Exfoliative cytological analysis of patients with diabetes mellitus for early detection of periodontitis

Objectives: This study aimed to evaluate and compare cytological changes in the periodontal pocket/gingival sulcus epithelium of individuals with and without type II diabetes mellitus for early detection of periodontitis. Methods: An analytical cross-sectional study was conducted including three groups: periodontally and systemically healthy individuals, systemically healthy periodontitis patients, and periodontitis patients with type II diabetes mellitus. Pocket epithelium samples were collected from sites with the deepest probing depth and bleeding on probing in periodontitis patients. Samples were stained using the Papanicolaou method and analyzed for nuclear abnormalities including micronucleation, condensed chromatin, nuclear buds, nuclear extensions, pyknotic nuclei, karyolysis, and other apoptotic changes. Statistical analysis was performed using SPSS version 26.0. Results: A significant difference in cells with pyknotic nuclei was observed between diabetic periodontitis and non-diabetic periodontitis groups. Binucleated cells showed significant differences between healthy individuals and diabetic periodontitis patients. Periodontitis groups demonstrated a significant increase in apoptotic markers such as karyorrhexis, pyknosis, and condensed chromatin compared to healthy controls. The presence of diabetes further amplified these cytological alterations. Conclusions: Exfoliative cytology is a simple, non-invasive, and effective technique for detecting cellular changes associated with periodontitis. The presence of diabetes mellitus enhances nuclear abnormalities, indicating its potential role in early detection and prognosis assessment of periodontal disease. This method may serve as a valuable screening tool in both clinical and community settings.