Manual and computer-assisted cytomorphometric analysis of saliva and gingival smears in diabetic patients

Abstract EN

Background Cytomorphometric analysis of oral mucosa play an important role in identifying changes of the oral cavity in diabetic patients, and it's an easy method to perform on exfoliated cells of saliva and gingival mucosa.

Aim to evaluate the mucosal changes by using different methods of smear collection and measurements as well as comparing the saliva exfoliated cells or the use of cytomorphometry computer-assisted analysis.

Methods The study included 60 patients diagnosed as type II diabetes mellitus (DM), for more than 10 years, and 30 non-diabetic healthy volunteers.

Papanicolaou stain was performed on their saliva and gingival cytobrush smears.

The morphological features of 50 unfolded, clearly outlined epithelial cells were evaluated under light microscope from each sample.

Then these cells were analyzed for the nuclear to cytoplasm ratio (N/C ratio) by using image J software computer program.

In addition the background of each slide was assessed manually for inflammation.

Results This results showed that diabetic oral mucosa cells were characterized by mild increase in the N/C ratio and slight irregular nuclear membrane; however the irregular nuclear membrane was statistically insignificant.

There were no differences in other nuclear features like binucleation, hyperchromatin and prominent nucleoli.

The results showed statistically highly significant increase in bacteria-coated epithelial cells (BCEC) in diabetic patients, particularly in the saliva smears.

The computer- assessed smears showed similar results for the N/C ratio and there was no statistical difference between the manual and computer- assessed results.

Conclusion: Oral cytomorphology changes occur in type II DM patients who showed epithelial cell degeneration and regeneration are more obvious in gingival cytobrush smears with no significance differences between the manual and the computer-assisted nuclear morphometry analysis, while BCEC and inflammation are more obvious in saliva smear