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

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.