Biomonitoring of mutagenicity and cytotoxicity in patients undergoing fixed orthodontic therapy

The use of micronucleus assay in exfoliated oral cells in patients undergoing fixed orthodontic therapy: a systematic review with meta-analysis

The aim of this systematic review was to evaluate published papers regarding the micronucleus assay in oral mucosal cells of patients undergoing orthodontic therapy (OT). A search of the scientific literature was made in the PubMed, Scopus, and Web of Science databases for all data published until November, 2021 using the combination of the following keywords: "fixed orthodontic therapy," "genetic damage", "DNA damage," "genotoxicity", "mutagenicity", "buccal cells", "oral mucosa cells," and "micronucleus assay". The systematic review was designed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Nine studies were retrieved. Some authors demonstrated that OT induces cytogenetic damage in oral mucosal cells. Out of the nine studies included, two were classified as strong, five as moderate, and two as weak, according to the quality assessment components of the Effective Public Health Practice Project (EPHPP). Meta-analysis data revealed no relationship between mutagenicity in oral cells and OT in different months of treatment. At one month, the SMD = 0.65 and p = 0.08; after three months of OT, the SMD = 1.21 and p = 0.07; and after six months of OT, the SMD = 0.56 and p = 0.11. In the analyzed months of OT, I2 values were >75%, indicating high heterogeneity. In summary, this review was not able to demonstrate that OT induces genetic damage in oral cells. The study is important for the protection of patients undergoing fixed OT, given that mutagenesis participates in the multi-step process of carcinogenesis.

Effects of fixed orthodontic treatment with and without chlorhexidine mouthwash on vitality of oral mucosal cells reflected by cell nuclear indexes: A preliminary 3-phase before-after clinical trial

INTRODUCTION

Effects of mouthwashes on the vitality of oral mucosal cells have not been determined in orthodontic patients. We aimed to assess, for the first time, the effects of fixed orthodontic treatment with and without chlorhexidine (CHX) mouthwash on the oral mucosal cell vitality.

MATERIALS AND METHODS

All patients meeting the eligibility criteria were consecutively included until the desired sample size was reached. Oral buccal mucosal cell samples were taken immediately before orthodontic treatment. For each patient, 20 metal brackets and 4 bands were installed on the teeth. Cell samples were recollected after one month of treatment. Then, the patients used an ethanol-free 0.12% CHX mouthwash two times a week for one month. Sampling was repeated at the end of the second month. Papanicolaou staining was used for micronucleus screening of the indexes: micronucleus (MIC), karyorrhexis (KR), karyolysis (KL), and broken eggs (BE). The repair index (RI) was calculated as RI=KR+KL/BE+MIC. Comparisons of nuclear changes over 3 intervals were done using the Friedman and Dunn-Bonferroni tests (α=0.05, β<0.05).

RESULTS

This prospective before-after clinical trial was performed on 408 observations of 34 patients (14 males, 20 females, mean age: 16.68±3.75 years) at 3 intervals (×4 parameters each). The means of MIC, KR, KL, BE, and RI were respectively 1.312±1.219, 0.241±0.564, 0.426±0.657, 0.115±0.224, and 0.476±0.360 before treatment. They were 1.348±1.171, 0.215±0.236, 0.406±0.369, 0.124±0.187, and 0.511±0.310 at the first interval and 1.909±1.263, 0.368±0.174, 0.615±0.269, 0.253±0.150, and 0.529±0.195 at the second interval. Friedman showed significant time-dependent changes for all variables (P<0.0005) except RI. Dunn-Bonferroni showed that except MIC (P=0.017), KR/KL/BE changed insignificantly after orthodontic treatment (P≥0.974). MIC/KR/KL/BE increased significantly after the addition of CHX (P<0.0005).

CONCLUSION

CHX mouthwash, together with orthodontic treatment, has a strong deteriorating effect on nuclear indexes associated with the vitality of buccal mucosal cells. Nuclear changes caused by orthodontic treatment alone might be negligible.

Minimization of Adverse Effects Associated with Dental Alloys

Metal alloys are one of the most popular materials used in current dental practice. In the oral cavity, metal structures are exposed to various mechanical and chemical factors. Consequently, metal ions are released into the oral fluid, which may negatively affect the surrounding tissues and even internal organs. Adverse effects associated with metallic oral appliances may have various local and systemic manifestations, such as mouth burning, potentially malignant oral lesions, and local or systemic hypersensitivity. However, clear diagnostic criteria and treatment guidelines for adverse effects associated with dental alloys have not been developed yet. The present comprehensive literature review aims (1) to summarize the current information related to possible side effects of metallic oral appliances; (2) to analyze the risk factors aggravating the negative effects of dental alloys; and (3) to develop recommendations for diagnosis, management, and prevention of pathological conditions associated with metallic oral appliances.

Toxicological Risks of the Cobalt-Chromium Alloys in Dentistry: A Systematic Review

Background: The toxicological risk of Co-Cr dental alloys is actually a sensitive subject with the European regulatory changes, namely regulation (EU) 2017/745 and annex VI to the CLP regulation (EC) 1972/2008. Objectives: The objective of this review is to conduct a rigorous analysis of the cytocompatibility of cobalt-chromium (Co-Cr) dental alloys. Considering various parameters such as cytotoxicity, type IV hypersensitivity reaction, sensitization, and irritation, we investigated evidence of toxicity of Co-Cr in human dental applications. Data sources: Specific search strategies were performed in three electronic databases, namely Medline, Embase, and Web of Science, using a main restriction in the search regarding the publication date (1995-2022). Study selection: Out of a total of 836 articles, only 21 studies were selected and analyzed according to PRISMA methodology. Results: Among them, 10 in vitro studies using human samples and 11 in vivo studies on human patients were distinguished. Most of the in vitro studies confirmed that Co-Cr alloys have a good cytocompatibility compared to Ni alloys. Regarding the in vivo studies, it appeared that Co-Cr could rarely cause sensitization, irritation, and allergic reactions. Reactions were mainly observed for people allergic to Co or Cr. Nevertheless, titanium-based materials showed better results. Conclusions: This study proposes a new state of the art on Co-Cr dental alloys and will thus be very useful for carrying out additional studies. Relevance: This review will help practitioners in their daily clinical choice.

Short tandem repeat (STR) instability in the oral mucosa of patients submitted to fixed orthodontic therapy: a limitation of STR profile quality for human identification

The purpose of this study was to evaluate changes in short tandem repeat (STR) profile quality before and after fixed orthodontic therapy. Samples of oral epithelial cells were obtained from 28 volunteers who had an indication for orthodontic treatment. The samples were collected before and three months after starting orthodontic treatment with fixed appliances. DNA extraction and integrity were evaluated by electrophoresis, and STR profiles were obtained by polymerase chain reaction amplification and STR typing via capillary electrophoresis. DNA electrophoresis showed a higher proportion (7/28, 25%) of DNA degradation in the samples collected after fixed orthodontic treatment compared to those obtained before starting orthodontic therapy (3/28, 11%), however, changes in DNA were not significant (p=0.289). In concordance all STR profiles showed complete genotyping; however, imbalances in the size of heterozygotes and in the signal were detected in 25% of STR profiles after orthodontic therapy. Moreover, STR instability was demonstrated by an increase in stutter bands detected in 60% of the DNA profiles after treatment and a spurious allele of the D195433 marker was found in one sample after treatment. The STR profiles of samples obtained from the oral cavity with orthodontic appliances should be interpreted with caution. STR instability increases the incidence of artifacts that could compromise the quality of the results of tests performed in forensic DNA laboratories.

Comparative assessment of periodontal status and genotoxicity in orthodontic patients on fixed mechanotherapy with and without adjunct chlorhexidine mouthrinse: A randomized control clinical trial

Background:

Adjunct chlorhexidine mouthrinse is used routinely in orthodontic clinical practice for plaque control. However, chlorhexidine has genotoxic effects on the oral cells. Moreover, orthodontic appliance leach Ni, Cr metals ions into saliva causing toxicity of surrounding mucosa. Hence, the aim of the study was to assess the periodontal status and genotoxicity in orthodontic patients on fixed mechanotherapy with and without adjunct chlorhexidine using micronucleus (MN) test.

Materials and Methods:

A randomized control clinical trial was conducted in 30 patients who were on fixed mechanotherapy. The patients were randomly assigned into two treatment groups; Group-A (Control Group): Included 15 patients who are on fixed orthodontic therapy with mechanical plaque control measures only., Group-B (Experimental Group:) included 15 patients on fixed orthodontic therapy with mechanical plaque control and adjunct chlorhexidine mouthrinse (0.2%) for 2 weeks. Periodontal status and genotoxicity using MN test were done at following time points; T0: Just before start of the orthodontic treatment., T1: 2 weeks after start of the orthodontic treatment., T2: 6 weeks after start of the orthodontic treatment., T3: 12 weeks after start of the orthodontic treatment.

Results:

Plaque index (PI) and bleeding on probing (BOP) were significantly decreased in Group B as compared to Group A in the time intervals; T0-T2, T0-T3, T1-T3 (P < 0.05). Probing pocket depth (PPD) and Clinical attachment level (CAL) showed no significant change in both the groups. The genotoxicity assessed by MN test was significantly increased in Group B than Group A at time intervals; T0-T1, T0-T2 and T0-T3.

Conclusion:

Adjunct chlorhexidine resulted in decreased PI and BOP scores but nonsignificant change in PPD and CAL. However, the genotoxicity increased significantly in both the groups but more with adjunct chlorhexidine.

Assessment of metal ion accumulation in oral mucosa cells of patients with fixed orthodontic treatment and cellular DNA damage: a systematic review

Intraoral fixed appliances remain in the potentially corrosive environment of the mouth for an average of two years. Over time, corrosion causes the release of metal ions, such as nickel and chromium. These metals can become allergenic and cytotoxic, causing different conditions in the human body. The aim of this study therefore is to carry out a systematic review of the available scientific evidence on the accumulation of metal ions, and the genotoxic and cytotoxic effects in oral mucosa cells deriving from short- and long-term exposure to them. The systematic review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The primary outcome (quantification of metal ion deposits and assessment of their genotoxic and/or cytotoxic effects) and secondary outcome (complementary analysis of cytotoxic and genotoxic effects) were examined. The Cochrane Collaboration tool and Toxicological data Reliability Assessment Tool (ToxRTool) were used for quality assessment. Once the search was performed, a total of seven articles met the inclusion criteria and were included in this study. Two main techniques were used to assess genotoxic effects: alkaline comet assay (6/7) and micronucleus method (1/7). Cytotoxicity was evaluated (4/7) using the trypan blue dye test. Accumulations of nickel (7/7), chromium (5/7), and other metals (zinc, cobalt, iron, manganese, molybdenum, titanium) were also quantified. The results allowed us to conclude that release of metal ions and acute cell and DNA damage in oral mucosa cells takes place in the early stages of treatment. However, more long-term studies are needed to evaluate chronic exposure to metals and DNA damage, as well as cellular capacity to recover DNA integrity.

Cytotoxicity, genotoxicity, and cellular metal accumulation caused by professionally applied fluoride products in patients with fixed orthodontic appliances: A randomized clinical trial

BACKGROUD

Corrosion of metal orthodontic appliances caused by professional fluoride products has been recently concerned. Therefore, the objective of this study was to evaluate the cytotoxic and genotoxic effect of these products on buccal mucosal cells from patients wearing fixed orthodontic appliances.

METHODS

A total of 44 patients, aged 12 to 35 years, who began orthodontic treatment with fixed appliances were included in this single-center, prospective, randomized clinical trial. Patients were randomly allocated into 4 parallel groups according to the type of professional fluoride treatment applied after placing the appliances: acidulated phosphate fluoride gel (APF); neutral fluoride gel (NGel); fluoride varnish (FVa); and without fluoride treatment (control). Buccal cells were collected before treatment (T1) and 3 months after appliance placement (T2). The cells were assayed for cell viability and underwent Papanicolaou staining. Cells with micronuclei and degenerative nuclear alterations were scored using a light microscope. Cell metal content was quantified by inductively coupled plasma-mass spectrometry. The data were analyzed with the Kruskal-Wallis test.

RESULTS

The intracellular nickel content in the APF group significantly increased (P < 0.05), whereas that of the control, NGel, and FVa groups did not. The changes in chromium concentration in all groups were not significantly different compared with control. Use of APF resulted in a significantly higher decrease in cell viability and increase in morphologic signs of cell death compared with control (P < 0.05). The change in frequency of micronucleated cells was not significantly different from that in the control group.

CONCLUSIONS

Applying APF gel on fixed orthodontic appliances increased the cell metal content and decreased cell viability; however, genotoxic effects were absent. FVa and NGel are suggested as the products of choice to use during orthodontic treatment.

Biomarkers of effect as determined in human biomonitoring studies on hexavalent chromium and cadmium in the period 2008-2020

A number of human biomonitoring (HBM) studies have presented data on exposure to hexavalent chromium [Cr(VI)] and cadmium (Cd), but comparatively few include results on effect biomarkers. The latter are needed to identify associations between exposure and adverse outcomes (AOs) in order to assess public health implications. To support improved derivation of EU regulation and policy making, it is of great importance to identify the most reliable effect biomarkers for these heavy metals that can be used in HBM studies. In the framework of the Human Biomonitoring for Europe (HBM4EU) initiative, our study aim was to identify effect biomarkers linking Cr(VI) and Cd exposure to selected AOs including cancer, immunotoxicity, oxidative stress, and omics/epigenetics. A comprehensive PubMed search identified recent HBM studies, in which effect biomarkers were examined. Validity and applicability of the markers in HBM studies are discussed. The most frequently analysed effect biomarkers regarding Cr(VI) exposure and its association with cancer were those indicating oxidative stress (e.g., 8-hydroxy-2'-deoxyguanosine (8-OHdG), malondialdehyde (MDA), glutathione (GSH)) and DNA or chromosomal damage (comet and micronucleus assays). With respect to Cd and to some extent Cr, β-2-microglobulin (B2-MG) and N-acetyl-β-D-glucosaminidase (NAG) are well-established, sensitive, and the most common effect biomarkers to relate Cd or Cr exposure to renal tubular dysfunction. Neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule (KIM)-1 could serve as sensitive biomarkers of acute kidney injury in response to both metals, but need further investigation in HBM studies. Omics-based biomarkers, i.e., changes in the (epi-)genome, transcriptome, proteome, and metabolome associated with Cr and/or Cd exposure, are promising effect biomarkers, but more HBM data are needed to confirm their significance. The combination of established effect markers and omics biomarkers may represent the strongest approach, especially if based on knowledge of mechanistic principles. To this aim, also mechanistic data were collected to provide guidance on the use of more sensitive and specific effect biomarkers. This also led to the identification of knowledge gaps relevant to the direction of future research.

Biomonitoring of children and adolescents using orthodontic appliances made of acrylic resins through micronucleus testing of exfoliated buccal and palatal mucosa cells

INTRODUCTION

The present study aimed to investigate the occurrence of micronuclei and the degenerative nuclear alterations indicative of apoptosis and necrosis in the exfoliated buccal and palatal mucosa cells of children and adolescents using orthodontic appliances made of self-curing acrylic resins.

METHODS

The micronuclei and nuclear alterations were evaluated in a minimum of 2000 cells collected from the cheeks and palates of 30 patients of both sexes, aged between 6 and 12 years. The cell evaluations were performed before appliance installation and 15 to 21 days after installation. A conditional test was used. In all analyses, the significance level was 5%.

RESULTS

No differences in the occurrence of micronuclei or the nuclear degenerative changes indicative of apoptosis and necrosis were observed in the cheek cells between the 2 time points (P > 0.05). However, evaluation of the palate cells revealed a significant increase in the occurrence of micronuclei and the nuclear alterations indicative of apoptosis (P < 0.01) but not of karyolysis (P > 0.05).

CONCLUSIONS

Direct contact of orthodontic appliances made of acrylic resins with the oral mucosa increases the incidence of chromosomal damage and degenerative nuclear alterations.

Evaluation of genotoxic damage in buccal mucosa cytome assays in Iraqi school children exposed to air pollutants emanating from oil fields

Presently, over 135 thousand barrels of crude oil are extracted daily from the Al-ahdeb oil fields (situated at 180 km south east of Baghdad, Iraq). Millions of gallons of untreated toxic wastes, gas and crude oil are released into the environment. Oil mining mediated pollution may cause damage to humans and the environment. To investigate potential health risks for children living in this area, we recruited a sample of 6-8 year old school children residing within a 5 km radius around the oil field, and a control sample of children of the same age from a school 40 km away from the oil-field. Exfoliated buccal mucosa cells obtained from these children were analyzed applying the micronucleus (MN) cytome assay. Possible confounding variables such as x-rays performed during three weeks preceding sampling were obtained by a questionnaire. Nuclear anomalies were significantly elevated in children living near the oil-field. Micronucleated cells 1.3-fold, nuclear buds 3-folds, binucleated cells 3-folds, karyorrhetic cells 4-folds and karyolysis more than 10 folds with a significant difference (P < 0.05). Hence, children living in the proximity of Iraqi oil-fields are at elevated risk of genetic damage, which can cause detrimental health effects in the future.

Gene (HPRT) and chromosomal (MN) mutations of nickel metal powder in V79 Chinese hamster cells

Nickel metal is a naturally occurring element used in many industrial and consumer applications. Human epidemiological data and animal cancer bioassays indicate that nickel metal is not likely to be a human carcinogen. Yet, nickel metal is classified as a suspected human carcinogen (CLP) and possibly carcinogenic to humans (IARC). There are no reliable studies on the potential for nickel metal to induce gene and micronucleus (MN) mutations. To fill these datagaps and increase our understanding of the mechanisms underlying the lack of nickel metal carcinogenicity, gene and micronucleus mutation studies were conducted with nickel metal powder (N36F) in V79 Chinese Hamster cells following OECD 476 and 487 guidelines, respectively, under GLP. Gene mutation at the hprt locus was tested, with and without metabolic activation, after 4-h treatment with 0.05-2.5 mM nickel metal powder. Cytokinesis-block MN frequency following exposure to 0.25-1.5 mM nickel metal was tested after 4-h treatment, with and without metabolic activation, followed by a 24-h treatment without metabolic activation. In the gene mutation assay, there were modest increases in hprt mutants observed at some test concentrations, not exceeding 2.2-fold, which were either within the historical control values and/or showed no concentration-response trend. The positive controls showed increases of at least 7-fold. Likewise, no increases in the MN frequency exceeding 1.5-fold were observed with nickel metal, with no concentration-response trends. Taking these results together, it can be concluded that nickel metal is non-mutagenic and does not cause gene nor chromosomal mutations.

Genotoxic and cytotoxic effects of Haas appliance in exfoliated buccal mucosa cells during orthodontic treatment

OBJECTIVES

To evaluate the genotoxic and cytotoxic effects of Haas appliances through micronuclei test and cytogenetic damage analysis in buccal mucosa epithelial cells of patients undergoing orthodontic treatment.

MATERIALS AND METHODS

Twenty-eight patients, 6-12 years of age and of both genders, who required a Haas appliance for the correction of a posterior crossbite were included. Epithelial cells from the mucosa were collected by gently scraping the inside of both the right and left cheeks. The cells were collected before the insertion of the appliance (T0), 1 month after the device was installed (T1), and again 3 months after the appliance was immobilized (T2). The cells were processed to obtain slides. Feulgen/Fast Green was used as the staining method, and the number of normal, karyolytic, pyknotic, nuclear buds, bi/trinucleated, and micronucleus cells were counted under light microscopy. Cellular abnormalities were evaluated with parametric and nonparametric tests for comparison of the means by analysis of variance testing, Tukey posttest, or the Kruskal-Wallis test and then by Dunn's posttest. The significance level was 5%.

RESULTS

There were no statistically significant changes in the micronuclei in the evaluated periods ( P > .05). Nuclear buds increased at T1 ( P < .05), returning to baseline levels at T2. Other abnormalities (cariolytic, pyknotic, and bi/trinucleated cells) showed a significant increase at T1 and T2 ( P < .0001).

CONCLUSIONS

The Haas appliance did not cause an increase in micronuclei in cells of the buccal mucosa. However, statistically significant increases in cariolytic, pyknotic, and bi/trinucleated cells were observed during treatment, suggesting possible DNA damage.

Cytomorphometric Analysis on the Effects of Components of Orthodontic Appliances on the Epithelial Cells of the Buccal Mucosa

Aim:

The aim of the present study was to evaluate the effect of fixed orthodontic appliances on the epithelial cells of buccal mucosa in patients undergoing orthodontic treatment.

Materials and Methods:

The study group included 30 healthy patients who were advised orthodontic treatment. Applying sterile cement spatula, scrapping of exfoliated buccal epithelial cells was performed from the middle part of the inner cheeks before starting the orthodontic treatment and at 1^st week, 2^nd week, 1 month, and 45 days after the treatment, followed by smearing and staining with Papanicolaou stain. Light microscope was used to score micronuclei, and independent two-tailed t-test was used for statistical analysis.

Results:

Micronuclei were assessed during the various stages of treatment and were recorded accordingly. At 1 week, there was increase in micronuclei number compared to before starting the treatment (day 0) and at 15^th day; 30^th day showed decrease in number compared to 1 week but increase compared to day 0. The results of day 45 were almost equal to day 0 with a significant P value (P < 0.001).

Conclusion:

Fixed orthodontic appliances induce increased micronuclei frequency, especially in the first weeks of treatment, however, these genotoxic effects tend to approach baseline levels in later period.

Exposure of Cleft Lip and Palate Patients to Toxic Elements Released during Orthodontic Treatment in the Study of Non-Invasive Matrices

THE OBJECTIVE

The aim of the study was evaluation of metal ions (nickel and chromium) released from orthodontic appliances in cleft lip and palate patients and the usefulness of non-invasive matrices (saliva and hair).

MATERIALS AND METHODS

The material studied consisted of 100 individuals, including 59 females and 41 males of 5 to 16 years of age, which were divided into 3 groups: experimental-patients with cleft lip and palate (36 individuals, the average treatment time 5.74 years); control group-patients without cleft lip and palate, during orthodontic treatment (32 individuals, the average treatment time 1.78 years) and the control group patients without cleft lip and palate, without any orthodontic appliances (32 individuals). Samples (saliva, hair) were collected and subjects underwent a survey by questionnaire. Multi-elemental analyses of the composition of non-invasive matrices was conducted in an accredited laboratory by inductively coupled plasma spectrometry technique ICP-OES. The results were reported as mean contents of particular elements (Cd, Cr, Cu, Fe, Mn, Mo, Ni, Si) in hair and in saliva.

RESULTS

The concentration of Cr, Ni, Fe and Cu ions in saliva of cleft lip and palate patients were several times higher as compared with not treated orthodontically control groups and higher than in the group with orthodontic appliances. Among the assessed matrices, hair of cleft lip and palate patients seem to be not a meaningful biomarker.

CONCLUSION

It was found that orthodontic appliances used in long-term treatment of cleft lip and palate patients do not release toxic levels of Cr and Ni ions.

In vitro and in vivo evidence of the cytotoxic and genotoxic effects of metal ions released by orthodontic appliances: A review

Intraoral fixed orthodontic appliances are frequently used in the clinical practice of dentistry. They are made from alloys containing different metals at various percentages. The use of these appliances leads to the long-term exposure of patients to these materials, and the potential toxic effects of this exposure raises concerns about patient safety. Thus, the biocompatibility (corrosion behaviour and toxicity) of these materials has to be evaluated prior to clinical use. In the present report, the most recent studies in the scientific literature examining metal ion release from orthodontic appliances and the toxic effects of these ions have been reviewed with a special focus on cytotoxicity and genotoxicity. Previous studies suggest that a case-by-case safety evaluation is required to take into account the increasing variability of materials, their composition and the manufacturing processes. Moreover, in vivo toxicity studies in regard to metal release, cytotoxicity and genotoxicity are still scarce. Therefore, in vitro and in vivo monitoring studies are needed to establish cause-effect relationships between metal ion release and biomarkers of cytotoxicity and genotoxicity. Further investigations could be performed to elucidate the toxic mechanisms involved in the observed effects with a special emphasis on oxidative damage.

Evaluation of salivary total oxidant-antioxidant status and DNA damage of children undergoing fixed orthodontic therapy

OBJECTIVE

To determine the total oxidant status (TOS), total antioxidant status (TAS), and the 8-hydroxy-2'-deoxyguanosine (8-OHdG) levels and their interrelationship in the saliva of children undergoing fixed orthodontic therapy.

MATERIALS AND METHODS

Thirty children were randomly divided into three groups. The attachments were bonded to all of the teeth using three different orthodontic composites: Transbond XT, Kurasper F, and GrenGloo. The salivary levels of TOS, TAS, and 8-OHdG were determined three times, as follows: before treatment (T1) and at 1 month (T2) and 3 months (T3) following appliance placement. All data were statistically analyzed.

RESULTS

There were no significant differences in TOS, TAS, and 8-OHdG within the same time periods among the three different orthodontic composites (P > .05). TAS in all composite groups decreased over time. These decreases were found to be significant for Kurasper F and GrenGloo at the T1-T3 and T2-T3 time periods (P < .05). In all composite groups 8-OHdG decreased between T1 and T2 (P < .05). However, 8-OHdG in all composite groups increased from T2 to T3. These differences in 8-OHdG were significant in Kurasper F and GrenGloo (P < .05).

CONCLUSIONS

Fixed orthodontic appliances bonded with the tested composites did not increase the cytotoxicity markers in saliva.

Evaluation of the genotoxicity and cytotoxicity in the buccal epithelial cells of patients undergoing orthodontic treatment with three light-cured bonding composites by using micronucleus testing

Objective

This study evaluated the cytotoxicity and genotoxicity of fixed orthodontic treatment with three different light-cured orthodontic bonding composites by analyzing micronucleus (MN) formation in the buccal mucosa during a 6-month period.

Methods

Thirty healthy volunteers were selected from consecutive patients referred for orthodontic treatment. Equilibrium 2 brackets and molar tubes (Dentaurum) were bonded with three different light-cured orthodontic bonding composites-Transbond XT (3M Unitek), Kurasper F (Kuraray Europe), or GrenGloo (Ormco Corporation)- to all teeth in both arches. Exfoliated buccal epithelial cells were scraped from the middle part of the inner cheeks with sterile cement spatulas before treatment and at 1, 3, and 6 months after treatment. MNs and nuclear alterations, such as karyorrhexis (KR), karyolysis (KL), and binucleated cells (BNs), were scored under a light microscope. Repeated measure ANOVA was used to calculate statistical differences in degenerative nuclear abnormalities.

Results

MN rates did not significantly differ among different time points within the same cell type (p > 0.05). In contrast, the number of BNs in buccal epithelial cells significantly increased in all composite groups (p < 0.01, Transbond XT; p < 0.001, Kurasper F and GrenGloo). KL frequency significantly increased between the beginning and end of the study in the Kurasfer F (0.80 ± 0.79 to 1.90 ± 1.10; p < 0.05) and GrenGloo (1.30 ± 1.06 to 2.40 ± 1.08; p < 0.05) groups.

Conclusions

After 6 months of fixed orthodontic treatment with different light-cured composites, morphological signs of cytotoxicity were observed but genotoxic effects were absent.

Preclinical alterations of oral epithelial cells in contact with orthodontic appliances

AIM

This study evaluated the behavior of oral epithelial cells in contact with orthodontic appliances.

METHODS

Oral epithelial cells of clinically normal buccal mucosa were obtained by liquid-based exfoliative cytology from 22 orthodontic patients. The following regions were evaluated: a) oral mucosa exposed to friction from orthodontic brackets; b) oral mucosa exposed to friction from the tube on the orthodontic band, and c) oral mucosa not exposed to friction (control area). Nuclear (NA) and cytoplasmic (CA) areas and NA/CA ratio were assessed by an image analysis system. Cell morphology and cellularity were also analyzed by Papanicolaou technique.

RESULTS

The NA of the cells in contact with orthodontic brackets and bands were smaller than the control area. Cells in contact with the brackets showed the greatest reduction in CA in comparison with the cells subjected to friction from the tube, and the control group. Smears classified as type I predominated in all regions analyzed, although type II were predominant, together with superficial epithelial cells, mainly in the oral mucosa in contact with the band tube.

CONCLUSION

Preclinical alterations in the epithelial cells of oral mucosa, caused by orthodontic appliances, are reduction in NA, increase in cell keratinization and inflammatory features, especially in the band tube area.