Oral Mucosal Changes in Acrylate Prosthesis Wearers Among Diabetic Patients: A Review Article

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

 
International Journal of Biomedicine. 2023;13(4):221-227.
DOI: 10.21103/Article13(4)_RA4
Originally published December 5, 2023

Abstract: 

Diabetes mellitus (DM) is one of the significant health problems in the world.  Diabetes affects most parts of the human organism, and the oral cavity is no exception. Among oral manifestations related to DM are dry mouth, tooth decay, periodontal disease, gingivitis, oral candidiasis, burning mouth syndrome, disorders of taste, oral lichen planus, geographic tongue, fissured tongue, delayed wound healing, increased incidence of infection, salivary dysfunction and neurosensory disorders. According to the literature, edentulous patients are more likely to have DM in comparison to the nondiabetic population. The effect of total prostheses on the oral mucosa (OM) has been the subject of many scientific studies. This study aimed to investigate existing evidence related to changes in the OM in DM patients who are wearers of total acrylic prostheses.
Based on the reviewed literature, changes in the OM are much more pronounced in DM patients wearing acrylate prostheses and are caused by severe inflammation and delayed keratinization. A total acrylate prosthesis introduces additional trauma, inflammation, and stress in DM patients.

Keywords: 
diabetes mellitus • acrylate prosthesis • oral mucosa • cytological changes
References: 
  1. Nandita KP, Karen Boaz, Srikant N, Amitha J Lewis, Nidhi M. Oral epithelium in diabetics:  A cytomorphometric correlation, Dental Hypotheses . Apr-Jun 2014;5(2):59-65 DOI:10.4103/2155-8213.133428]
  2. Sahu M, Suryawanshi H, Nayak S, Kumar P. Cytomorphometric analysis of gingival epithelium and buccal mucosa cells in type 2 diabetes mellitus patients. J Oral Maxillofac Pathol. 2017 May-Aug;21(2):224-228. doi: 10.4103/jomfp.JOMFP_152_16. 
  3. Bushra Rahman. Prosthodontic Concerns in a Diabetic Patient.19. Sep.2013.Junior Resident OMFS, Government Dental College & Hospital, Srinagar, J&K, ISSN: 2249-9571
  4. Mauri-Obradors E, Estrugo-Devesa A, Jané-Salas E, Viñas M, López-López J. Oral manifestations of Diabetes Mellitus. A systematic review. Med Oral Patol Oral Cir Bucal. 2017 Sep 1;22(5):e586-e594. doi: 10.4317/medoral.21655. 
  5. Kothari S, Rakshagan, Ganesh B. Prevalence of Diabetes Mellitus Among Complete Denture Patients. IJRPS. 2020;11(Spl 3) doi: 10.26452/ijrps.v11iSPL3.3375.
  6. Felton DA. Edentulism and comorbid factors. J Prosthodont. 2009 Feb;18(2):88-96. doi: 10.1111/j.1532-849X.2009.00437.x. 
  7. [7]. Watson IB. Oral Mucosa with Particular Reference to The Edentulous Mouth; University of Glasgow (United Kingdom) ProQuest Dissertations Publishing.1978.
  8. Chen J, Ahmad R, Li W, Swain M, Li Q. Biomechanics of oral mucosa. J R Soc Interface. 2015 Aug 6;12(109):20150325. doi: 10.1098/rsif.2015.0325.
  9. 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. 
  10. 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.
  11. 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.
  12. Wojciech Pawlina. Histology – A Text and Atlas, With Correlated Cell and Molecular Biology; Seventh Edition, 2016.
  13. Ivkovic, Nedeljka & Božović, Djordje & Ristic, Sinisa & Mirjanić, Vladan & Janković, Olivera. (2013). THE RESIDUAL MONOMER IN DENTAL ACRYLIC RESIN AND ITS ADVERSE EFFECTS. Contemporary Materials. IV. 84-91.doi:10.7251/COMEN1301084I.
  14. Verhulst MJL, Loos BG, Gerdes VEA, Teeuw WJ. Evaluating All Potential Oral Complications of Diabetes Mellitus. Front Endocrinol (Lausanne). 2019 Feb 18;10:56. doi: 10.3389/fendo.2019.00056. 
  15. Hoseini A, Mirzapour A, Bijani A, Shirzad A. Salivary flow rate and xerostomia in patients with type I and II diabetes mellitus. Electron Physician. 2017 Sep 25;9(9):5244-5249. doi: 10.19082/5244. 
  16. Eldarrat AH. Diabetic patients: their knowledge and perception of oral health. Libyan J Med. 2011 May 9;6. doi: 10.3402/ljm.v6i0.5691. 
  17. Cicmil A, Govedarica O, Lecic J, Puhalo-Sladoje D, Lukic R, Cicmil S, et al. Salivary flow rate and oral health status in type 2 diabetics. Stomatoloski glasnik Srbije.2020;67:7-14. doi: 10.2298/SGS2001007C
  18. Al-Dwairi Z, Lynch E. Xerostomia in complete denture wearers: prevalence, clinical findings and impact on oral functions. Gerodontology. 2014 Mar;31(1):49-55. doi: 10.1111/ger.12002.
  19. Aslam A.  XEROSTOMIA AND ITS EFFECT ON COMPLETE DENTURE STABILITY. Pakistan Oral and Dental Journal. 2017;37:188-191
  20. Soell M, Hassan M, Miliauskaite A, Haïkel Y, Selimovic D. The oral cavity of elderly patients in diabetes. Diabetes Metab. 2007 Apr;33 Suppl 1:S10-8. doi: 10.1016/s1262-3636(07)80053-x.
  21. Lotfi-Kamran MH, Jafari AA, Falah-Tafti A, Tavakoli E, Falahzadeh MH. Candida Colonization on the Denture of Diabetic and Non-diabetic Patients. Dent Res J (Isfahan). 2009 Spring;6(1):23-7. 
  22. Webb BC, Thomas CJ, Willcox MD, Harty DW, Knox KW. Candida-associated denture stomatitis. Aetiology and management: a review. Part 3. Treatment of oral candidosis. Aust Dent J. 1998 Aug;43(4):244-9. doi: 10.1111/j.1834-7819.1998.tb00172.x. 
  23. Ganapathy DM, Joseph S, Ariga P, Selvaraj A. Evaluation of the influence of blood glucose level on oral candidal colonization in complete denture wearers with Type-II Diabetes Mellitus: An in vivo Study. Dent Res J (Isfahan). 2013 Jan;10(1):87-92. doi: 10.4103/1735-3327.111806. 
  24. Cristina de Lima D, Nakata GC, Balducci I, Almeida JD. Oral manifestations of diabetes mellitus in complete denture wearers. J Prosthet Dent. 2008 Jan;99(1):60-5. doi: 10.1016/S0022-3913(08)60010-4. 
  25. Trentin MS, Verardi G, De C Ferreira M, de Carli JP, da Silva SO, Lima IF, Paranhos LR. Most Frequent Oral Lesions in Patients with Type 2 Diabetes Mellitus. J Contemp Dent Pract. 2017 Feb 1;18(2):107-111. doi: 10.5005/jp-journals-10024-1999. 
  26. Khatibi M, Amirzadeh Z, Shahab M, Heidary I, Estifaee A, Examining the relationship between type II diabetes with denture stomatitis. J Appl Environ Biol Sci.2015 Sep, 5(12)284-287,
  27. Bookout GP, Ladd M, Short RE. Burning Mouth Syndrome. 2023 Jan 29. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 30137814.
  28. Aravindhan R, Vidyalakshmi S, Kumar MS, Satheesh C, Balasubramanium AM, Prasad VS. Burning mouth syndrome: A review on its diagnostic and therapeutic approach. J Pharm Bioallied Sci. 2014 Jul;6(Suppl 1):S21-5. doi: 10.4103/0975-7406.137255.
  29. Nada A, Abdel Moneim W, Fakhr M, El Sawy S. Prevalence of Burning Mouth Syndrome in A sample of Egyptian Patients with Diabetic Neuropathy: A Cross Sectional Hospital-Based Study. Advanced Dental Journal, 2020; 2(2): 34-42. doi: 10.21608/adjc.2020.23213.1050
  30. Mukatash-Nimri GE, Al-Nimri MA, Al-Jadeed OG, Al-Zobe ZR, Aburumman KK, Masarwa NA. Patients with burning mouth sensations. A clinical investigation of causative factors in a group of "compete denture wearers" Jordanian population. Saudi Dent J. 2017 Jan;29(1):24-28. doi: 10.1016/j.sdentj.2016.10.002. 
  31. 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. 
  32. Ship JA. Diabetes and oral health: an overview. J Am Dent Assoc. 2003 Oct;134 Spec No:4S-10S. doi: 10.14219/jada.archive.2003.0367.
  33. Otero Rey EM, Yáñez-Busto A, Rosa Henriques IF, López-López J, Blanco-Carrión A. Lichen planus and diabetes mellitus: Systematic review and meta-analysis. Oral Dis. 2019 Jul;25(5):1253-1264. doi: 10.1111/odi.12977.
  34. Shen ZY, Liu W, Zhu LK, Feng JQ, Tang GY, Zhou ZT. A retrospective clinicopathological study on oral lichen planus and malignant transformation: analysis of 518 cases. Med Oral Patol Oral Cir Bucal. 2012 Nov 1;17(6):e943-7. doi: 10.4317/medoral.17778.
  35. Mozaffari HR, Sharifi R, Sadeghi M. Prevalence of Oral Lichen Planus in Diabetes Mellitus: a Meta-Analysis Study. Acta Inform Med. 2016 Dec;24(6):390-393. doi: 10.5455/aim.2016.24.390-393. 
  36. Kaomongkolgit R. Oral lichenoid drug reaction associated with antihypertensive and hypoglycemic drugs. J Drugs Dermatol. 2010 Jan;9(1):73-5. 
  37. Rath SK, Arnav M. Oral lichenoid contact reaction to a complete denture: A rare case report. Int J Health Allied Sci 2016;5:274-7
  38. Mneizel T. A study of the palatal keratinization levels beneath complete acrylic resin dentures. JRMS June 2005; 12(1): 25-29
  39. 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. 
  40. 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 Dec;14(Suppl 1):93-7. doi: 10.1007/s13191-014-0372-0.
  41. Östlund SG. The Effect of Complete Dentures on Gum Tissues. Acta Odontologica Scandinavica. 1958;16(1):1-41. doi: 10.3109/00016355809028181.
  42. 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. 
  43. 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. 
  44. 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. 
  45. Shetty S; Gokul S. Keratinization and its disorders. Oman Med J. 2012 Sep;27(5):348-57. doi: 10.5001/omj.2012.90. 
  46. Lindholm K, Hakala PE, Mäkilä E. Leukocyte count and keratinization of the palatal denture-bearing mucosa. J Prosthet Dent. 1982 Apr;47(4):440-4. doi: 10.1016/s0022-3913(82)80098-x. 
  47. 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.

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Received August 12, 2023.
Accepted September 25, 2023.
©2023 International Medical Research and Development Corporation.