Cytological and Cytometric Analysis of Epithelial Cell Changes Under the Surface of Acrylate Prosthesis in Diabetic Patients

ORIGINAL ARTICLE
Erejeta Deva Kurshumliu, Gordana Kovacevska, Kujtim Shala, Blerta Musliu Krasniqi, Fisnik Kurshumiu

 
For citation: Kurshumliu ED, Kovacevska G, Shala K, Krasniqi BM, Kurshumiu F. Cytological and Cytometric Analysis of Epithelial Cell Changes Under the Surface of Acrylate Prosthesis in Diabetic Patients. International Journal of Biomedicine. 2024;14(2):324-328. doi:10.21103/Article14(2)_OA15
 
Originally published June 5, 2024
 

Abstract: 

Background: The aim of this study was to assess cytological alterations of the squamous epithelium of the alveolar ridge mucosal surface under the acrylate prosthesis in T2D patients.
Methods and Results: The subjects of interest were patients in whom the total acrylate prosthesis had been applied 3-5 years or more prior to the examination. The subjects were divided into two groups: 30 adult subjects with T2D (T2D group) and 30 adult subjects without T2D (control group). Both groups were over 49 years of age. Cytological smears were obtained by cytobrush from the mucosal surface of the gingival crest underlying the acrylate prosthesis. The following parameters were assessed: type of cells (basal, intermediate, superficial, superficial without nucleus, and parakeratotic), proportions of the types of cells, cytoplasmic diameter, nuclear diameter, and nucleus-to-cytoplasm ratio. An independent sample t-test was used to compare the two study groups. The percentage of superficial cells was significantly lower in the T2D group than in the control group (P=0.001). The T2D group tended to have a higher rate of parakeratotic cells (13.0±11.12 vs. 8.07±7.92, P=0.052). Superficial cells in the T2D group had a significantly lower mean cytoplasmic diameter than the control group (32.7947±8.61929 µ vs. 36.6383±4.32228 µ, P=0.03). Additionally, the nucleus-to-cytoplasm ratio of intermediate and superficial cells in the T2D group was significantly higher than in the control group (0.2407±0.07206 vs. 0.2000±o.03291, P=0.007 and 0.2573±0.06330 vs. 0.2280±0.03178, P=0.027).
Conclusion: The results of our study show that total acrylate prostheses in diabetic patients are responsible for the disrupted maturation of squamous epithelial cells. This is reflected in smaller superficial cells, increased parakeratosis, and the higher nucleus-to-cytoplasm ratio of intermediate and superficial cells.

Keywords: 
exfoliative cytology • liquid-based cytology • cytometric analysis • diabetes mellitus
References: 
  1. Rathee M, Jain P, Singh S, Divakar S, Chahal S, Wakure P. Role of diabetes in the prosthodontic management of a completely edentulous patient. International Journal of Dental Research. Jun 2021; 3(1):50-5
  2. Jivanescu A, Bratu EA, Goguta L, Borgnakke WS. Effect of Improvement of Complete Dentures on Quality of Life in Type 2 Diabetes. Diabetes, Stoffwechsel und Herz. 2013;22(4):207-211
  3. Al-Maskari AY, Al-Maskari MY, Al-Sudairy S. Oral Manifestations and Complications of Diabetes Mellitus: A review. Sultan Qaboos Univ Med J. 2011 May;11(2):179-86. Epub 2011 May 15. PMID: 21969888; PMCID: PMC3121021.
  4. Emami E, de Souza RF, Kabawat M, Feine JS. The impact of edentulism on oral and general health. Int J Dent. 2013;2013:498305. doi: 10.1155/2013/498305. Epub 2013 May 8. PMID: 23737789; PMCID: PMC3664508
  5. Al-Rafee MA. The epidemiology of edentulism and the associated factors: A literature Review. J Family Med Prim Care. 2020 Apr 30;9(4):1841-1843. doi: 10.4103/jfmpc.jfmpc_1181_19. PMID: 32670928; PMCID: PMC7346915
  6. Shinde J, Mowade T, Gupta P, Tekale R, Pande N, Deshmukh K, Lokhande T, Radke U. Satisfaction in conventional acrylic complete denture patient with and without denture liners - a systematic review. Pan Afr Med J. 2022 Aug 22;42:296. doi: 10.11604/pamj.2022.42.296.33035. PMID: 36415342; PMCID: PMC9643794
  7.  Olms C, Hix N, Neumann H, Yahiaoui-Doktor M, Remmerbach TW. Clinical comparison of liquid-based and conventional cytology of oral brush biopsies: a randomized controlled trial. Head Face Med. 2018 May 29;14(1):9. doi: 10.1186/s13005-018-0166-4. PMID: 29843756; PMCID: PMC5975412.
  8. Sun X, Meng L, Chen Y, Wang J, Wang Q. Efficacy and risk factors of traditional denture restoration versus biofunctional complete denture restoration system. Am J Transl Res. 2023 Jul 15;15(7):4755-4762. PMID: 37560251; PMCID: PMC10408514.
  9. Menon RS, Dhakshaini MR, Gujjari AK, Hegde U. A clinical evaluation on the effect of astringent on keratinization of oral mucosa before and after the insertion of complete denture. Indian J Dent Res. 2019 May-Jun;30(3):347-351. doi: 10.4103/ijdr.IJDR_620_17. PMID: 31397406.
  10. Shetty S; Gokul S. Keratinization and its disorders. Oman Med J. 2012 Sep;27(5):348-57. doi: 10.5001/omj.2012.90. PMID: 23074543; PMCID: PMC3472583.
  11. Mneizel T.A study of the palatal keratinization levels beneath complete acrylic resin dentures. JRMS. June 2005; 12(1): 25-29
  12. Markov NJ. Cytologic study of keratinization under complete dentures. J Prosthet Dent 1968;20:8-13.
  13. Watson IB, MacDonald DG. Oral mucosa and complete dentures. J Prosthet Dent. 1982 Feb;47(2):133-40. doi: 10.1016/0022-3913(82)90176-7. PMID: 6173477
  14. Mori S, Sato T, Hara T, Nakashima K, Minagi S. Effect of continuous pressure on histopathological changes in denture-supporting tissues. J Oral Rehabil. 1997 Jan;24(1):37-46. doi: 10.1046/j.1365-2842.1997.00443.x. PMID: 9049918.
  15. Menon RS, Dhakshaini MR, Gujjari AK, Hegde U. A clinical evaluation on the effect of astringent on keratinization of oral mucosa before and after the insertion of complete denture. Indian J Dent Res. 2019 May-Jun;30(3):347-351. doi: 10.4103/ijdr.IJDR_620_17. PMID: 31397406.
  16. Radke U, Kahar A, Zade P, Lambade D, Deshpande S, Radke P. Evaluation of Effect of Astringent on Oral Mucosa as a Non-surgical Preprosthetic Treatment Modality in Edentulous Patients: An In Vivo Study. J Indian Prosthodont Soc. 2014;14(Suppl 1):93-97. doi:10.1007/s13191-014-0372-0
  17. Stig Gson Östlund. The Effect of Complete Dentures on the Gum Tissues, Acta Odontologica Scandinavica. 1958;16(1):1-41. doi: 10.3109/00016355809028181
  18. Jani RM, Bhargava K. A histologic comparison of palatal mucosa before and after wearing complete dentures. J Prosthet Dent. 1976 Sep;36(3):254-60. doi: 10.1016/0022-3913(76)90179-7. PMID: 1066479.
  19. Nedelman C, Gamer S, Bernick S. The alveolar ridge mucosa in denture and non-denture wearers. J Prosthet Dent. 1970 Mar;23(3):265-73. doi: 10.1016/0022-3913(70)90181-2. PMID: 5263308.
  20. Verma R, Singh A, Badni M, Chandra A, Gupta S, Verma R. Evaluation of exfoliative cytology in the diagnosis of oral premalignant and malignant lesions: A cytomorphometric analysis. Dent Res J (Isfahan). 2015 Jan-Feb;12(1):83-8. doi: 10.4103/1735-3327.150339. PMID: 25709680; PMCID: PMC4336977.
  21. Kokubun K, Nakajima K, Yamamoto K, Akashi Y, Matsuzaka K. Evaluation of oral brush liquid-based cytology for oral squamous cell carcinoma: a comparative study of cytological and histological diagnoses at a single center. BMC Oral Health. 2023 Mar 11;23(1):145. doi: 10.1186/s12903-023-02839-w. PMID: 36906554; PMCID: PMC10007825.
  22. Olms C, Hix N, Neumann H, Yahiaoui-Doktor M, Remmerbach TW. Clinical comparison of liquid-based and conventional cytology of oral brush biopsies: a randomized controlled trial. Head Face Med. 2018 May 29;14(1):9. doi: 10.1186/s13005-018-0166-4. PMID: 29843756; PMCID: PMC5975412.
  23. Nandita KP, Boaz K, Srikant N, Lewis AJ, Nidhi M. Oral epithelium in diabetics: A cytomorphometric correlation, Dental Hypotheses. Apr-Jun 2014;5(2):59-65. doi:10.4103/2155-8213.133428
  24. Lee JH, Han JS, Han K, Lee SY. Association between Diabetes and the Use of Removable Dental Prostheses among the Korean Population. J Korean Med Sci. 2019 Oct 28;34(41):e262. doi: 10.3346/jkms.2019.34.e262. PMID: 31650717; PMCID: PMC6813424.
  25. Kumaresan GD, Jagannathan N.  Exfoliative cytology - A predictive diagnostic tool. International Journal of Pharmacy and Pharmaceutical Sciences,.2014;6(5): 1-3.
  26. Farhan RS, Yas LS.  Oral Finding and Cytomorphometric Analysis of Oral Mucosal Cells in Type 2 Diabetic Patients. International Journal of Medical Research & Health Sciences. 2018;7(6): 86-93
  27. Kydd WL, Daly CH, Nansen D. Variation in the response to mechanical stress of human soft tissues as related to age. J Prosthet Dent. 1974 Nov;32(5):493-500. doi: 10.1016/0022-3913(74)90003-1. PMID: 4531483.
  28. Jenny N. Beneath the Complete Denture Prosthesis: A Review. International Journal of Dental Sciences and Research. 2018;6(4):87-89. doi: 10.12691/ijdsr-6-4-2.
  29. Gonçalves TS, Morganti MA, Campos LC, Rizzatto SM, Menezes LM. Allergy to auto-polymerized acrylic resin in an orthodontic patient. Am J Orthod Dentofacial Orthop. 2006 Mar;129(3):431-5. doi: 10.1016/j.ajodo.2005.10.017. PMID: 16527642.
  30. Lunder T, Rogl-Butina M. Chronic urticaria from an acrylic dental prosthesis. Contact Dermatitis. 2000 Oct;43(4):232-3. PMID: 11011931.
  31. Martin N, Bell HK, Longman LP, King CM. Orofacial reaction to methacrylates in dental materials: a clinical report. J Prosthet Dent. 2003 Sep;90(3):225-7. doi: 10.1016/s0022-3913(03)00331-7. PMID: 12942054.
  32. Koutis D, Freeman S. Allergic contact stomatitis caused by acrylic monomer in a denture. Australas J Dermatol. 2001 Aug;42(3):203-6. doi: 10.1046/j.1440-0960.2001.00517.x. PMID: 11488717.
  33. Ruiz-Genao DP, Moreno de Vega MJ, Sánchez Pérez J, García-Díez A. Labial edema due to an acrylic dental prosthesis. Contact Dermatitis. 2003 May;48(5):273-4. doi: 10.1034/j.1600-0536.2003.00100.x. PMID: 12868970.

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Received March 23, 2024.
Accepted May 4, 2024.
©2024 International Medical Research and Development Corporation.