Evaluation of early cytotoxic and genotoxic changes in buccal mucosa following exposure to orthodontic radiographs

By: Material type: TextTextPublication details: Kathmandu, Nepal ; Kathmandu University & Nepal Health Research Council (NHRC) ; 2025.Description: 48pSubject(s): NLM classification:
  • WU 141.5R2
Summary: Background Orthodontic radiographs, including orthopantomograms and lateral cephalograms, are routinely used worldwide for diagnosis and treatment planning. With the increasing global demand for orthodontic care especially among adolescents and young adults there is a corresponding rise in the frequency of dental radiographic examinations. Although these imaging techniques involve relatively low doses of ionizing radiation, concerns have been raised about their potential to induce genotoxic and cytotoxic changes in oral tissues. Several studies are being conducted internationally to address this issue. However, there is limited clinical data evaluating the biological effects of routine orthodontic radiographs, particularly in the South Asian population. Objectives The purpose of the study is to evaluate early cytotoxic and genotoxic changes in buccal mucosal cells following exposure to orthodontic radiographs. Materials and methods An analytical cross sectional study was conducted of 32 adult participants undergoing exposure to orthodontic radiographs (both OPG and lateral cephalogram). Buccal mucosal cell samples were collected before and ten days after radiographic exposure and stained using the PAP stain. Cytological analysis was performed to assess the frequency of micronucleated cells and cells showing other nuclear alterations preexposure and post exposure to radiation. The statistical analysis was done using SPSS version 23. Results The frequency of micronucleated cells was 0.20% and 0.28% pre-exposure and post exposure respectively. The frequency of cells with other nuclear alterations was 1.4% and 2.57% pre-exposure and post exposure respectively. These differences in frequency of micronucleated cells and other nuclear alterations before and after exposure to orthodontic radiographs were found to be statistically significant with p <0.05. Conclusion: Our report suggests that even low dose diagnostic radiation used in orthodontic diagnosis and treatment planning can induce early cytotoxic and genotoxic changes in buccal mucosal cells. This highlights the need for cautious use of radiographic procedures and strict adherence to radiation safety guidelines. Keywords: buccal mucosal cells, cytotoxicity, genotoxicity, micronucleus, papanicolaou stain
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In partial fulfilment of the requirements for the degree of Master in Medical Research.

Background
Orthodontic radiographs, including orthopantomograms and lateral cephalograms, are routinely used worldwide for diagnosis and treatment planning. With the increasing global demand for orthodontic care especially among adolescents and young adults there is a corresponding rise in the frequency of dental radiographic examinations. Although these imaging techniques involve relatively low doses of ionizing radiation, concerns have been raised about their potential to induce genotoxic and cytotoxic changes in oral tissues. Several studies are being conducted internationally to address this issue. However, there is limited clinical data evaluating the biological effects of routine orthodontic radiographs, particularly in the South Asian population.
Objectives
The purpose of the study is to evaluate early cytotoxic and genotoxic changes in buccal mucosal cells following exposure to orthodontic radiographs.

Materials and methods
An analytical cross sectional study was conducted of 32 adult participants undergoing exposure to orthodontic radiographs (both OPG and lateral cephalogram). Buccal mucosal cell samples were collected before and ten days after radiographic exposure and stained using the PAP stain. Cytological analysis was performed to assess the frequency of micronucleated cells and cells showing other nuclear alterations preexposure and post exposure to radiation. The statistical analysis was done using SPSS version 23.

Results
The frequency of micronucleated cells was 0.20% and 0.28% pre-exposure and post exposure respectively. The frequency of cells with other nuclear alterations was 1.4% and 2.57% pre-exposure and post exposure respectively. These differences in frequency of micronucleated cells and other nuclear alterations before and after exposure to orthodontic radiographs were found to be statistically significant with p <0.05.
Conclusion: Our report suggests that even low dose diagnostic radiation used in orthodontic diagnosis and treatment planning can induce early cytotoxic and genotoxic changes in buccal mucosal cells. This highlights the need for cautious use of radiographic procedures and strict adherence to radiation safety guidelines.
Keywords: buccal mucosal cells, cytotoxicity, genotoxicity, micronucleus, papanicolaou stain

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