步的研究来确定最活跃的化合物、与传统疗法相比的疗法的功效以及规范和标准化方案的规划。抗微生物光动力疗法 (aPDT) 具有高度选择性的杀真菌活性且无副作用，也正在研究作为药物给药的有力替代方案。所有这些疗法都是对复发性和非药物反应性口腔念珠菌病的常规治疗的替代或支持。然而，需要进一步的研究来确定最活跃的化合物、与传统疗法相比的疗法的功效以及规范和标准化方案的规划。抗微生物光动力疗法 (aPDT) 具有高度选择性的杀真菌活性且无副作用，也正在研究作为药物给药的有力替代方案。所有这些疗法都是对复发性和非药物反应性口腔念珠菌病的常规治疗的替代或支持。然而，需要进一步的研究来确定最活跃的化合物、与传统疗法相比的疗法的功效以及规范和标准化方案的规划。